Thyroid Hormone and the Kidney

Abstract

Thyroid hormones affect both renal morphology and function. They are required for kidney growth and development, and thyroid deficiency results in decreased renal plasma flow and glomerular filtration rate and in impaired urinary concentration and dilution. Thyroid hormones also influence membrane transport and electrolyte metabolism, and alterations in mineral metabolism in hyperthyroidism frequently cause calcium nephropathy which affects renal function adversely. The kidney plays an important role in the peripheral metabolism of iodine and thyroid hormones, and thyroid function is altered in certain kidney diseases, particularly chronic renal failure. The pathogenesis of these alterations is currently under active investigation.

Functional Abnormalities and Thyroid Nodules in Patients with End-stage Renal Disease

“…The link between kidney and thyroid function has been well known for many years (25)(26). 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). The presence of hypothyroidism results in increased cardiovascular risk in patients with ESRD on a kidney transplant waiting list, a population with several cardiovascular risk factors (8,26). Moreover, after transplant, cardiovascular immunosuppressive therapy exerts a detrimental effect on many cardiovascular risk factors and might further exacerbate cardiovascular risk (29,30).…”

Kidney failure in the elderly due to hypothyroidism: a case report

“…Consequently, this deficiency reduces the renal blood flow and, finally, the glomerular filtration rate. 11,16 The result from this is an elevation in the serum levels of creatinine and a reduction in its clearance. There may also be slight proteinuria, secondary to increased capillary transudation of proteins.…”

“…This leads to deficits of renal function, associated with reductions in the cardiac output. 10,11 It can also cause glomerulopathy (nephritic and/ or nephrotic syndrome) and occur in diverse forms of chronic kidney disease, including in hemodialysis patients, thereby worsen ing the prognosis. 10 Most kidney abnormalities (structural, metabolic and morphological) caused by hypothyroidism can be reverted after supplementation with thyroxin.…”

“…10 Most kidney abnormalities (structural, metabolic and morphological) caused by hypothyroidism can be reverted after supplementation with thyroxin. 11 Here, we describe the case of a patient attended at the geriatric outpatient clinic of Hospital do Servidor Público Estadual, in São Paulo, who was diagnosed as presenting renal dysfunction associated with hypothyroidism. The importance of this report lies in the high prevalence of this association, since primary hypothyroidism can occur in 9.5% of the patients with chronic renal disease, compared with a prevalence of 0.6 to 1.1% in the general population.…”