Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism

Dong Ho Shin, Mi Jung Lee, Hye Sun Lee, Hyung Jung Oh, Kwang Il Ko, Chan Ho Kim, Fa Mee Doh, Hyang Mo Koo, Hyoung Rae Kim, Jae Hyun Han, Jung Tak Park, SeungHyeok Han, TaeHyun Yoo, Shin-Wook Kang

Research output: Contribution to journalArticle

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Abstract

Background: Subclinical hypothyroidism (SCH) is not a rare condition in females, the elderly, or patients with chronic kidney disease (CKD). Even though previous studies have demonstrated that thyroid hormone replacement therapy (THRT) improves cardiac function and dyslipidemia in patients with SCH, it remains unclear as to whether THRT can improve renal function in CKD patients with SCH. This study investigated the impact of THRT on changes in estimated glomerular filtration rates (eGFR) in this patient population. Methods: A total of 113 CKD patients with SCH who were treated with L-thyroxine and had eGFR available for at least 24 months before and after THRT were enrolled between January 2005 and December 2011. A linear mixed model was used to compare patients' clinical and biochemical parameters at various time points. The slope of the decline in eGFR over time, both before and after THRT, was also calculated and compared using a linear mixed model. Results: The mean age of the study participants was 63.2±12.7 years, and 36 patients (31.9%) were men. The mean follow-up duration before and after THRT was 28.6±4.5 and 30.6±6.4 months respectively. After 24 months of THRT, serum thyrotropin (TSH) levels were significantly reduced - 8.86±0.49 versus 1.41±0.73 μIU/mL, p<0.001 - but there were no significant changes in triiodothyronine and free thyroxine concentrations. Serum albumin, calcium, phosphate, cholesterol, and triglyceride levels were also comparable before and after THRT. The rates of decline in eGFR were significantly attenuated by THRT (-4.31±0.51 vs.-1.08±0.36 [mL/min]/[year·1.73 m 2 ], p<0.001), even after adjustment for age, sex, diabetes, mean arterial pressure, and serum albumin, cholesterol, and triglyceride concentrations (p<0.001). Conclusion: THRT attenuated the rate of decline in renal function in CKD patients with SCH, suggesting that THRT may delay reaching end-stage renal disease in these patients.

Original languageEnglish
Pages (from-to)654-661
Number of pages8
JournalThyroid
Volume23
Issue number6
DOIs
Publication statusPublished - 2013 Jun 1

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Hormone Replacement Therapy
Hypothyroidism
Thyroid Hormones
Chronic Renal Insufficiency
Kidney
Glomerular Filtration Rate
Thyroxine
Serum Albumin
Linear Models
Triglycerides
Cholesterol
Triiodothyronine
Thyrotropin
Dyslipidemias
Chronic Kidney Failure
Arterial Pressure

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Shin, Dong Ho ; Lee, Mi Jung ; Lee, Hye Sun ; Oh, Hyung Jung ; Ko, Kwang Il ; Kim, Chan Ho ; Doh, Fa Mee ; Koo, Hyang Mo ; Kim, Hyoung Rae ; Han, Jae Hyun ; Park, Jung Tak ; Han, SeungHyeok ; Yoo, TaeHyun ; Kang, Shin-Wook. / Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism. In: Thyroid. 2013 ; Vol. 23, No. 6. pp. 654-661.
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title = "Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism",
abstract = "Background: Subclinical hypothyroidism (SCH) is not a rare condition in females, the elderly, or patients with chronic kidney disease (CKD). Even though previous studies have demonstrated that thyroid hormone replacement therapy (THRT) improves cardiac function and dyslipidemia in patients with SCH, it remains unclear as to whether THRT can improve renal function in CKD patients with SCH. This study investigated the impact of THRT on changes in estimated glomerular filtration rates (eGFR) in this patient population. Methods: A total of 113 CKD patients with SCH who were treated with L-thyroxine and had eGFR available for at least 24 months before and after THRT were enrolled between January 2005 and December 2011. A linear mixed model was used to compare patients' clinical and biochemical parameters at various time points. The slope of the decline in eGFR over time, both before and after THRT, was also calculated and compared using a linear mixed model. Results: The mean age of the study participants was 63.2±12.7 years, and 36 patients (31.9{\%}) were men. The mean follow-up duration before and after THRT was 28.6±4.5 and 30.6±6.4 months respectively. After 24 months of THRT, serum thyrotropin (TSH) levels were significantly reduced - 8.86±0.49 versus 1.41±0.73 μIU/mL, p<0.001 - but there were no significant changes in triiodothyronine and free thyroxine concentrations. Serum albumin, calcium, phosphate, cholesterol, and triglyceride levels were also comparable before and after THRT. The rates of decline in eGFR were significantly attenuated by THRT (-4.31±0.51 vs.-1.08±0.36 [mL/min]/[year·1.73 m 2 ], p<0.001), even after adjustment for age, sex, diabetes, mean arterial pressure, and serum albumin, cholesterol, and triglyceride concentrations (p<0.001). Conclusion: THRT attenuated the rate of decline in renal function in CKD patients with SCH, suggesting that THRT may delay reaching end-stage renal disease in these patients.",
author = "Shin, {Dong Ho} and Lee, {Mi Jung} and Lee, {Hye Sun} and Oh, {Hyung Jung} and Ko, {Kwang Il} and Kim, {Chan Ho} and Doh, {Fa Mee} and Koo, {Hyang Mo} and Kim, {Hyoung Rae} and Han, {Jae Hyun} and Park, {Jung Tak} and SeungHyeok Han and TaeHyun Yoo and Shin-Wook Kang",
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Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism. / Shin, Dong Ho; Lee, Mi Jung; Lee, Hye Sun; Oh, Hyung Jung; Ko, Kwang Il; Kim, Chan Ho; Doh, Fa Mee; Koo, Hyang Mo; Kim, Hyoung Rae; Han, Jae Hyun; Park, Jung Tak; Han, SeungHyeok; Yoo, TaeHyun; Kang, Shin-Wook.

