Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat

Author(s): F. Di Mario, R. Pofi, A. Gigante*, L. Rivoli, E. Rosato, A. M. Isidori, R. Cianci, B. Barbano.

Journal Name: Current Vascular Pharmacology

Volume 15 , Issue 5 , 2017

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Abstract:

Background: Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free triiodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine- binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition.

Conclusion: In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies.

Keywords: Nephrotic syndrome, hypothyroidism, glomerulonephritis, thyroid hormones, replacement, treatment.

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Article Details

VOLUME: 15
ISSUE: 5
Year: 2017
Page: [398 - 403]
Pages: 6
DOI: 10.2174/1570161115999170207114706
Price: $58

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