Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Chronic Renal Failure and Hypothyroidism


Affiliations
1 Department of Pharmacology, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India
2 Department of Biochemistry, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India
3 Department of Medicine, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India
     

   Subscribe/Renew Journal


This study was undertaken to test the thyroid function with chronic renal failure. Forty patients of CRF and forty healthy who served as control were studied for their thyroid function status. The study observed low total T3 and total T4 values in clinically euthyroid CRF patients. However, finding of normal free T4 values (which is metabolically active fraction) and TSH would indicate functional euthyroid status. It can be presumed that free T4 values would fall if these patients develop hypothyroidism, and TSH values would rise simultaneously. Thus free T4 and TSH level combined can be used for diagnosis of hypothyroidism in presence of chronic renal failure. This study found that the plasma concentrations of thyroid hormones in patients with chronic renal failure both free T3 1.38±0.31 pmol/L and total T3 serum concentrations1.06±0.23 nmol/L were reduced as compare to control respectively. Similarly both serum freeT4 06.27±1.09 pmol/L and total T4 56.17±0.8.96 nmol/L were also reduced in chronic renal failure patients .There was slightly increase in serum TSH 6.21±0.73 mlU/L as compared to control 3.43±0.44 mlU/L. Thus it is suggested that thyroid hormones should be evaluated in chronic renal failure patients and thyroid hormone therapy should be given in these patients to maintain thyroid hormone level.

Keywords

Chronic Renal Failure (CRF), Creatinine Clearance, Goiter, Hypothyroidism, Thyroid Hormones (TH)
Subscription Login to verify subscription
User
Notifications
Font Size


