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Evaluation of Thyroid Hormone Status in Children with Steroid Resistant Nephrotic Syndrome: A North India Study

Shikha Sharma, Pradeep Kumar Dabla1, Manish Kumar

  • 1Department of Biochemistry, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi -110031, India. pradeep_dabla@yahoo.com.

Endocrine, Metabolic & Immune Disorders Drug Targets
|October 1, 2015
PubMed

Insights

Thyroid dysfunction, including hypothyroidism, is common in children with steroid-resistant nephrotic syndrome (SRNS). Routine thyroid screening is recommended for SRNS patients, especially during relapse, to monitor and manage potential complications.

Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Internal Medicine

Background:

  • Steroid-resistant nephrotic syndrome (SRNS) is a chronic kidney disease with progressive implications.
  • Limited research exists on thyroid function in pediatric SRNS patients.
  • This study investigates thyroid hormone status in Indian children diagnosed with SRNS.

Purpose of the Study:

  • To assess thyroid hormone levels (FT3, FT4, TSH) in children with SRNS.
  • To correlate thyroid function with the clinical status (remission vs. relapse) of SRNS.
  • To explore the relationship between proteinuria and thyroid function in SRNS.

Main Methods:

  • A cross-sectional study involving 50 Indian children (aged 1-12 years) with SRNS.
  • Patients were categorized into complete remission, partial remission, and relapse groups based on the Urine Protein:Urine Creatinine (Up:Uc) ratio.
  • Serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were measured.

Main Results:

  • 20% of SRNS children exhibited hypothyroidism (7 subclinical, 3 overt).
  • Elevated TSH levels were significantly associated with SRNS relapse (p=0.042).
  • TSH showed a significant positive correlation with the Up:Uc ratio (p=0.0098), indicating increased thyroid stress during higher proteinuria.

Conclusions:

  • Subclinical hypothyroidism in SRNS may be transient and improve with disease remission.
  • Prolonged proteinuria in SRNS can lead to renal tubule damage and impaired protein absorption, potentially causing overt hypothyroidism.
  • Regular thyroid function monitoring is crucial for children with SRNS to detect and manage thyroid abnormalities.
Abstract

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