Reversal deterioration of renal function accompanied with primary hypothyrodism

Dragović, Tamara

doi:10.2298/vsp1202205d

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Hypothyroidism, another main type of thyroid dysfunction assessed on the current study, has been associated with decrease mean values of creatinine and uric acid, and increase mean value of eGFR. The decrement of serum creatinine in the present study as well as other studies [ 8 , 17 ] argues against the previously held notion of increased serum creatinine value due to a decrease in eGFR or alteration in RAAS. But in the current study, increased eGFR and decreased serum creatinine values might be due to, abnormality in creatin kinase level muscular weakness, dystrophy, and poor physiological activity, or in agreement with Kreisman SH, et al, it might be due to the net unchanged creatinine value due to a balance between the decrease in renal clearance and a decrease in creatinine generation [ 18 ].…”

Section: Discussioncontrasting

confidence: 76%

Assessment of renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia: a cross sectional study

Werissa¹,

Kebede²,

Wolde³

2016

Pan Afr Med J

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IntroductionStudies demonstrated that abnormal thyroid functions may result in decreased or increased kidney size, kidney weight, and affect renal functions. In this regard, studies on the association of abnormal thyroid functions and renal function tests are scarcely found in Ethiopia.ObjectiveTo assess renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia.MethodsCross sectional study was conducted from March 21/2015-May 27/2015 at Arsho Advanced Medical Laboratory. During the study period, 71 patients with thyroid dysfunction were eligible, and socio demographic data collected by structured questionnaire. Then blood sample was collected for thyroid function tests, renal function and blood electrolyte analysis. The collected data was analyzed by SPSS version 20. ANOVA and binary logistic regression were employed to evaluate the mean deference and associations of thyroid hormone with renal function and electrolyte balances.ResultsAmong the renal function tests, serum uric acid, and creatinine mean values were significantly decreased in hyperthyroid patients; whereas, eGFR mean value was significantly increased in hyperthyroid study patients (P<0.05). Meanwhile, from the electrolyte measurements made, only the mean serum sodium value was significantly increased in hyperthyroid study participants. Binary logistic regression analysis on the association of thyroid dysfunction with electrolyte balance and renal function tests indicated that serum sodium, creatinine, eGFR values and hyperthyroidism have a statistical significant association at AOR 95% CI of 0.141(0.033-0.593, P=0.008); 16.236(3.481-75.739, P=0.001), and 13.797(3.261-58.67, P=0.001) respectively.ConclusionThe current study reveals, thyroid abnormalities may lead to renal function alterations and also may disturb electrolyte balance. Knowledge of this significant association has worthwhile value for clinicians, to manage their patients' optimally.

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Section: Discussioncontrasting

confidence: 76%

Assessment of renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia: a cross sectional study

Werissa¹,

Kebede²,

Wolde³

2016

Pan Afr Med J

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“…Some studies estimated frequency and consistency of complaints in a large number of patients with SCH. Among the many frequent symptoms, not specific to mild hypothyroidism alone, dry skin and poor memory were the most common in the Colorado study (2,6,24). Patients with SCH may tolerate their symptoms in different ways, which also may enhance the importance of the quality of life assessment.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a three-month trial of thyroxine replacement in symptomatic subclinical hypothyroidism: An impact on clinical presentation, quality of life and adoption of long-term therapy

et al. 2020

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Background / Aim. Although subclinical hypothyroidism (SCH) is frequently a biochemical diagnosis, some symptoms and signs of overt disease may be present, influencing our decision to start the treatment with levothyroxine (LT4). The aim of this study was to examine the effect a 3-month LT4 treatment on clinical presentation and quality of life in symptomatic SCH with TSH < 10 mIU/L. We also considered whether treatment discontinuation additionally improves reliability of these findings. Methods. Clinical parameters (disease-specific score) and quality of life (Short Form 36 questionnaire) were measured in 35 patients with persistent symptomatic SCH before the intervention (TSH 7.0±2.1 mIU/L), 3 months after the euthyroid state had been achieved and 3 months after cessation of LT4 substitution. Results. The median of Zulewski index significantly decreased after the treatment with LT4: 5.0 (4.0-7.0) vs 3.0 (2.0-5.0) (p <0.001) representing a reduction of symptoms. The most common ailments before treatment were dry skin (71.4%), hoarseness (65.7%) and rough skin (54.3 %). After the treatment, there was a significant reduction in the frequency of constipation (p=0.004), dry skin (p=0.022), hoarseness (p=0.002), decreased sweating (p=0.006), and delayed Achilles reflex (p=0.002). Quality of life was not changed significantly after LT4 treatment. In the group of 18 patients who discontinued the treatment, many symptoms and signs reappeared with the increasing of TSH (6.8±1.1 mIU/L): periorbital edema, constipation, weight gain, decreased sweating, slow motion and delayed Achilles reflex. The median of the Żulewski index after discontinuation of LT4 was 6.0 (4.0-9.0) (p = 0.010). Also, there was a statistically significant reduction in the general health score, vitality, role emotional and mental health scores. Conclusions. Clinical score based on symptoms and signs is a sensitive and reproducible test for objective estimation of LT4 treatment effects in symptomatic SCH patients with TSH <10 mIU/L and supports individually adjusted treatment. Symptomatic SCH is not necessarily associated with a quality of life impairment that may be significantly improved by thyroxine treatment. Changes in general health, vitality, mental health and emotional role after LT4 cessation suggest that some aspects of life quality can be affected by subtle variations in thyroxine availability.

