OBJECTIVE -The aim of this study was to examine the effect of protein kinase C inhibition with ruboxistaurin on renal hemodynamic function and urinary biomarkers (monocyte chemoattractant protein-1 [MCP-1] and epidermal growth factor) in renin angiotensin system blockade-treated type 1 diabetic subjects.RESEARCH DESIGN AND METHODS -Albuminuric subjects were randomized (2:1) to ruboxistaurin (32 mg daily; n ϭ 13) or placebo (n ϭ 7) for 8 weeks. Renal hemodynamic function was measured during clamped euglycemia or hyperglycemia and before and after ruboxistaurin or placebo.RESULTS -Ruboxistaurin was not associated with between-group differences during clamped euglycemia or hyperglycemia. In a post hoc analysis comparing hyperfilterers with normofilterers during euglycemia, glomerular filtration rate and MCP-1 decreased, whereas the epidermal growth factor-to-MCP-1 ratio increased in hyperfilterers versus normofilterers (all P Ͻ 0.05).CONCLUSIONS -The effect of ruboxistaurin is modest and dependent, at least in part, on the level of ambient glycemia and baseline glomerular filtration rate.
Diabetes Care 32:91-93, 2009