Do not forget the kidney in graves' disease

Area of Science:

• Endocrinology
• Nephrology
• Immunology

Background:

• Graves' disease (GD) is an autoimmune disorder affecting the thyroid gland.
• Microalbuminuria, an early indicator of kidney damage, has not been extensively studied in GD patients.
• Understanding factors associated with microalbuminuria in GD is crucial for early detection and management of potential renal complications.

Purpose of the Study:

• To determine the prevalence of microalbuminuria in patients diagnosed with Graves' disease.
• To identify clinical and laboratory factors associated with the presence of microalbuminuria in GD patients.

Main Methods:

• A cross-sectional study involving 99 GD patients and 47 healthy controls (HC).
• Exclusion criteria included active infection, uncontrolled diabetes, and chronic kidney disease.
• Analysis of spot urine samples for microalbuminuria (urine albumin-to-creatinine ratio - UACR), alongside recording of clinical data, comorbidities, medications, and thyroid antibody levels.

Main Results:

• The prevalence of microalbuminuria was 12.1% in the GD group.
• Patients with GD exhibited a significantly higher median UACR compared to the HC group (p=0.033).
• UACR showed correlations with thyroid-stimulating hormone receptor antibody (TRAb), TSH, and FT3 levels. Regression analysis confirmed a significant association between TRAb levels and UACR (p=0.040).

Conclusions:

• Graves' disease is associated with an increased prevalence of microalbuminuria.
• A significant correlation exists between microalbuminuria and TRAb levels in GD patients.
• Autoimmunity, as indicated by TRAb levels, may be a contributing factor to the development of microalbuminuria in Graves' disease.