Abstract
Background: Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free triiodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine- binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition.
Conclusion: In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies.Keywords: Nephrotic syndrome, hypothyroidism, glomerulonephritis, thyroid hormones, replacement, treatment.
Current Vascular Pharmacology
Title:Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat
Volume: 15 Issue: 5
Author(s): F. Di Mario, R. Pofi, A. Gigante*, L. Rivoli, E. Rosato, A. M. Isidori, R. Cianci and B. Barbano
Affiliation:
- Department of Clinical Medicine, Sapienza, University of Rome, Viale dell’Università, 37, 00185 Rome,Italy
Keywords: Nephrotic syndrome, hypothyroidism, glomerulonephritis, thyroid hormones, replacement, treatment.
Abstract: Background: Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free triiodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine- binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition.
Conclusion: In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies.Export Options
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Cite this article as:
Mario Di F., Pofi R., Gigante A.*, Rivoli L., Rosato E., Isidori M. A., Cianci R. and Barbano B., Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat, Current Vascular Pharmacology 2017; 15 (5) . https://dx.doi.org/10.2174/1570161115999170207114706
DOI https://dx.doi.org/10.2174/1570161115999170207114706 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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