Hassan, S., El Shahawy, E., Mahmoud, A., Ali, E., Ibrahim, M. (2021). Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy. test, 83(1), 1496-1503. doi: 10.21608/ejhm.2021.170514
Saddam A Hassan; El Metwally L. El Shahawy; Ashraf Talaat Mahmoud; Enas Mamdouh Mohamed Ali; Mohamed E. Ibrahim. "Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy". test, 83, 1, 2021, 1496-1503. doi: 10.21608/ejhm.2021.170514
Hassan, S., El Shahawy, E., Mahmoud, A., Ali, E., Ibrahim, M. (2021). 'Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy', test, 83(1), pp. 1496-1503. doi: 10.21608/ejhm.2021.170514
Hassan, S., El Shahawy, E., Mahmoud, A., Ali, E., Ibrahim, M. Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy. test, 2021; 83(1): 1496-1503. doi: 10.21608/ejhm.2021.170514

Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy

The Egyptian Journal of Hospital Medicine
Article 106, Volume 83, Issue 1, April 2021, Pages 1496-1503    PDF (551.88 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2021.170514
Authors
Saddam A Hassan* 1; El Metwally L. El Shahawy2; Ashraf Talaat Mahmoud2; Enas Mamdouh Mohamed Ali2; Mohamed E. Ibrahim2
19, Saad Zaghloul, Kasr Alaini
2Internal Medicine Department, Faculty of Medicine, Benha University, Benha, Egypt
Abstract
Background: Emerging evidence shows a bi-directional talk between the kidney and thyroid; yet to date, sparse data exist as to the screening and treatment of hypothyroid states, whether Subclinical Hypothyroidism (SCH) or Clinical Hypothyroidism (CHT), in Chronic Kidney Disease (CKD) patients.
Objectives: The aim of the current study was to examine the association between thyroid hypofunction (whether subclinical or clinical) and proteinuric CKD (low eGFR and/or proteinuria), and to assess the impact of treating thyroid hypofunction on the progression of CKD.
Patients and methods: We conducted a prospective cohort study on 100 participants with baseline proteinuric CKD who were subcategorized according to their thyroid status into three groups: 20 euthyroid, 40 (SCH), 40 (CHT). All subjects were then followed up for 2 years after receiving Thyroid Hormone Replacement Therapy (THRT) according to their thyroid status.
Results: At baseline, we found a highly statistically significant association between SCH/CHT and low eGFR and proteinuria (P-value  0.001 for both) in univariate and multivariate analyses. After THRT, we found a statistically significant reduction in CKD progression as evidenced by preservation of mean eGFR and decrease in proteinuria in both groups with SCH and CHT (P-value  0.001 and 0.016 respectively) after the first 6 months of treatment that persisted over the remainder of 2-year follow-up period at a P-value 0.001.
Conclusion: The current study demonstrated a strong association between baseline proteinuric CKD and hypothyroid states and showed that THRT significantly halted CKD progression in hypothyroid patients who achieved euthyroid state.

Keywords
Chronic Kidney Disease (CKD); Proteinuria; Subclinical Hypothyroidism (SCH); Thyroid Hormone Replacement Therapy (THRT)
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