Cardiovascular and Renal Effects of Bromocriptine in Diabetic Patients with Stage 4 Chronic Kidney Disease
Cardiovascular and Renal Effects of Bromocriptine in Diabetic Patients with Stage 4 Chronic Kidney Disease
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DOI：
10.1155/2013/104059
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Paniagua, Ramon
中科院分区：
文献类型：
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作者：
Mejia-Rodriguez, Oliva;Herrera-Abarca, Jorge E.;Paniagua, Ramon
目标。本研究旨在探讨溴隐亭(BEC)对慢性肾脏病(CKD)合并2型糖尿病(T2D)患者左心室重量指数(LVMI)和残余肾功能(RRF)的影响。研究设计与方法。对28例T2D和4期CKD患者进行了为期6个月的双盲随机对照试验。14名患者接受BEC(2.5 mg，最初1片，随后增加到每天3次)和14例接受安慰剂(PBO，最初1片，随后增加到每天3次)。通过监测24小时动态血压、二维引导的M型超声心动图和N-末端脑利钠肽(NT-proBNP)血浆水平来评估心血管变化。以内生肌酐清除量和半胱氨酸氨基转移酶-C水平作为评价RRF的指标。结果。BEC组和PBO组都能降低血压，但BEC组的效果更明显。平均24小时血压、昼夜血压和昼夜节律均较PBO组有改善，BEC组LVMI降低14%，PBO组增加8%。BEC中NT-proBNP减少(0.54+/-0.15至0.32+/-0.17 pg/mL)，PBO中NT-proBNP增加(0.37+/-0.15至0.64+/-0.17 pg/mL)。肌酐清除率在BEC组无变化，而在PBO组降低。结论。BEC可降低血压，降低LVMI。BEC还可以防止CKD的进展，同时保持肌酐清除量不变。
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). Research Design and 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 (2.5mg, 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.