  • Feinstein EL.Kaptien EM.Nicoloff JT & Marssy SG.Thyroid functions in patients with nephroitic syndrome and normal renal function.American journal of Nephrology 1982; 2: 70-72.
  • Kaptien EM.Quion-Verde H & Marssy SG. Hemodyanamic effects of thyroid hormone.Contributions to Nephology 1984:41: 151-159.
  • Kaptien.EM.Thyroid functions in renal failure.Contributions to Nephrology 1986; 50: 64-72.
  • KaptienEM. Feinstien EI& Massy SG. Thyroid hormone metabolism in renal disease.Contributions to Nephrology 1982; 33: 122-135.
  • Katz Al. &Lindheimer MD. Action of hormone on kidneys. Annual Review of Physiology 1977; 39: 97 -133.
  • Katz Al.Emmanouel DS & Lindhemir MD. Thyroid hormone and the kidney.Nephron 1975; 15:223-249.
  • Kaptien EM, Quion – VerdeH, Choolijan CJ, Tang WW, Friedman PE, Rodriquez HJ &MarssySG .The thyroid in end Stage renal disease. Medicine 1988; 67: 187-197.
  • BraunlicH. Thyroid hormones i8nfluencing renal electrolyte excretion in saline loaded rats of different ages. Physiologia Bahemoslovaca 1984; 33: 303 – 308.
  • Gattineni i. Sas D. Dagan A Dwarakanath V & Baum MG. Effect of thyroid hormone on the postnatal renal expression of NHF.8. American journal of physiology Renal Physiology 2008; 294 F: 198-F204.
  • Li Bok N Fekete F & Harsing L Renal structural and function changes and sodium balance in hypothyroid rats. Acta Medica Academiae Scientiarum Hungaricare 1982; 39: 219-225.
  • Katyare SS Modi HR Patel SPW&Patel MA. Thyroid hormone –induced alterations in membrane structure –function Relationship : studies on kinetic properties of rat kidney microsomal Na (+).K (+)-ATPase and lipid phospolipid profiles. Journal of membrane Biology2007; 219: 71-81.
  • Vargas F. Moreno JM. Redriguez- GomeZ l wangeensteen R Osuna A. Alvarez-Guerra M &Gareia –Estan J. Vascular and Renal function in experimental thyroid disorders. European Journal of Endocrinology 2006; 154: 197 -212.
  • Kumar JGordillo R Kaskel FJ. Druschel CM& Woroniecki RP Increased Prevalence of renal and urinary tract anomalies in children with congenital hypothyroidism . Journal of Pediatrics 2009; 154: 263-266.
  • Capasso G.De Tommaso G pica A.Anastasio P Cpasso J. Kinne R & De Santo NG. Effects of thyroid hormones on heart and kidney functions. Mineral and Electrolyte Metabolism 1999; 25:56-64.
  • den Hollander JG Wulkan RW. Mantel MJ& Berghour A.Correlation between seventy of thyroid dysfunction and renal Function. Clinical Endocrinology 2005; 62: 423 – 427.
  • Liu XM.Bai Y & Guo ZS. Study on urinary function and metabolism of water and electrolytes in primary hypothyroidism. Zhonghua Nei Ke Za Zhi 1990; 29: 299 -302.
  • Emmanouel DS. Lindheimer MD& Al Mechanism of impaired water excretion in the hypothyroid rat. Journal of Clinical Investigation 1974; 54: 926-934.
  • Katz Al & indheimer MD. Renal sodium-and potassium– activated adenosine triphosphate and sodium reabsorption in the Hypothyroid rat. Journal of Clinical Investigation 1973; 521: 796-804.
  • Capasso G. kinne R. de Santo Ng & Giordano C. The use of micropuncture. Isolated tubule.and vesicle technique in the study of the action of thyroid hormones on the proximal tubule function. Uremia investigation 1985; 9:151 – 157.
  • Holmes EW Jr & DiScala VA studies on the exaggerated natriuretic response to a saline infusion in the hypothyroid rat Journal of clinical investigation 1970; 49: 1224-1236.
  • Sattyanarayanan, U. Textbook of Biochemistry. Press book and allied private limited 1st Edition March 1999 revised Edition 2001; 238-241.
  • Lin HH & Tang MJ. Thyroid hormone upregulates Na K- ATPase alpha beta mRNA in primary cultures of proximal Tubule cells. Life Science 1977; 60: 375-382.
  • Vaamonde CA. Sebastianelli MJ. Vaamonde lS. Pellegrini FL, Watts RS Klinger EL Jr & Ppper S. Impaired renal tubular Reabsorption of sodium in hypothyroid man. Journal of Laboratory and clinical Medicine 1975: 85:451-466.
  • MeCaffery C & Quamme GA Effects of thyroid status on renal calcium and magnesium handing. Canadian journal of comparative Medicine 1984; 48: 51-57.
  • Hunger-klevene JH. De Vito E & Fasciolo JC. The effect of thyroid hormone on rennin production and release by rat kidney slices. Acta physiologica Latino Americana 1977; 27: 37-41.
  • Segarra AB Ramirez M. Banegas l. HarmosoF. Vargas F. Vives F. Alba F. F. de gasparo M &Prietol. Influence of thyroid disorders on kidney angiotensinase activity. Hormone and Mtabolic Research 2006; 38: 48-52.
  • Dawson PA & markovich D Regulation of the mouse Nasl promoter by vitamin D and thyroid hormone. Pflugers Archiv European journal of physiology 2002; 444: 353 – 359.
  • Del compareJA, Aguirre JA. Ibarra FR. Barontini M & Armando l Effects of thyroid hormone on the renal dopaminerge Endodocrine 2001; 15:297-303.
  • Villabona C. Sahun M. Roca M. Mora j. Gomez N. Gomez JM. Puchal R & SolerJ. Bllod volums and renal function in overt and subclinical primary hypothyroidism. American journal of the Medical sciences 1999; 318P: 277-280.
  • Davis RG. Madsen KM. Fregly MJ & Tisher CC kidney bstructure in hypothyroidism. American journal of physiology 1983; 113: 41-49.
  • Dimitrios S, Marshall. Mechanism of impaired water excretion in hypothyroid rats. J Clin. Invest 1974; 54(4):926-934.
  • MontenegroJ Gonzalez O Saracho R. Aguirre R. Gonzalez O& Martinez l Changes in renal function in primary hypothyroidism. American of kidney Diseases 1996; 27: 195-198.
  • Kreisman SH & Hennessey JV. Consistent reversible elevation of serum creatinine levels in severe hypothyroidism. Arcives of internal Medicine 1999; 159: 79-82.
  • Mooraki A Broumand B. Neekdoost F. Amirmokri P & Bastani B. Reversible acute renal failure associated with Hypothyroidism: report of four cases with brief review of literature Nephrology 2003; 8:57-60.
  • Karanikas G. Schutz M. Szabo M. BeechererA. Wiesnewr K Dudezak R & Kletter K Isotopic renal function studies in severe hypothyroidism and after thyroid hormone replacement therapy. American journal of Nephrology 2004: 41-45.
  • Al-FifiS. Giradin C.Sharma A & Rodd C. Moderate renal failure in association withprolonged acquired hypothyroidism in Children. Acta Paediatrica 1999; 88:715-718.
  • del-rio CG tapiaCL.picazoAB. Ruz MoremoJA HOrtas nieto ML & RomeroGJ. Renal failure and acquired hypothyroidism. Pediatric Nephrology 2003; 18: 290-292.
  • Verheilst J. Berwarets J. Marescau B. Abs R. Neels H. Mahler C & De Deyn PP. Serum creatine. Creatinine.and other guanidine compounds in patients with thyroid dysfunction. Metabolism 1997; 46: 1063-1067.
  • Nikolaeva AV & Pimenov LT Lipid metabolism and functional status of the kidney in hypothyroid patients depending on the phase of disease. Terapevticheskii Arkhiv 2002; 74: 20-23.
  • Van welsem ME & LabattoS Treatment of severe hypothyroidism in a patient with progressive renal failure leads to significant improvement of renal function. Clinical Nephrology2007; 67: 391-393.
  • Gadi A. Vaerbovski P. Marcus C & Berg UB Long –term effects of primary hypothyroidism on renal function in children. Journal of pediatrics 2008; 152: 860-864.
  • Suher M. Koc E Ata N & Ensari C. Relation of thyroid disfunction, thyroid autoantibodies. And renal function.Renalfailure 2005; 27: 739-742.
  • Carrero JJ. Qureshi AR. Axelsson J. Yilmaz Ml. Rehnmark s. Witt MR. Barany P.HeimburgerO. Suliman ML. Alvestrand A. Lindholm B& Stenvinkel P. Clinical and biochemical implications of low thyroid hormone levels (total and free forms) Ineuthyroid patients with chronic kidney disease. Journal of internal Medicine 2007; 262: 690-701.
  • Zoccali C. Mallamaci F. Tripepi G Cutrupi S & PizziniP. Low triiodithyrinine and survival in end – stage renal disease. Kidney international 2006; 70: 523-528.
  • Enia G. Panuccio V CutrupiS. Pizzini P. Tripepi G. Mallamaci F & Zoccali C. Subclinical hypothyroidism is linked to Microinlammation and predicts death in continuous ambulatory peritoneal dialysis. Nephrology. Dialysis. Transplatation 2007; 22:538-544.
  • Zoccali c. Tripepi G. Cutrupi S. PizziniP & Mallamaci F. Low triiodothyronine: a new facet of inflammation in end- stage renal disease.Journal of American Society of Nephorology 2005; 16:2789-2795.

