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Correlation between thyroid function and proteinuria in patients with chronic kidney disease stages 3 and 4
Karina Schiavoni Scandelai1, Pietra Desiree Bourdon Fuentes Azevedo Vianna2, João Pedro Barbosa Sanches2
1Postgraduate Program in Clinical and Experimental Physiopathology (Fisclinex), Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
International Urology and Nephrology
|July 4, 2025
Summary
Proteinuria in chronic kidney disease (CKD) stages 3 and 4 is linked to altered thyroid function, with higher protein loss correlating with increased thyroid stimulating hormone (TSH) and decreased free T4 (FT4). Thyroid function did not significantly differ between CKD stages 3 and 4.
Area of Science:
- Nephrology
- Endocrinology
- Clinical Chemistry
Background:
- Proteinuria in nephrotic syndrome can lead to thyroid hormone imbalances.
- Subclinical hypothyroidism may arise from the loss of thyroxine-binding protein and levothyroxine.
- Understanding thyroid function in chronic kidney disease (CKD) is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between thyroid function and proteinuria in patients with stages 3 and 4 CKD.
- To determine if thyroid function differs between CKD stages 3 and 4.
- To assess the impact of urinary protein loss on thyroid hormone levels.
Main Methods:
- An observational, cross-sectional study was conducted with 150 patients diagnosed with CKD stages 3 and 4.
- Measurements included thyroid stimulating hormone (TSH), free T4 (FT4), and urine protein-creatinine ratio (PCR).
- Proteinuria was defined as a PCR of ≥200 mg/g.
Main Results:
- A significant positive correlation was observed between PCR and TSH, and a negative correlation between PCR and FT4 in the overall sample and in CKD stage 3.
- Over 60% of patients exhibited proteinuria (PCR ≥200 mg/g).
- Significant differences in age, estimated glomerular filtration rate, TSH, and FT4 were found between patients with and without significant proteinuria.
Conclusions:
- Urinary protein loss is significantly correlated with altered thyroid function in CKD stages 3 and 4.
- Thyroid function parameters (TSH and FT4) showed significant differences based on the presence of proteinuria.
- No significant differences in thyroid function were detected between CKD stages 3 and 4.
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