Different Aspects of Kidney Function in Well-Controlled Congenital Hypothyroidism

Abstract

Objective: Congenital hypothyroidism (CH) increases the prevalence of kidney and urogenital malformations. There are limited studies considering different aspects of kidney function in well-controlled CH patients. We evaluated some features of kidney function in euthyroid children with CH who have been receiving thyroxine hormone since early life.Methods: This cross-sectional study was conducted in Isfahan, Iran, on 74 children aged 2-15 years old (36 CH patients and 38 healthy children). Inclusion criteria for CH patients were euthyroidism at the time of the survey and initiation of replacement therapy during the early neonatal period. Kidney ultrasound evaluation was performed in all participants. Serum biochemistry included urea, creatinine, sodium (Na), potassium (K), magnesium, calcium, and cystatin C levels. Urine electrolytes, fraction excretion (FE) of electrolytes and microalbumin, and glomerular filtration rate (GFR) were also determined.Results: The male/female ratio was 0.8/1 and 1.5/1 in the patient and control groups, respectively. Mean age and height did not differ significantly between the two groups. Ultrasound evaluation of the kidney revealed that the anteroposterior diameter of the right kidney was significantly higher in CH patients as compared to healthy subjects. No significant difference was observed between GFRs in patients with CH and healthy children. The mean values for FENa and FEK were significantly higher in the patient group.Conclusions: Increased FENa and FEK may be a manifestation of impaired tubular maturation in CH. More longitudinal studies are needed to evaluate kidney function in CH patients. Conflict of interest:None declared.

Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review

“…A study conducted in Greece [ 37 ], reported an association between albuminuria and severe obstructive sleep apnea in children aged 2–14 years, which occurred as a result of hypoxemia (oxidative stress). Congenital hypothyroidism and Kwashiorkor disease have also been studied, although no relationship with albuminuria has been established to the best of our knowledge [ 38 , 39 ].…”

Evaluation of inflammatory and oxidative biomarkers in children with well-controlled congenital hypothyroidism

“…DNA and protein damage induced by oxidative stress were observed in experimental hypothyroid animals (3,4) . Fortunately, the glomerular filtration rates between patients with CH and healthy children were not significantly different, although Brought to you by | New York University Bobst Library Technical Services Authenticated Download Date | 5/30/15 6:58 AM the mean values for fractional excretion of sodium and potassium were significantly higher in patients with CH (5) . CH may increase the prevalence of oxidative stress, but little is known about the effect of well-controlled CH on early renal injury and DNA damage.…”

Cystatin C, a Controversial Biomarker in Hypothyroid Patients under Levothyroxine Therapy: THYRenal, a Pilot Cohort Observational Study

“…In several studies, the association of overt and/or subclinical primary hypothyroidism with GFR reduction and elevated serum creatinine has been demonstrated, in addition to effects on salt and water homeostasis [ 4 , 8 , 12 ]. These effects are generally normalized following levothyroxine therapy in adult hypothyroid patients and can be improved in hypothyroid patients with chronic kidney disease (CKD) [ 4 , 13 , 14 , 15 ]. In addition, it is remarkable that patients with appropriately treated vs. untreated thyroid disorders have a lower risk of developing renal dysfunctions [ 1 , 4 , 16 , 17 ].…”

“…In light of the importance of an early detection of renal damage in hypothyroidism, a correct therapeutic approach is fundamental to decrease the risk of CKD development [ 13 , 14 , 15 ]. Similarly, a precise and reliable measure of renal function in hypothyroid patients is strongly desirable.…”