Evaluation of thyroid dysfunction in patients with primary nephrotic syndrome: A single-center retrospective cohort...

Research on autoimmune diseases has revealed multi-organ interactions, including thyroid-renal associations. This study aims to investigate the clinical features of primary nephrotic syndrome (PNS) patients with thyroid dysfunction, assess the impact of thyroid autoantibodies (anti-TPO Ab and anti-Tg Ab) on renal damage, and identify risk factors for thyroid dysfunction to facilitate early clinical intervention.

A total of 175 PNS patients diagnosed between January 2023 and June 2024 were enrolled. Thyroid function and autoantibodies were measured upon admission. Comparisons were made between groups with normal and abnormal thyroid function, and between autoantibody-positive and double-negative patients. Logistic regression was used to analyze risk factors for thyroid dysfunction.

A total of 134 patients were identified with thyroid dysfunction. The abnormal group showed higher total cholesterol, triglycerides, low-density lipoprotein cholesterol, and 24-hour urinary protein (UP), and lower total protein, albumin (ALB), calcium, immunoglobulin G, and immunoglobulin A. Autoantibody-positive patients had higher TSH, 24-hour UP, and urinary albumin-to-creatinine ratio, and lower FT4 (p < 0.05), though renal pathology did not differ significantly. Logistic regression analysis identified reduced ALB (OR = 0.900, 95% CI 0.815 - 0.993, p = 0.036) and elevated 24-hour UP (OR = 1.192, 95% CI 1.040 - 1.368, p = 0.012) as independent risk factors.

Thyroid dysfunction is common in PNS and is associated with more severe proteinuria and hypoalbuminemia, though not with specific pathological types. Thyroid autoimmunity was not an independent predictor; however, antibody-positive patients had significantly higher TSH and proteinuria levels. Routine thyroid function and antibody screening are recommended for early intervention in PNS patients.