Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients

Uemura, Osamu; Iwata, Naoyuki; Nagai, Takuhito; Yamakawa, Satoshi; Hibino, Satoshi; Yamamoto, Masaki; Nakano, Masaru; Tanaka, Kazuki

doi:10.1007/s13730-018-0320-7

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Furthermore, kidney function in lean patients should be assessed by GFR without correction for normalized body surface area, particularly for the dose determination of drugs excreted by the kidney. Using eGFR-cysC, we evaluated the kidney function of 111 SMID patients, and the mean value was 87.1 ± 27.1 mL/min/1.73 m 2 ; CKD with GFR < 60 mL/min/1.73 m 2 occurred in 14 cases (12.6%), which were not high compared with that in the Japanese population (13) . About 13.3-14.8 million Japanese people aged ≥20 years were estimated to have decreased kidney function with GFR < 60 mL/min/1.73 m 2 (14) .…”

Section: Discussionmentioning

confidence: 95%

“…We hope that eGFR-β2MG for adults will be developed. However, it should be noted that infectious, inflammatory, and malignant diseases affect eGFR-β2MG, and thyroid disease affects eGFR-cysC and eGFR-β2MG (13) . Furthermore, kidney function in lean patients should be assessed by GFR without correction for normalized body surface area, particularly for the dose determination of drugs excreted by the kidney.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of eGFRs to Calculate Kidney Function in Adults with Severe Motor and Intellectual Disabilities

2023

JMA J

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Introduction: The gold standard for evaluating kidney function is kidney inulin clearance (Cin). However, this procedure is difficult to perform in patients with neuromuscular disabilities and/or bladder dysfunction. We aimed to develop a simpler method for determining the estimated glomerular filtration rate (eGFR) using equations and values for three biomarkers: serum creatinine (sCr), serum cystatin C (cysC), and serum beta-2 microglobulin (β2MG). This study evaluated three eGFR equations in patients with severe motor and intellectual disabilities (SMID). Methods: We evaluated the equations using data of 18 adult SMID patients with a clinical need for creatinine clearance (Ccr). We compared the results of each equation with Ccr-based eGFR instead of Cin using mean error (ME), root mean square error (RMSE), and P30. Results: Based on eGFR, the ME values of Cr, cysC, β2MG, and Ccr were 74.5, 2.3, and 6.5 mL/min/1.73 m 2 , RMSE values, 92.3, 25.7, and 33.4 mL/min/1.73 m 2 ; and P30, 16.7%, 77.8%, and 72.2%, respectively. Conclusions: eGFR-Cr cannot be used to reliably assess kidney function in adult SMID patients. It is better to use eGFR-cysC to evaluate kidney function in this patient population.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Evaluation of eGFRs to Calculate Kidney Function in Adults with Severe Motor and Intellectual Disabilities

2023

JMA J

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“…For such patients, renal function should be evaluated by eGFR calculated from serum Cys-C (sCys-C) or serum BMG (sBMG). However, it has been reported that sCys-C is increased by hyperthyroidism, human immunodeficiency virus (HIV) infection and steroids, while it is decreased by hypothyroidism, and taking cyclosporine [4][5][6]. In addition, it has been reported that sBMG is increased by inflammatory diseases, infections, malignant tumors, autoimmune diseases, and hyperthyroidism, while it is decreased by hypothyroidism [7,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of inulin clearance with 2-h creatinine clearance in Japanese pediatric patients with renal disease: open-label phase 3 study of inulin

