Effects of Thyroid Hormone on Urinary Concentrating Ability

Abstract

Background: Hypothyroidism has been associated with impaired urinary concentrating ability. However, previous reports on thyroid hormone and urinary concentrating ability in humans only studied a limited number of patients with autoimmune thyroid disease or used healthy controls instead of paired analysis within the same patients. Objective: To study the urinary concentrating ability in athyreotic patients with differentiated thyroid cancer on and off levothyroxine treatment as they are exposed to different thyroid states as part of their treatment in the absence of an autoimmune disease. Design and Methods: We studied 9 patients (mean age of 42.7 years) during severe hypothyroid state (withdrawal of levothyroxine before radioactive iodine therapy) and TSH-suppressed state (on levothyroxine therapy). At these two points, serum and urine samples were collected after 14 h of overnight fasting without any food or drink. Results: Serum and urine osmolality were not significantly different between on and off levothyroxine treatment. Serum creatinine levels were significantly higher in patients off versus on levothyroxine treatment (87.0 vs. 71.0 µmol/L, respectively; p = 0.044) and, correspondingly, the estimated glomerular filtration rate was significantly lower (89.6 vs. 93.1 mL/min, respectively; p = 0.038). Conclusion: Short-term, severe hypothyroidism has no effect on urinary concentrating ability. Our study confirms the well-known effects of thyroid hormone on serum creatinine concentrations.

Effect of withdrawal of thyroid hormones versus administration of recombinant human thyroid-stimulating hormone on renal function in thyroid cancer patients

“…The results of the present study indicated that THW significantly increased serum Cr and decreased eGFR to an abnormal level, thus reflecting adverse effects on the kidney. These results are consistent with those of previous studies 8 , 9 , 12 , 13 , 17 . It is known that renal function is decreased in hypothyroidism owing to an increased serum Cr level 19 .…”

Urine concentrating ability in cats with hyperthyroidism: Influence of radioiodine treatment, masked azotemia, and iatrogenic hypothyroidism

“…Complicating this issue of azotemia and hypothyroidism is that impaired urine concentrating ability has been reported in some, 26,27 but not all, 28 studies of human hypothyroid patients, an effect that can sometimes be reversed with thyroid hormone treatment. 26,27 When we compared our hypothyroid and euthyroid cats, however, cats destined to become hypothyroid were older, had higher pretreatment serum concentrations of creatinine, urea nitrogen, and SDMA, with a higher proportion having pretreatment USG <1.035 (57% vs 45%; Table S3).…”

“…4,[19][20][21][22][23] Such azotemia would be expected to improve once thyroid hormone replacement therapy normalizes GFR and renal blood flow. [23][24][25] In addition, hypothyroidism has been reported to impair urine concentrating ability in some, 26,27 but not all, 28 studies of human patients, an effect that can sometimes be reversed with thyroid hormone treatment. 26,27 To our knowledge, no reports on urine concentration in hypothyroid cats, either with or without azotemia, exist.…”

The spectrum of Thyroid function Abnormalities and associated Biochemical factors in Patients with Chronic Kidney Disease in Cameroon

“…The categories of thyroid dysfunction were classified based on the reference intervals for the hormones and pattern of derangement in the thyroid hormones profile. Euthyroid hyperthyroxinaemia: isolated elevation of FT 4 or TT 4 in the presence of TSH, FT 3 and TT 3 within reference limits [26].…”