Relation of Thyroid Disfunction, Thyroid Autoantibodies, and Renal Function

Abstract

Fifty-eight patients with thyroid dysfunction were included, comparing 27 healthy subjects to evaluate the relationship between thyroid autoimmunity, thyroid functional status, and renal function. Regardless of clinical status, hypothyroidism was defined as T3-T4<normal limits and TSH>upper limit of normal, and hyperthyroidism was defined as T3-T4>normal limits and TSH <0.1 mcU/mL. In all participants, serum antithyroperoxidase level, serum antithyroglobulin level, creatinine clearance (CC), and urinary albumin excretion rate (UAER) in 24-h urine collections were measured. Of 85 persons, 41 patients ages 20 to 71 years (median; 44) had hypothyroidism, 17 patients ages 22 to 56 years (median; 32) had hyperthyroidism, and 27 subjects ages 20 to 67 years (median; 50) were normal. Regarding thyroid autoantibody positiveness, the positive group had a higher UAER than the negative group (30.2 mg/day, 20.8 mg/day, respectively; p=0.05). In hypothyroid patients, UAER was significantly higher than in hyperthyroid patients and control subjects (30.1 mg/day, 11.8 mg/day, 10.5 mg/day, respectively; p<0.001). In the hypothyroid population, with regard to UAER and CC, we could not find a significant difference between the thyroid autoantibody positive and negative groups. In view of CC, hypothyroid patients had significantly lower CC than the hyperthyroid group (79.0 mL/ min, 86.5 mL/min, respectively; p<0.01). A careful control of the renal function in thyroid diseases should be evaluated. Renal dysfunction seems to be secondary to hypothyroidism rather than thyroid autoimmunity.

Measuring glomerular filtration rate in children; can cystatin C replace established methods? A review

“…The underlying mechanisms for these changes in s-CysC have not been investigated, and GFR was not measured in either study. However, it is unlikely that changes in s-CysC are reflected by an actual change in GFR, since the hypothyroid and hyperthyroid states are well known to be associated with decreased and increased GFR, respectively [93][94][95]. The impact of thyroid hormones on CysC has not yet been investigated in children.…”

Thyroid hormone ameliorates diabetic nephropathy in a mouse model of type II diabetes

“…The GFR in hypothyroid patients is approximately one-third lower than that of the euthyroid individuals (Singer 2001). Suher et al (2005) showed that subjects with hypothyroidism are associated with increased urinary albumin excretion rate and decreased creatinine clearance. In corroboration with our findings, T 3 was reported to have beneficial effects on renal function in a diabetic patient with end-stage renal failure and severe hypothyroidism (van Welsem & Lobatto 2007).…”

Effect of Thyroxine Supplementation on Glomerular Filtration Rate in Hypothyroid Dogs

“…First, hypothyroidism is associated with decreased renal perfusion, 3 which results from decreased cardiac output and circulating volume, impaired RAAS activity, and decreased atrial natriuretic peptide concentration. 20,22,23 Second, growth retardation in the parenchyma of the kidney, as described in mature rats with experimental hypothyroidism, can decrease glomerular surface area. 24 Third, filtrate overload caused by deficient sodium and water reabsorption in the proximal tubule could lead to adaptive preglomerular vasoconstriction.…”