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Thyroid function in patients with idiopathic nephrotic syndrome.

Shivendra Singh1, Om Prakash Mishra2, Partha Pratim Mandal3

  • 1Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

International Urology and Nephrology
|January 12, 2021
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Summary

Hypothyroidism is common in nephrotic syndrome patients, particularly those with steroid-resistant nephrotic syndrome (SRNS). Routine thyroid screening is recommended for SRNS patients to detect subclinical or overt hypothyroidism.

Keywords:
HypothyroidismNephrotic syndromeSubclinical

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Area of Science:

  • Endocrinology
  • Nephrology

Background:

  • Nephrotic syndrome (NS) involves significant albuminuria and excretion of low-molecular-weight proteins, including thyroid hormone-binding globulins.
  • This protein loss suggests a potential link between nephrotic syndrome and thyroid dysfunction, possibly leading to hypothyroidism.

Purpose of the Study:

  • To investigate the prevalence of hypothyroidism in patients with idiopathic nephrotic syndrome.
  • To assess the relationship between thyroid hormone levels and disease severity in nephrotic syndrome.

Main Methods:

  • Prospective observational study of 100 patients (aged 1-40 years) with idiopathic nephrotic syndrome.
  • Serum T3, T4, and TSH levels were measured at diagnosis and at 12 weeks or remission.
  • Patients were categorized into first episode, frequent relapse/steroid-dependent NS, and steroid-resistant NS (SRNS).

Main Results:

  • Overt hypothyroidism was found in 3% of patients, and subclinical hypothyroidism in 18%.
  • Hypothyroidism was more prevalent in the steroid-resistant nephrotic syndrome (SRNS) subgroup.
  • Thyroid hormone levels (T3, T4, TSH) significantly improved upon remission. TSH correlated positively with proteinuria and negatively with serum albumin.

Conclusions:

  • Hypothyroidism is a common comorbidity in nephrotic syndrome, especially in the SRNS subgroup.
  • Routine thyroid function screening is recommended for patients with steroid-resistant nephrotic syndrome.