title: Cardiovascular and renal effects of bromocriptine in diabetic patients with stage 4 chronic kidney disease.
abstract: OBJECTIVE
  The objective of this study was to investigate the effect of bromocriptine (BEC) on left ventricular mass index (LVMI) and residual renal function (RRF) in chronic kidney disease (CKD) patients with type 2 diabetes (T2D).
  
  
  METHODS
  A 6-month double-blind randomized controlled trial was conducted in 28 patients with T2D and stage 4 CKD with increased LVMI. Fourteen patients received BEC (2.5 mg, initially 1 tablet with subsequent increase to three times a day) and 14 received a placebo (PBO; initially 1 tablet with subsequent increase to three times a day). Cardiovascular changes were assessed by monitoring 24 h ambulatory blood pressure, two-dimensional-guided M-mode echocardiography, and N-terminal brain natriuretic peptide (NT-proBNP) plasma levels. RRF was evaluated by creatinine clearance and cystatin-C plasma levels.
  
  
  RESULTS
  Both BEC and PBO groups decreased blood pressure-but the effect was more pronounced in the BEC group. Average 24 h, diurnal and nocturnal blood pressures, and circadian profile showed improved values compared to the PBO group; LVMI decreased by 14% in BEC and increased by 8% in PBO group. NT-proBNP decreased in BEC (0.54 ± 0.15 to 0.32 ± 0.17 pg/mL) and increased in PBO (0.37 ± 0.15 to 0.64 ± 0.17 pg/mL). Creatinine clearance did not change in the BEC group and decreased in the PBO group.
  
  
  CONCLUSIONS
  BEC resulted in a decrease on blood pressure and LVMI. BEC also prevented the progression of CKD while maintaining the creatinine clearance unchanged.
authors.affiliation: Coordinación de Educación e Investigación en Salud, Unidad de Medicina Familiar No 80, Instituto Mexicano del Seguro Social, Morelia, Mich, Mexico. olivamejia@yahoo.com
authors.forename: Oliva
authors.initials: O
authors.lastname: Mejía-Rodríguez
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Herrera-Abarca
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ceballos-Reyes
authors.forename: Marcela
authors.initials: M
authors.lastname: Avila-Diaz
authors.forename: Carmen
authors.initials: C
authors.lastname: Prado-Uribe
authors.forename: Francisco
authors.initials: F
authors.lastname: Belio-Caro
authors.forename: Antonio
authors.initials: A
authors.lastname: Salinas-González
authors.forename: Helios
authors.initials: H
authors.lastname: Vega-Gomez
authors.forename: Cleto
authors.initials: C
authors.lastname: Alvarez-Aguilar
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Elvia
authors.initials: E
authors.lastname: García-López
authors.forename: Ramón
authors.initials: R
authors.lastname: Paniagua
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D001971:Bromocriptine / Q000494:pharmacology* / Q000627:therapeutic use*; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D010919:Placebos; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D006727:Hormone Antagonists; D010919:Placebos; D001971:Bromocriptine