Two unusual cases of hypothyroidism with renal dysfunction (original) (raw)

Renal Dysfunction in Hypothyroid Patients Estimation of Blood Urea, Serum Creatinine, T3, T4 and TSH

Introdction: Thyroid gland produces two principal hormones-Thyroxine (T4) and triiodothyronine (T3). They act on thyroid α and β receptors for performing various functions. To maintain the growth and metabolism of renal system, they play an indispensable role. Decrease or fall in the activity of renal system is accompanied by compensatory alteration in the level, synthesis and metabolism of thyroid hormones. It is well established fact that renal system is affected by hypothyroid states of the body. Hence; we evaluated the effect of hypothyroidism on the renal functions of the body. Material and methods: The present study included assessment of 80 patients who reported to the department with the chief problem of hypothyroidism. 80 healthy controls were also evaluated for comparing with the study group. With the help of a disposable syringe, approximately 4 ml of venous blood was withdrawn from the patients under sterile and aseptic conditions. Clotting of the blood was allowed to occur followed by separation of the serum of the patients by a centrifugation machine at three thousand revolutions per minute. Following methods were used for the assessment of creatinine and blood urea levels; Modified Jaffe's method for estimation of serum creatinine and Modified Trinder peroxide method for the estimation of blood urea. All the results were analyzed by SPSS software. Results: Mean age of the patients in the control group and in the hypothyroid group was 39.5 and 36.8 years respectively. Non-significant results were obtained while comparing the demographic details of the patients in the two study groups. Mean level of T3 in the control group and in the hypothyroid group was 1.15 and 0.82 ng/ml respectively. Mean level of T4 in the control group and hypothyroid group were 8.91 and 4.75 µg/dl respectively. However; while comparing the mean levels of T3, T4 and TSH in between the two study groups, significant difference was obtained. Conclusion: Thyroid hormones have a profuse effect on the renal system.

Hypothyroidism presenting as reversible renal impairment: an interesting case report

Renal Failure, 2013

We describe an interesting case of reversible renal impairment secondary to hypothyroidism. A 57-years-old man was referred from peripheral institution for evaluation of elevated serum creatinine. He had vague complaints of weakness, lethargy and muscle ache but no urinary symptoms. He was found to have hypothyroidism, and thyroid hormone replacement therapy (THRT) was started which resulted in reversal of the renal dysfunction. There was marked improvement in estimated glomerular filtration rate. 99mTc DTPA renal scans done before and after THRT suggested hypothyroidism responsible for this reversible renal impairment. Several studies have described the pathophysiology of diminished renal function in hypothyroidism. Few studies or case reports have shown total amelioration of renal impairment as seen in our patient. The etiology is presumed to be multifactorial, in which hemodynamic effects and a direct effect of thyroid hormone on the kidney play an important role. We suggest that patients with renal impairment of unknown cause have thyroid function tests undertaken as part of routine investigation.

Kidney failure in the elderly due to hypothyroidism: a case report

Sao Paulo Medical Journal, 2008

CONTEXT: Hypothyroidism is more prevalent in the elderly and its symptoms can be confused with other changes due to aging. Doctors caring for the elderly need to be attentive to this diagnostic possibility. This case report case is notable not only because it presents a rare complication of hypothyroidism (kidney failure), but also because patients with chronic kidney failure of any etiology may suffer increased renal dysfunction as a result. CASE REPORT: This was a 66-year-old male outpatient with a history of generalized edema over the preceding eight years, with periods of worsening, that was intractable to treatment with diuretics. Physical examination revealed bradycardia (heart rate: 52 bpm), pallor, dry and infiltrated skin, macroglossia, edema in the lower limbs and a palpable thyroid with hard consistency. Laboratory tests showed: creatinine 3.9 mg/dl; urea 95 mg/dl; potassium 6.0 mEq/l; thyroid-stimulating hormone > 100 mUI/ml; triiodothyronine 0.01 ng/dl; free thyroxin...

