1. Prevalence of hypothyroidism in Japanese chronic kidney disease patients
- Author
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Kumiko Tsuboi, Seiichiro Shishido, Akinobu Saito, Ken Sakai, Yasushi Ohashi, and Rena Yuasa
- Subjects
Adult ,Male ,Urinary protein ,endocrine system ,medicine.medical_specialty ,overt hypothyroidism ,endocrine system diseases ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,lcsh:RC870-923 ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Hypothyroidism ,Japan ,Internal medicine ,Prevalence ,medicine ,Humans ,Renal Insufficiency, Chronic ,urinary protein ,Aged ,Autoantibodies ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,non-thyroidal illness ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,female genital diseases and pregnancy complications ,subclinical hypothyroidism ,Cross-Sectional Studies ,Logistic Models ,Nephrology ,ckd ,Clinical Study ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,Research Article ,Glomerular Filtration Rate ,Kidney disease - Abstract
Background Major symptoms of progressive chronic kidney disease (CKD) are similar to those of hypothyroidism. Hidden symptoms of hypothyroidism underlying CKD are often observed in clinical practice. This study aimed to ascertain the frequency of hypothyroidism complicated by CKD, and to analyze factors impacting thyroid function. Methods During the period from April 2012 through October 2016, 510 CKD patients at our outpatient clinic were measured thyroid and kidney function for diagnosing hypothyroidism (overt hypothyroidism, OH; subclinical hypothyroidism, SH; non-thyroidal illness, NTI) and evaluating the stage of CKD. All patients were over 15 years of age. Results There were significant differences in age, estimated glomerular filtration rate (eGFR), urinary protein (UP), and serum albumin (Alb) among patients with OH, SH, and NTI compared to the normal group in univariate and multivariate analyses. UP showed the highest odds ratio of OH, SH, and NTI but no differences were recognized in gender in each group. Frequency distribution showed that the prevalence of thyroid dysfunction was greater among more severe stage of CKD with higher amount of UP. OH and SH did not show high positive ratio of anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb). NTI and normal subjects showed higher positive ratio as 50.0% and 42.9% of TgAb and TPOAb than OH and SH. Conclusions Hypothyroidism complicated by CKD exhibited a high prevalence. Age, eGFR, UP, and serum Alb were related to the prevalence of hypothyroidism, whereas gender was not and this was contradicted to the prevalence of hypothyroidism in general population. The prevalence of OH and SH was higher among patients with higher stage of CKD with increased UP. Hypothyroidism complicated by CKD may involve different onset mechanisms unrelated to antithyroid antibodies (ATAb). In CKD patients, assessments of OH and SH, as well as NTI, are needed for proper diagnosis.
- Published
- 2020
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