Changes in the thyroid hormone profiles in children with nephrotic syndrome

Area of Science:

• Pediatric Endocrinology
• Nephrology
• Internal Medicine

Background:

• Nephrotic syndrome (NS) is a kidney disorder affecting children, potentially impacting various bodily functions.
• Thyroid hormone imbalances can occur in various systemic diseases, but data in pediatric NS is limited.

Purpose of the Study:

• To compare thyroid hormone profiles in pediatric patients with nephrotic syndrome (NS) during active disease and after achieving remission.

Main Methods:

• The study included 31 pediatric NS patients.
• Thyroid hormone profiles assessed included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4.
• Correlations between hormone levels, urinary protein/creatinine ratio, and serum albumin were analyzed.

Main Results:

• Over half of the patients (51.6%) exhibited abnormal thyroid hormone profiles during the nephrotic phase, including hypothyroidism and low T3 syndrome.
• Significantly lower levels of T3, T4, and free T4, and higher TSH levels were observed during the nephrotic phase compared to remission (P<0.001 for all).
• Urinary protein/creatinine ratio correlated significantly with T3, T4, free T4, and TSH during the nephrotic phase, while serum albumin correlated with T3. These correlations resolved post-remission.

Conclusions:

• Abnormal thyroid hormone profiles are common in pediatric patients with NS.
• Thyroid hormone levels tend to normalize upon remission of NS, independent of levothyroxine treatment.