Low T3 Syndrome in Adult Patients with Nephrotic Syndrome

Tatar, Erhan; Yeniay, Kezban Pınar; Ok, Ebru Sevinç; Isikyakar, Tolgay; Güngör, Özkan; Taşlı, Funda; Şen, Sait; Demirci, Meltem Seziş; Başçı, Alı

doi:10.5262/tndt.2014.1002.10

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“…Compared to the general population, hypothyroidism and low triiodothyronine (T3) syndrome is more common in chronic kidney disease (CKD) patients (1)(2)(3)(4)(5). According to various studies, the low T3 syndrome is closely related to the stage of CKD.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Low FT3 Level on Kidney Disease Progression and Potassium Levels in Euthyroid Adult Patients with Solitary Kidney

Tatar¹,

Uslu²,

Atakaya³

et al. 2017

Turk Neph Dial Transpl

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OBJECTIVE: The aim of this study was to investigate the effect of low FT3 levels on CKD progression and hyperkalemia in euthyroid patients with solitary kidney. MATERIAL and METHODS:Seventy-six solitary kidney outpatients were enrolled in the study. Patients with a preexisting thyroid disease were excluded. The baseline and final laboratory parameters were evaluated. Serum Thyroid hormones (TSH, FT3 and FT4) were measured at baseline. RESULTS:The mean age of the patients was 50.4 ± 13.8 years and mean follow-up was 43 ± 29 months. Of the patients, 24% had progressive CKD and 19.7% developed hyperkalemia. Patients with a progressive course had lower FT3 levels (2.71 ± 0.34 vs. 3.17±0.47; p <0.001). Similarly hyperkalemic patients had lower FT3 values (2.77 ± 0.34 vs. 3.13 ± 0.49; p = 0.011). FT3 levels were negatively correlated with, age, history of hypertension and serum potassium level and positively correlated with serum albumin and eGFR levels. In multivariate regression analysis, FT3 levels were independently associated with progression of CKD. Low eGFR and RAS-blocker use was independently associated with the development of hyperkalemia. CONCLUSION:In patients with solitary kidney, low FT3 level is associated with the progression of CKD. In addition, development of hyperkalemia is common in CKD patients with low FT3 levels. KEy wORDS:Chronic kidney disease, Hyperkalemia, Low T3 syndrome, Solitary kidney, Thyroid hormones Öz AMAÇ: Çalışmanın amacı ötiroid soliter böbrekli hastalarda düşük serbest T3 seviyelerinin, KBH ilerlemesi ve hiperkalemi üzerine etkilerini incelemektir. GEREÇ ve yÖNTEMLER:Poliklinikte izlenen 76 tek böbrekli erişkin hasta çalışmaya dahil edildi. Tiroid hastalığı olanlar çalışma dışı bırakıldı. Başlangıç ve son kontrol laboratuvar sonuçları değerlendirildi. Tiroid hormon testlerine (TSH, sT4 ve sT3) başlangıçta bakıldı. BULGULAR:Hastaların yaş ortalamaları 50,4±13,8 yıl ve ortalama takip süresi 43±29 aydı. Hastaların %24'de KBH'da ilerleme ve %19,7'de hiperkalemi gelişti. KBH'da ilerleme gösteren hastalarda sT3 seviyeleri daha düşüktü (2,71±0,34 vs. 3,17±0,47; p <0,001). Benzer şekilde hiperkalemi gelişen hastalarda sT3 seviyeleri daha düşüktü (2,77±0,34 vs. 3,13±0,49; p =0,011). sT3 seviyesi yaş, hipertansiyon öyküsü ve potasyum düzeyi ile negatif, serum albümin ve GFH ile pozitif koreleydi. Çoklu analizde; sT3 düzeyi KBH progresyonu ile, hiperkalemi gelişimi ise düşük GFH ve RAS bloker kullanımıyla bağımsız ilişkiliydi. SONUÇ:Soliter böbrekli hastalarda düşük serbest T3 seviyeleri KBH ilerlemisi ile ilişkilidir. Düşük sT3 seviyeli KBH hastalarında hiperkalemi gelişimi sıktır.

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