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“…Moreover, TT4 fluctuations have been reported in hyperthyroid cats before and after treatment, 4,[33][34][35][36] and could possibly also account for the borderline subnormal TT4 values in clinically normal cats after therapy. However, given the potentially negative effect of a decreased thyroid function on renal function, as described in both humans and cats, [9][10][11] we chose to consider this low TT4 outcome as not successful. A low TT4 concentration can exacerbate renal disease and shorten the patient's life span, especially in cats with underlying chronic kidney disease, which might not have been detected before therapy.…”

Section: Discussionmentioning

confidence: 99%

“…A final low TT4 outcome has a potentially negative effect on renal function and may create the need for thyroxine supplementation, meaning daily medication and an additional cost for the owner. [7][8][9][10][11] Persistent hyperthyroidism results in the need for a second radioiodine therapy or another form of treatment. The relationship between a large thyroid volume and a persistent hyperthyroid outcome has been reported in human medicine by different authors, [12][13][14][15][16][17][18][19][20] although this has been disputed by others.…”

Section: Introductionmentioning

confidence: 99%

Effect of thyroid volume on radioiodine therapy outcome in hyperthyroid cats

Volckaert

Vandermeulen

Dobbeleir

et al. 2015

Journal of Feline Medicine and Surgery

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Introduction: Radioiodine therapy in hyperthyroid cats is commonly used and has a high success rate ranging from 85% to 95%. However given the drawbacks associated with a final hypothyroid or hyperthyroid outcome, a quest for causes of therapy failure is justified. As in human medicine, thyroid volume has been reported as a factor influencing radioiodine therapy outcome in hyperthyroid cats. Purpose: The goal of this study was to relate total thyroid volume, calculated by a newly constructed formula for feline patients, to the outcome of radioiodine therapy. We hypothesized that larger volumes would result in a higher percentage of persistent hyperthyroidism and smaller volumes would increase the risk for hypothyroidism. Materials & Methods: For the calculation of total thyroid volume a new formula was introduced (0.438*L*W²). One hundred and sixty-seven hyperthyroid cats were included in search of a correlation between total thyroid volume and therapy outcome. Additionally the relationship between pretreatment total T 4 and therapy outcome was investigated in 62 cats. Patients were categorized according the administered radioiodine dose and therapy outcome. The effect of volume and TT4 on the outcome was modeled by a logistic regression model with generalized logits, with the euthyroid cats as a reference category, and with dose as categorical, and volume and TT4 as continuous fixed effects. Results: All patients had a follow-up of at least 6 months after the radioiodine therapy, 66.5% of them were euthyroid, 24% were hypothyroid and 9.5% were hyperthyroid. 31.7% of our patients were unilaterally affected, 56.9% were bilaterally affected and 11.4% were either unilaterally or bilaterally affected with additional ectopic thyroid tissue. A borderline significant increase (P=0.0528) in the odds of hyperthyroidism relative to the odds of euthyroidism with increasing thyroid volume was found. Concerning the pretreatment total T 4 concentration no significant relationships were detected. Conclusion: The influence on therapy outcome is most likely multifactorial and although only a small effect was observed in this study, large thyroid volumes can increase the risk of a hyperthyroid outcome after radioiodine therapy. Surprisingly, in the two higher dose categories larger total thyroid volumes were also observed in final hypothyroid cats, compared to those with a euthyroid outcome, and the majority of them were bilaterally affected, possibly introducing another contributing factor on therapy outcome. No significant effect of pretreatment total T 4 on outcome was observed.

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Reversal deterioration of renal function accompanied with primary hypothyrodism

Cited by 7 publications

References 11 publications

Assessment of renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia: a cross sectional study

Assessment of renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia: a cross sectional study

Evaluation of a three-month trial of thyroxine replacement in symptomatic subclinical hypothyroidism: An impact on clinical presentation, quality of life and adoption of long-term therapy

Effect of thyroid volume on radioiodine therapy outcome in hyperthyroid cats

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