CHANGES IN BIOCHEMICAL MARKERS OF RENAL FUNCTION IN SUBCLINICAL AND OVERT HYPOTHYROIDISM

The present study aimed to determine whether thyroid dysfunction has deleterious effects on renal function. Both renal function tests (urea, creatinine and uric acid) and thyroid function tests (TSH, fT3 and fT4) were conducted in 100 patients with euthyroid status and 50 patients with subclinical and overt hypothyroidism respectively. A statistically significant rise in the levels of urea and creatinine has been observed in patients with subclinical and overt hypothyroidism as compared to euthyroid subjects. Also, a positive correlation been observed between the rise in TSH levels and creatinine in patients with overt hypothyroidism. A statistically significant rise in uric acid levels has been observed in patients with overt hypothyroidism as compared to controls. These observations are suggestive of monitoring the renal function in patients with hypothyroidism.

Reversal deterioration of renal function accompanied with primary hypothyrodism

Vojnosanitetski pregled. Military-medical and pharmaceutical review, 2012

Hypothyroidism is often accompanied with decline of kidney function, or inability to maintain electrolyte balance. These changes are usually overlooked in everyday practice. Early recognition of this association eliminates unnecessary diagnostic procedures that postpone the adequate treatment. Two patients with elevated serum creatinine levels due to primary autoimmune hypothyroidism, with complete recovery of creatinine clearance after thyroid hormone substitution therapy are presented. The first patient was a young male whose laboratory tests suggested acute renal failure, and the delicate clinical presentation of reduced thyroid function. The second patient was an elderly woman with a history of a long-term signs and symptoms attributed to ageing, including the deterioration of renal function, with consequently delayed diagnosis of hypothyroidism. Serum thyrotropin and thyroxin levels measurement should be done in all cases of renal failure with undefined renal desease, even if t...

Renal function impairment in Hypothyroidism

Bangladesh Journal of Medical Biochemistry, 2013

Background: Hypothyroidism is an important public health problem in Bangladesh. It is associated with increased risk for atherosclerosis and other complications. The frank development of hypothyroidism is associated with metabolic derangements including dyslipidemia- which is an etiopathologic factor for development of renal impairment. This study was to evaluate whether hypothyroidism is associated with impaired renal function. Methods: Using a cross sectional analytical study design, a total of 111 subjects attending Out Patient Department, Center for Nuclear Medicine and Ultrasound, Bogra Medical College during January 2007 to December 2007 were included purposively. Eighty newly diagnosed hypothyroid patients (Group I) and 31 healthy adults (Group II) were enrolled in this study. Serum thyroid stimulating hormone and serum free thyroxine were assayed by radioimmunoassay. Serum fasting lipid profile, serum creatinine and serum uric acid were estimated by enzymatic colorimetric me...

Evaluation of renal function in subclinical hypothyroidism

Journal of laboratory physicians

Patients with subclinical hypothyroidism (SCH) have a few or no symptoms or signs of thyroid dysfunction and thus by its very nature, SCH is a laboratory diagnosis. Serum creatinine is elevated and glomerular filtration rate (GFR) values are reversibly reduced in overt hypothyroid patients. We hypothesize that SCH also may be associated with low GFR. The objective of this study was (1) to know the effect of SCH on kidney function, (2) to find the correlation between the renal function parameter creatinine, estimated GFR (eGFR), and thyroid-stimulating hormone (TSH), and (3) to know if creatinine values can be predicted by TSH values in SCH cases. This is a hospital-based cross-sectional study for 1 year. A total of 608 subjects of either sex were included in the study and were divided into 3 groups: (1) SCH, (2) overt hypothyroidism (OHT), and (3) euthyroidism (ET). TSH, free triiodothyronine, free thyroxine, and serum creatinine were estimated and eGFR was calculated using modifica...