1. Low thyroid function is not associated with an accelerated deterioration in renal function
- Author
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Douglas C. Bauer, Anton J. M. de Craen, Giorgio Iervasi, Patricia M. Kearney, Alexandra Bremner, Graziano Ceresini, José Augusto Sgarbi, Bert Vaes, Friedo W. Dekker, Rui M. B. Maciel, Michael G. Shlipak, Sabrina Molinaro, J. Wouter Jukema, Merel van Diepen, Stella Trompet, Trine Bjøro, Waka Ohishi, Bjørn Olav Åsvold, Wendy P. J. den Elzen, Robin P. Peeters, Henry Völzke, Massimo Iacoviello, Kay-Tee Khaw, Anne R. Cappola, Mark J. Sarnak, Stephan J. L. Bakker, Christiaan L. Meuwese, Oscar H. Franco, Lars J. Vatten, Nicolas Rodondi, Luigi Ferrucci, Jacobijn Gussekloo, Misa Imaizumi, Linda P. Fried, Robert Luben, David J. Stott, John P. Walsh, Robin P. F. Dullaart, Jean Degryse, Lifestyle Medicine (LM), Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Epidemiology, and Internal Medicine
- Subjects
Male ,CHRONIC KIDNEY-DISEASE ,NONTHYROIDAL ILLNESS ,Kidney Disease ,endocrine system diseases ,030232 urology & nephrology ,Thyroid Function Tests ,030204 cardiovascular system & hematology ,GLOMERULAR-FILTRATION-RATE ,Gastroenterology ,chemistry.chemical_compound ,SUBCLINICAL HYPOTHYROIDISM ,0302 clinical medicine ,creatinine clearance ,80 and over ,Euthyroid ,Longitudinal Studies ,Renal Insufficiency ,Chronic ,610 Medicine & health ,Netherlands ,Aged, 80 and over ,medicine.diagnostic_test ,Incidence ,CARDIOVASCULAR RISK ,Thyroid ,Middle Aged ,Urology & Nephrology ,OLDER PERSONS ,Prognosis ,medicine.anatomical_structure ,Nephrology ,HEART-FAILURE ,Female ,epidemiology ,Thyroid function ,Life Sciences & Biomedicine ,360 Social problems & social services ,Glomerular Filtration Rate ,Thyroid Hormones ,medicine.medical_specialty ,Clinical Sciences ,Renal and urogenital ,Renal function ,Thyroid function tests ,03 medical and health sciences ,Meta-Analysis as Topic ,Thyroid-stimulating hormone ,Clinical Research ,chronic renal failure ,Internal medicine ,CKD ,medicine ,Humans ,Renal Insufficiency, Chronic ,Metabolic and endocrine ,Aged ,Transplantation ,Creatinine ,Science & Technology ,SERUM CREATININE ,thyroid function ,business.industry ,HORMONE REPLACEMENT THERAPY ,Thyroid Studies Collaboration ,medicine.disease ,Thyroid Diseases ,Cross-Sectional Studies ,chemistry ,RISK-FACTORS ,ORIGINAL ARTICLES ,business ,Kidney disease - Abstract
Background Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. Methods Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. Results A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) −4.07 (−6.37 to −1.78) and −2.40 (−3.78 to −1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50–4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. Conclusions Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.
- Published
- 2018
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