et al. 2021

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Background There is no approved dosage and administration of inulin for children. Therefore, we measured inulin clearance (Cin) in pediatric patients with renal disease using the pediatric dosage and administration formulated by the Japanese Society for Pediatric Nephrology, and compared Cin with creatinine clearance (Ccr) measured at the same time. We examined to what degree Ccr overestimates Cin, using the clearance ratio (Ccr/Cin), and confirmed the safety of inulin in pediatric patients. Methods Pediatric renal disease patients aged 18 years or younger were enrolled. Inulin (1.0 g/dL) was administered intravenously at a priming rate of 8 mL/kg/hr (max 300 mL/hr) for 30 min. Next, patients received inulin at a maintenance rate of 0.7 × eGFR mL/min/1.73 m2 × body surface area (max 100 mL/hr) for 120 min. With the time the maintenance rate was initiated as a starting point, blood was collected at 30 and 90 min, while urine was collected twice at 60-min intervals. The primary endpoint was the ratio of Ccr to Cin (Ccr/Cin). Results Inulin was administered to 60 pediatric patients with renal disease; 1 patient was discontinued and 59 completed. The primary endpoint, Ccr/Cin, was 1.78 ± 0.52 (mean ± standard deviation). Regarding safety, five adverse events were observed in four patients (6.7%); all were non-serious. No adverse reactions were observed in this study. Conclusions The results in this study on the dosage and administration of inulin showed that inulin can safely and accurately determine GFR in pediatric patients with renal disease. ClinicalTrials.gov identifier NCT03345316.

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“…Subclinical hypothyroidism (SCH) is an asymptomatic stage of hypothyroidism defined by elevated serum thyrotropin levels and normal serum free thyroxine levels [7,8]. Research has shown that SCH may lead to renal dysfunction through decreased GFR as well as changes in cardiovascular function and disorders of the renin-angiotensin system [9,10]. Several clinical studies have reported that SCH is also associated with diabetes and microalbuminuria [8,11].…”

Section: Introductionmentioning

confidence: 99%

Association between Subclinical Hypothyroidism and Albuminuria in Patients with Type 2 Diabetes Mellitus: A Cross Sectional Study in Iran

Najmaldin

Askari

Foroutan

2020

JPRI

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Introduction: Studies have shown the association between subclinical hypothyroidism and type 2 diabetes. However, the common complications of type 2 diabetes, such as diabetic nephropathy and albuminuria with subclinical hypothyroidism, are not fully clear yet. This study thus aimed to determine the association between subclinical hypothyroidism and albuminuria in patients with type 2 diabetes mellitus. Methods: This was a cross-sectional study, of 140 individuals diagnosed with type 2 diabetes mellitus (DM) admitted to the internal clinics of Kosar Hospital in Semnan, Iran in 2017-2018. The participants were selected, and were compared based on having 2 TSH levels above normal (>4.2 mIU/L) 3 months apart, as well as patients were divided to two groups including, subclinical hypothyroidism group (n=40) and euthyroid group (n=100) based on demographic information, laboratory information and indicators such as albuminuria, and urinary albumin-to-creatinine ratio (UACR). Findings: The mean and standard deviation of UACR in patients with subclinical hypothyroidism were significantly higher than those of euthyroid patients (46.09 ± 27 9.27 vs. 3.94 ± 0.24 and P = 0.015, respectively). In patients with subclinical hypothyroidism, there was a statistically significant and direct relationship between UACR values with primary TSH level (r = 0.555, P< 0.001) and UACR values with secondary TSH level (r = 0.563, P< 0.001). Conclusion: Among type 2 DM patients, the rate of albuminuria in subclinical hypothyroidism group was significantly higher than that of euthyroid patients and with increasing initial and recurrent TSH levels, UACR values and consequently albuminuria increased.

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Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients

Cited by 4 publications

References 14 publications

Evaluation of eGFRs to Calculate Kidney Function in Adults with Severe Motor and Intellectual Disabilities

Evaluation of eGFRs to Calculate Kidney Function in Adults with Severe Motor and Intellectual Disabilities

Comparison of inulin clearance with 2-h creatinine clearance in Japanese pediatric patients with renal disease: open-label phase 3 study of inulin

Association between Subclinical Hypothyroidism and Albuminuria in Patients with Type 2 Diabetes Mellitus: A Cross Sectional Study in Iran

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