Subclinical and Clinical Hypothyroidism in Proteinuric Nephropathies: Amelioration of Proteinuria and Preservation of Renal Function by Thyroid Hormone Replacement Therapy
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. EKB Journal Management System, 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". EKB Journal Management System, 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', EKB Journal Management System, 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. EKB Journal Management System, 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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