Evaluation of renal function in subclinical hypothyroidism

Abstract

INTRODUCTION:Patients with subclinical hypothyroidism (SCH) have a few or no symptoms or signs of thyroid dysfunction and thus by its very nature, SCH is a laboratory diagnosis. Serum creatinine is elevated and glomerular filtration rate (GFR) values are reversibly reduced in overt hypothyroid patients. We hypothesize that SCH also may be associated with low GFR.AIMS AND OBJECTIVES:The objective of this study was (1) to know the effect of SCH on kidney function, (2) to find the correlation between the renal function parameter creatinine, estimated GFR (eGFR), and thyroid-stimulating hormone (TSH), and (3) to know if creatinine values can be predicted by TSH values in SCH cases.MATERIALS AND METHODS:This is a hospital-based cross-sectional study for 1 year. A total of 608 subjects of either sex were included in the study and were divided into 3 groups: (1) SCH, (2) overt hypothyroidism (OHT), and (3) euthyroidism (ET). TSH, free triiodothyronine, free thyroxine, and serum creatinine were estimated and eGFR was calculated using modification of diet in renal disease study equation and the chronic kidney disease epidemiology collaboration equations.RESULTS:Serum creatinine levels were higher and eGFR was lower significantly in the subclinical hypothyroid group when compared to the control ET group (P < 0.001). The overtly hypothyroid group had significantly higher levels of serum creatinine and lower eGFR when compared to both the groups (P < 0.001). Significant correlation between TSH, creatinine, and eGFR was found in OHT group only. Linear regression analysis showed the regression in creatinine upon TSH is attributable to 44.5% among OHT group, 48.2% in SCH group.CONCLUSION:It can be concluded that the SCH group behaves biochemically similar to OHT group and changes in serum creatinine reflect tissue hypothyroidism in SCH cases.

Implementing Reverse Phase Protein Array Profiling as a Sensitive Method for the Early Pre‐Clinical Detection of Off‐Target Toxicities Associated with Sunitinib Malate

“…Levels of the circulating thyroid hormones T3 and T4 were measured in another cohort ( N = 3 vehicle, N = 5 sunitinib) of mice with no significant differences found between groups data not shown). These findings suggest presence of sub‐clinical hypothyroidism, which has been previously been linked to poor glomerular filtration rates …”

“…Sunitinib treatment resulted in human equivalent grade 2 proteinuria (30–100 mg dL −1 of protein in the urine; 1–2 g per day). The effect of sunitinib on thyroid morphology and function was also assessed to investigate preclinical evidence of clinically reported thyroid AEs . A significant decrease in thyroid epithelial cell height in the thyroids of mice ( N = 3 per group) treated with 40 mg kg −1 sunitinib was observed (Figure C,D).…”

Study of Serum Creatine Kinase Level, Cystatin C and Creatinine Level in Hypothyroidism

“…Hypothyroid Cases r value p value eGFR(ml/min) vs T 3 Hypothyroidism is a common endocrine disorder associated with decreased myocardial contractility, cardiac output and increase in peripheral vascular resistance. The increase in peripheral resistance can predispose to the alteration in renal hemodynamics such as reduced renal blood flow and diminution of glomerular filtration rate resulting in decrease in the clearance of certain substances like creatine kinase, creatinine and others in hypothyroidism [9]. Hypothyroidism may be contributing to the low GFR in some of the hypothyroid cases [10].…”

Influence of low free thyroxine on progression of chronic kidney disease

“…Hypothyroidism diminishes protein synthesis and cellular development, which leads to decreases in cell number, density, and size of the kidney [3]. It has been demonstrated that subclinical hypothyroidism might be a risk factor for faster decline of renal function [4][5][6], with possible effect on recovery or preservation of renal function with treatment [7,8]. However, this finding are controversial and the effect of low free thyroxine (LFT) levels on eGFR decline in CKD patients has not been thoroughly investigated.…”