PeRsOnalising Treatment Of Diabetic Nephropathy: (PROTON)
PeRsOnalising Treatment Of Diabetic Nephropathy: From Albuminuria to Multidimensional Characterisation of Diabetic Nephropathy - a Cross-sectional Study
Background: Today diabetic nephropathy is a frequent, and the most lethal and costly complication of diabetes. Although treating blood pressure with agents blocking renin angiotensin system has improved outcome, the prognosis is still poor and no new interventions have been successful during the past decade. There is an urgent need for discovery of new pathways behind the development and progression of diabetic nephropathy as well as of biomarkers which can identify subjects at risk of developing adverse events. Objective: By using a multidimensional 'omics' approach, we aim to search for novel proteins, metabolites and pathways that will point to the putative new mechanisms which underlie the early renal decline.
Design: Cross-sectional study, with long-term register-based follow-up. Study population: 160 patients with type 1 diabetes recruited from Steno Diabetes Center Copenhagen stratified based on stage of diabetic kidney disease, and 50 healthy non-diabetic controls. Endpoints: Primary endpoint: Glycocalyx thickness, assessed as perfused boundary region. Secondary endpoints: Gut microbiome characterisation and markers of gastrointestinal inflammation, autonomic and periphery neuropathy, urine and plasma Flow Cytometry Analysis (FACS), metabolomics and proteomics in plasma and urine, and other potential biomarkers.
調査の概要
詳細な説明
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Copenhagen
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Gentofte、Copenhagen、デンマーク、2820
- Steno Diabetes center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patients with type 1 diabetes
- Written informed consent must be provided before participation
- Male or female patients >18 years of age with a diagnosis of type 1 diabetes (WHO criteria)
- Persistent urinary albumin creatinine ratio (UACR) assessed from EPJ (Electronic Patient Journal):
- < 30 mg/g in 2 out of 3 consecutive samples (normoalbuminuria)
- 30 - 299 mg/g in 2 out of 3 consecutive samples (microalbuminuria)
≥ 300 mg/g in 2 out of 3 consecutive samples (macroalbuminuria) - at least 30 with concurrent eGFR < 60 ml/min/1.73m2
2. Control subjects without diabetes
- Written informed consent must be provided before participation.
- Male or female patients >18 years of age without a diagnosis of diabetes (assessed by Hb1Ac, haemoglobin and creatinine)
Exclusion Criteria: (Both subjects with and without diabetes)
- Non-diabetic kidney disease as indicated by medical history and/or laboratory findings
- Renal failure (eGFR<15 ml/min/1.73m2), dialysis or kidney transplantation
- Change in RAAS blocking treatment during the last month
- Treatment with antibiotics during the last 2 month
- Pregnancy or breastfeeding (urine HCG is performed on all fertile women)
- Patients who, in the judgement of the investigator, is incapable to participate
- For controls: Other diseases or intake of medicine which in the judgement of the investigator could affect the results, specifically renal, cardiovascular or inflammatory/infectious diseases should be considered for exclusion
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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Type 1 DM, Normo albuminuric
Type 1 diabetics with no history of albumnuria (UACR < 30 mg/g in 2 out of 3 consecutive samples)
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Type 1 DM, Micro albuminuric
Type 1 diabetics with history of micro albumnuria (UACR 30-299 mg/g in 2 out of 3 consecutive samples)
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Type 1 DM, Macro albuminuric
Type 1 diabetics with history of macro albumnuria (UACR 30-299 mg/g in 2 out of 3 consecutive samples)
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Healthy subjects
Subjects with no history of diabetes, other diseases or intake of medicine which in the judgement of the investigator could affect the results, specifically renal, cardiovascular or inflammatory/infectious diseases should be considered for exclusion.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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The microvascular function by estimating the glycocalyx thickness
時間枠：2019
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Glycocalyx thickness assessed as perfused boundary region by a hand-hold camera (GlycoCheck)
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2019
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Gut microbiome
時間枠：2019
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Characterisation of the gut microbiota and markers of gastrointestinal inflammation
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2019
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Urine and plasma Flow Cytometry Analysis (FACS)
時間枠：2019
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cell types related to inflammation
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2019
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Metabolomics in plasma
時間枠：2019
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metabolite risk score in plasma
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2019
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Metabolomics in urine
時間枠：2019
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metabolite risk score in urine
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2019
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proteomics in urine
時間枠：2019
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proteomic risk score in urine
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2019
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proteomics in plasma
時間枠：2019
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proteomic risk score in plasma
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2019
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Autonomic neuropathy
時間枠：2019
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beat to beat variation (R-R test) upon Deep breathing
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2019
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peripheral neuropathy
時間枠：2019
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vibration perception threshold
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2019
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協力者と研究者
スポンサー
捜査官
- スタディチェア：peter Rossing、Steno Diabetes Center Copenhagen
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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