Acute Renal Failure: A Rare Presentation of Hypothyroidism

Liakopoulos, Vassilios; Dovas, Spyros; Simopoulou, Theodora; Zarogiannis, Sotirios G.; Giannopoulou, Myrto; Kourti, Panagiota; Arampatzis, Spyridon; Eleftheriadis, Theodoros; Stefanidis, Ioannis

doi:10.1080/08860220902780127

Cited by 11 publications

(5 citation statements)

References 21 publications

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“…After the beginning of thyroid replacement therapy, thyroid status improved and kidney function progressively recovered. This observation is consistent with the previously published data [2][3][4][5] .…”

Section: Discussionsupporting

confidence: 95%

Reversal deterioration of renal function accompanied with primary hypothyrodism

Dragović

2012

VOJNOSANIT PREGL

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Section: Discussionsupporting

confidence: 95%

Reversal deterioration of renal function accompanied with primary hypothyrodism

Dragović

2012

VOJNOSANIT PREGL

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“…However, the predominant mode of kidney injury is thought to be the reduced plasma flow and glomerular filtration rate due to the hypodynamic circulation[2]. The hypodynamic circulatory state results in a pre-renal insufficiency and this may be aggravated by other multi-systemic effects of hypothyroidism such as reduced cardiac output, low volume status, hyponatraemia with associated haemodynamic changes and increased peripheral resistance due to arterial wall stiffness[2]. However, this alone may not explain the extent of acute kidney injury.…”

Section: Discussionmentioning

confidence: 99%

“…Hypothyroidism presenting with acute kidney injury is rare, with only few cases reported so far [1,2]. Hypothyroidism may induce de novo acute kidney injury (AKI) or may exacerbate ongoing chronic kidney disease[3] or contribute to the occurrence of AKI in the presence of other renal insults.…”

Section: Introductionmentioning

confidence: 99%

Hypothyroidism causing paralytic ileus and acute kidney injury - case report

et al. 2011

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We present a patient with severe hypothyroidism complicated by paralytic ileus and acute kidney injury. A 65 year old male patient, diagnosed with hypothyroidism one year ago was transferred to our unit in a state of drowsiness and confusion. He was severely hypothyroid and had paralytic ileus and impaired renal function at the time of transfer. Hypokalaemia was present, and was likely to have contributed to the paralytic ileus and this together with dehydration was likely to have contributed to renal injury. Nonetheless, hypothyroidism is very likely to have been the principal precipitant of both these complications, and both paralytic ileus and acute kidney injury improved with thyroxine replacement. Unfortunately, the patient died unexpectedly eight days after admission to the unit.Hypothyroidism may induce de novo acute kidney injury or it may exacerbate ongoing chronic kidney disease. This rare complication is assumed to be due to the hypodynamic circulatory state created by thyroid hormone deficiency. Paralytic ileus is an even rarer fatal manifestation of hypothyroidism and is thought to be due to an autonomic neuropathy affecting the intestines that is reversible with thyroxine replacement. To our knowledge, both these complications have not been observed in a single patient so far.It is important that clinicians are aware of these rare manifestations of hypothyroidism as in most occasions, thyroxine deficiency may be missed, and treatment can reverse the complications.

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“…However, renal dysfunction from hypothyroidism can also occur in the absence of rhabdomyolysis. In these cases, the AKI reversed with thyroid hormone replacement and reestablishment of euthyroid state [17][18][19][20][21][22][23][24][25][26][27]; renal biopsies were carried out in only two of these reports [18,21] and were reported as unremarkable. We present a patient with AKI in CKD resulting from severe hypothyroidism, in the absence of myopathy, and with the renal biopsy suggesting findings seen in hypothyroid states.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Hypothyroidism in a Patient with CKD

Chandra

Haririan²,

Drachenberg³

2022

Kidney and Dialysis

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Acute kidney injury (AKI) in the setting of hypothyroidism has been documented in the literature. However, hypothyroidism is not generally considered a cause during investigation of an acute kidney injury. Most of the cases described have been reported in setting of rhabdomyolysis, while fewer cases describe AKI occurring in the absence of rhabdomyolysis. Only rarely have case reports been supplemented by renal biopsy findings to ensure other etiologies of acute kidney injury were ruled out, and none of these reports have documented changes in the kidney that could be associated with the hypothyroid state. We report a case of AKI in chronic kidney disease in the absence of rhabdomyolysis, occurring during severe hypothyroidism, that resolved completely after achievement of a euthyroid state. In addition, we provide renal biopsy findings likely associated with the hypothyroid state. We propose that evaluation of the thyroid function should be considered in any patient during evaluation of an acute kidney injury.

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Acute Renal Failure: A Rare Presentation of Hypothyroidism

Cited by 11 publications

References 21 publications

Reversal deterioration of renal function accompanied with primary hypothyrodism

Reversal deterioration of renal function accompanied with primary hypothyrodism

Hypothyroidism causing paralytic ileus and acute kidney injury - case report

Acute Kidney Injury and Hypothyroidism in a Patient with CKD

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