In: Thyroid, Vol. 23, No. 6, 01.06.2013, p. 654-661.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism

AU - Shin, Dong Ho

AU - Lee, Mi Jung

AU - Lee, Hye Sun

AU - Oh, Hyung Jung

AU - Ko, Kwang Il

AU - Kim, Chan Ho

AU - Doh, Fa Mee

AU - Koo, Hyang Mo

AU - Kim, Hyoung Rae

AU - Han, Jae Hyun

AU - Park, Jung Tak

AU - Han, SeungHyeok

AU - Yoo, TaeHyun

AU - Kang, Shin-Wook

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: Subclinical hypothyroidism (SCH) is not a rare condition in females, the elderly, or patients with chronic kidney disease (CKD). Even though previous studies have demonstrated that thyroid hormone replacement therapy (THRT) improves cardiac function and dyslipidemia in patients with SCH, it remains unclear as to whether THRT can improve renal function in CKD patients with SCH. This study investigated the impact of THRT on changes in estimated glomerular filtration rates (eGFR) in this patient population. Methods: A total of 113 CKD patients with SCH who were treated with L-thyroxine and had eGFR available for at least 24 months before and after THRT were enrolled between January 2005 and December 2011. A linear mixed model was used to compare patients' clinical and biochemical parameters at various time points. The slope of the decline in eGFR over time, both before and after THRT, was also calculated and compared using a linear mixed model. Results: The mean age of the study participants was 63.2±12.7 years, and 36 patients (31.9%) were men. The mean follow-up duration before and after THRT was 28.6±4.5 and 30.6±6.4 months respectively. After 24 months of THRT, serum thyrotropin (TSH) levels were significantly reduced - 8.86±0.49 versus 1.41±0.73 μIU/mL, p<0.001 - but there were no significant changes in triiodothyronine and free thyroxine concentrations. Serum albumin, calcium, phosphate, cholesterol, and triglyceride levels were also comparable before and after THRT. The rates of decline in eGFR were significantly attenuated by THRT (-4.31±0.51 vs.-1.08±0.36 [mL/min]/[year·1.73 m 2 ], p<0.001), even after adjustment for age, sex, diabetes, mean arterial pressure, and serum albumin, cholesterol, and triglyceride concentrations (p<0.001). Conclusion: THRT attenuated the rate of decline in renal function in CKD patients with SCH, suggesting that THRT may delay reaching end-stage renal disease in these patients.

AB - Background: Subclinical hypothyroidism (SCH) is not a rare condition in females, the elderly, or patients with chronic kidney disease (CKD). Even though previous studies have demonstrated that thyroid hormone replacement therapy (THRT) improves cardiac function and dyslipidemia in patients with SCH, it remains unclear as to whether THRT can improve renal function in CKD patients with SCH. This study investigated the impact of THRT on changes in estimated glomerular filtration rates (eGFR) in this patient population. Methods: A total of 113 CKD patients with SCH who were treated with L-thyroxine and had eGFR available for at least 24 months before and after THRT were enrolled between January 2005 and December 2011. A linear mixed model was used to compare patients' clinical and biochemical parameters at various time points. The slope of the decline in eGFR over time, both before and after THRT, was also calculated and compared using a linear mixed model. Results: The mean age of the study participants was 63.2±12.7 years, and 36 patients (31.9%) were men. The mean follow-up duration before and after THRT was 28.6±4.5 and 30.6±6.4 months respectively. After 24 months of THRT, serum thyrotropin (TSH) levels were significantly reduced - 8.86±0.49 versus 1.41±0.73 μIU/mL, p<0.001 - but there were no significant changes in triiodothyronine and free thyroxine concentrations. Serum albumin, calcium, phosphate, cholesterol, and triglyceride levels were also comparable before and after THRT. The rates of decline in eGFR were significantly attenuated by THRT (-4.31±0.51 vs.-1.08±0.36 [mL/min]/[year·1.73 m 2 ], p<0.001), even after adjustment for age, sex, diabetes, mean arterial pressure, and serum albumin, cholesterol, and triglyceride concentrations (p<0.001). Conclusion: THRT attenuated the rate of decline in renal function in CKD patients with SCH, suggesting that THRT may delay reaching end-stage renal disease in these patients.

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