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Low thyroid function is not associated with an accelerated deterioration in renal function

Christiaan L Meuwese1, Merel van Diepen1, Anne R Cappola2

  • 1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|April 24, 2018
PubMed

Insights

Thyroid hormone dysfunction does not worsen kidney function over time. Instead, impaired kidney function may cause changes in thyroid hormone levels. This study analyzed data from over 70,000 individuals.

Area of Science:

  • Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Chronic kidney disease (CKD) is often linked to thyroid hormone abnormalities.
  • The causal relationship between thyroid dysfunction and CKD remains unclear.
  • This study investigates whether thyroid alterations cause or result from CKD.

Purpose of the Study:

  • To determine the effect of thyroid hormone status on kidney function.
  • To analyze cross-sectional and longitudinal data across all adult age groups.
  • To clarify the direction of causality between thyroid and kidney health.

Main Methods:

  • Individual participant data (IPD) meta-analysis of 16 cohorts.
  • Included measurements of thyroid stimulating hormone, free thyroxine, and creatinine.
  • Calculated estimated glomerular filtration rate (eGFR) using the MDRD formula.
  • Employed linear regression and linear mixed models for eGFR analysis.
  • Pooled effect estimates using random effects models.

Main Results:

  • Analysis included 72,856 individuals.
  • Hypothyroidism (overt and subclinical) was associated with lower baseline eGFR.
  • Hyperthyroidism was associated with higher baseline eGFR.
  • No evidence of accelerated eGFR decline in individuals with low thyroid function during follow-up.

Conclusions:

  • Low thyroid function is not a cause of renal function deterioration.
  • Observed cross-sectional associations may be due to renal dysfunction affecting thyroid hormones.
  • Findings suggest renal dysfunction may precede thyroid alterations in CKD.
Abstract

Keywords:
CKDchronic renal failurecreatinine clearanceepidemiologythyroid function

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