International Journal of Medical Sciences

Impact factor
2.399

23 October 2017

ISSN 1449-1907 News feeds of published articles

My Manuscript | My Account

Journal of Genomics now in PubMed/PubMed Central. Submit manuscript...

Journal of Biomedicinenew

Theranostics

Journal of Cancer

Oncomedicine

International Journal of Biological Sciences

Journal of Genomics

Journal of Bone and Joint Infection (JBJI)

Nanotheranostics

PubMed Central Indexed in Journal Impact Factor

Int J Med Sci 2014; 11(1):52-59. doi:10.7150/ijms.7186

Research Paper

Unresolved Subclinical Hypothyroidism is Independently Associated with Progression of Chronic Kidney Disease

Eun Oh Kim1, Ihn Suk Lee2, Yoo A Choi1, Sang Ju Lee1, Yoon Kyung Chang1, Hye Eun Yoon1, Yi Sun Jang2, Jong Min Lee2, Hye Soo Kim2, Chul Woo Yang1, Suk Young Kim1, Hyeon Seok Hwang1 ✉

1. Division of Nephrology, Departments of Internal Medicine, The Catholic University of Korea, Seoul, Korea
2. Division of Endocrinology, Departments of Internal Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Background and Aim: Patients with chronic kidney disease (CKD) often have subclinical hypothyroidism. However, few reports have investigated changes in the status of subclinical hypothyroidism in CKD patients and its clinical significance in CKD progression.

Methods: We included 168 patients with nondialysis-dependent CKD stages 2-4. The normalization of subclinical hypothyroidism during follow-up was assessed, and the association between transitions in subclinical hypothyroid status and the rate of decline of the estimated glomerular filtration rate (eGFR) was investigated.

Results: At baseline, 127 patients were euthyroid and 41 (24.4%) patients were diagnosed with subclinical hypothyroidism. Of these 41 patients, 21 (51.2%) spontaneously resolved to euthyroid during follow-up. The rate of eGFR decline of patients with resolved subclinical hypothyroidism was similar to that of euthyroid patients. The patients with unresolved subclinical hypothyroidism showed a steeper renal function decline than patients with euthyroidism or resolved subclinical hypothyroidism (all p < 0.05). The progression to end-stage renal disease was more frequent in those with unresolved subclinical hypothyroidism than in those who were euthyroid (p = 0.006). In multivariate linear regression for rate of eGFR decrease, unresolved subclinical hypothyroidism (β = -5.77, p = 0.001), baseline renal function (β = -0.12, p < 0.001) and level of proteinuria (β = -2.36, p = 0.015) were independently associated with the rate of renal function decline.

Conclusions: Half of the CKD patients with subclinical hypothyroidism did not resolve to euthyroidism, and this lack of resolution was independently associated with rapid renal function decline.

Keywords: chronic kidney disease, progression, subclinical hypothyroidism.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Kim EO, Lee IS, Choi YA, Lee SJ, Chang YK, Yoon HE, Jang YS, Lee JM, Kim HS, Yang CW, Kim SY, Hwang HS. Unresolved Subclinical Hypothyroidism is Independently Associated with Progression of Chronic Kidney Disease. Int J Med Sci 2014; 11(1):52-59. doi:10.7150/ijms.7186. Available from http://www.medsci.org/v11p0052.htm