Copeptin in Adolescent Participants With Type 1 Diabetes and Early Renal Hemodynamic Function



Status:Recruiting
Conditions:Diabetic Neuropathy, Renal Impairment / Chronic Kidney Disease, Neurology, Diabetes, Diabetes
Therapuetic Areas:Endocrinology, Nephrology / Urology, Neurology
Healthy:No
Age Range:12 - 21
Updated:10/21/2018
Start Date:October 1, 2018
End Date:August 2020
Contact:Carissa Vinovskis, MS
Email:carissa.vinovskis@childrenscolorado.org
Phone:720-777-2660

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CASPER Study: Copeptin in Adolescent Participants With Type 1 Diabetes and Early Renal Hemodynamic Function

Over 1.25 million Americans have type 1 diabetes (T1D), increasing risk for early death from
cardiorenal disease. The strongest risk factor for cardiovascular disease (CVD) and mortality
in T1D is diabetic kidney disease (DKD). Current treatments, such as control of hyperglycemia
and hypertension, are beneficial, but only partially protect against DKD.

Hyperfiltration is common in youth with T1D, and predicts progressive DKD. Hyperfiltration is
also associated with early changes in intrarenal hemodynamic function, including increased
renal plasma flow (RPF) and glomerular pressure. Intrarenal hemodynamic function is strongly
influenced by the renin-angiotensin-aldosterone system (RAAS), which is also considered a key
player in the pathogenesis of DKD. Preliminary data demonstrate differences in intrarenal
hemodynamic function and RAAS activation in early and advanced DKD in T1D. However, the
pathophysiology contributing to the differences observed in RAAS activation and intrarenal
hemodynamic function in T1D are poorly defined Animal research demonstrates that arginine
vasopressin (AVP) acts directly to modify intrarenal hemodynamic function, but also
indirectly by activating RAAS. Preliminary data suggest that elevated copeptin, a marker of
AVP, which predicts DKD in T1D adults, independently of other risk factors. However, no human
studies to date have examined how copeptin relates to intrarenal hemodynamic function in
early DKD in T1D. A better understanding of this relationship is critical to inform
development of new therapies targeting the AVP system in T1D. Accordingly, in this study, the
investigators propose to define the relationship between copeptin and intrarenal hemodynamics
in early stages of DKD, by studying copeptin levels, renal plasma flow, and glomerular
filtration in youth (n=50) aged 12-21 y with T1D duration < 10 y.


Inclusion Criteria:

- Antibody+ T1D with <10 yr duration

- Age 12-21 years

- BMI ≥ 5%ile

- Weight<350 lbs and > 57 lbs.

- No anemia

- HbA1c <12%

Exclusion Criteria:

- Severe illness, recent diabetic ketoacidosis (DKA)

- Estimated Glomerular Filtration Rate (eGFR) <60ml/min/1.73m2 or creatinine > 1.5mg/dl
or history of ACR≥300mg/g

- Anemia or allergy to shellfish or iodine

- Pregnancy or nursing

- MRI scanning contraindications (claustrophobia, implantable devices, >350 lbs)

- Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB),
diuretics, sodium-glucose co-transport (SGLT) 2 or 1 blockers, daily NSAIDs or
aspirin, sulfonamides, procaine, thiazolsulfone or probenecid, atypical antipsychotics
and steroids
We found this trial at
1
site
13123 E 16th Ave
Aurora, Colorado 80045
(720) 777-1234
Principal Investigator: Petter Bjornstad, M.D.
Phone: 720-777-4659
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