Abstract Views: 190

PDF Views: 0




  • Chronic Renal Failure and Hypothyroidism

Abstract Views: 190  |  PDF Views: 0

Authors

Vivek Singh
Department of Pharmacology, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India
Yogesh Kumar Rai
Department of Biochemistry, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India
Anil Kumar Kem
Department of Medicine, Saraswathi Institute of Medical Sciencies, Hapur, Ghaziabad, U.P., India

Abstract


This study was undertaken to test the thyroid function with chronic renal failure. Forty patients of CRF and forty healthy who served as control were studied for their thyroid function status. The study observed low total T3 and total T4 values in clinically euthyroid CRF patients. However, finding of normal free T4 values (which is metabolically active fraction) and TSH would indicate functional euthyroid status. It can be presumed that free T4 values would fall if these patients develop hypothyroidism, and TSH values would rise simultaneously. Thus free T4 and TSH level combined can be used for diagnosis of hypothyroidism in presence of chronic renal failure. This study found that the plasma concentrations of thyroid hormones in patients with chronic renal failure both free T3 1.38±0.31 pmol/L and total T3 serum concentrations1.06±0.23 nmol/L were reduced as compare to control respectively. Similarly both serum freeT4 06.27±1.09 pmol/L and total T4 56.17±0.8.96 nmol/L were also reduced in chronic renal failure patients .There was slightly increase in serum TSH 6.21±0.73 mlU/L as compared to control 3.43±0.44 mlU/L. Thus it is suggested that thyroid hormones should be evaluated in chronic renal failure patients and thyroid hormone therapy should be given in these patients to maintain thyroid hormone level.

Keywords


Chronic Renal Failure (CRF), Creatinine Clearance, Goiter, Hypothyroidism, Thyroid Hormones (TH)

References