2016
DOI: 10.1007/s11154-016-9395-7
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Thyroid dysfunction and kidney disease: An update

Abstract: Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible w… Show more

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Cited by 186 publications
(162 citation statements)
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“…As a consequence, cardiac preload and vascular resistance raise, resulting in increased diastolic blood pressure and cardiac afterload (3). Renin gene expression is also regulated by circulating levels of free triiodothyronine (FT3) and free thyroxine (FT4) through beta-adrenergic activation; accordingly, the reduced sensitivity to beta-adrenergic stimulus occurring in hypothyroidism can cooperate with other hemodynamic abnormalities decreasing renin release (4, 5). The resulting negative inotropic effect on the heart, as well as the altered equilibrium between the reduced expression of vasodilators such as vascular endothelial growth factor or insulin-like growth factor-1, can lead to further renal vasoconstriction.…”
Section: The Effects Of Thyroid Hormones On Kidneymentioning
confidence: 99%
“…As a consequence, cardiac preload and vascular resistance raise, resulting in increased diastolic blood pressure and cardiac afterload (3). Renin gene expression is also regulated by circulating levels of free triiodothyronine (FT3) and free thyroxine (FT4) through beta-adrenergic activation; accordingly, the reduced sensitivity to beta-adrenergic stimulus occurring in hypothyroidism can cooperate with other hemodynamic abnormalities decreasing renin release (4, 5). The resulting negative inotropic effect on the heart, as well as the altered equilibrium between the reduced expression of vasodilators such as vascular endothelial growth factor or insulin-like growth factor-1, can lead to further renal vasoconstriction.…”
Section: The Effects Of Thyroid Hormones On Kidneymentioning
confidence: 99%
“…Hypothyroidism may affect renal function through direct (glomerular and tubular changes) and indirect (hemodynamic changes) mechanisms (27). In spite of the continuous improvement of dialysis technology and pharmacological treatments for ESRD, the impact of thyroid abnormalities on cardiovascular morbidity and mortality in renal patients has progressively emerged over the past decade (8,28).…”
Section: Discussionmentioning
confidence: 99%
“…38 Per quanto riguarda il possibile ruolo di infezioni virali, sono stati riscontrati componenti di virus quali Parvovirus B19, Coxachie ed Herpes, 39,40 HCV 41 in tiroidi di HT ma vi sono risultati contrastanti e poco convincenti, per la difficoltà di definire un'associazione causale certa. 42 Anche le radiazioni ionizzanti sono state considerate tra i possibili fattori ambientali della HT, ma con risultati contrastanti. 43 Dopo l'incidente nucleare di Chernobyl, i bambini esposti hanno sviluppato una maggiore frequenza di Ab-TPO, ma senza evidenza di un maggiore sviluppo di ipotiroidismo.…”
Section: Fattori Geneticiunclassified
“…20,40,41 Negli ultimi anni, diversi studi, per lo più osservazionali, hanno mostrato una forte correlazione tra IpoS ed outcome renali, infatti: esiste una relazione inversa tra concentrazione di TSH sierico e filtrato glomerulare; l'IpoS correla con gli eventi cardiovascolari nei soggetti con nefropatia cronica; la terapia con L-T4 è in grado di migliorare il filtrato glomerulare e di rallentare la progressione dell'insufficienza renale cronica. [42][43][44][45][46] Si è già evidenziato che nell'IpoS si riscontrano numerose alterazioni fisiopatologiche fortemente aterogene: disfunzione endoteliale, insulino-resistenza, flogosi cronica subclinica, ipercolesterolemia, aumento delle resistenze periferiche totali. Quest'ultimo elemento rende ragione della conferma del riscontro, anche nella più recente metanalisi mirata sull'argomento, di valori pressori diastolici (+0,75 mmHg) e sistolici (+1,89 mmHg) modestamente ma significativamente più elevati rispetto a soggetti eutiroidei.…”
Section: Significato Biologico Dell'ipotiroidismo Subclinico Nell'adultounclassified