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Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat

[ Vol. 15 , Issue. 5 ]

Author(s):

F. Di Mario, R. Pofi, A. Gigante, L. Rivoli, E. Rosato, A. M. Isidori, R. Cianci and B. Barbano   Pages 398 - 403 ( 6 )

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.

Affiliation:

Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Department of Experimental Medicine, Sapienza University of Rome, Rome, Department of Clinical Medicine, Sapienza, University of Rome, Viale dell’Università, 37, 00185 Rome, Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Department of Clinical Medicine, Sapienza University of Rome, Rome, Department of Experimental Medicine, Sapienza University of Rome, Rome, Department of Clinical Medicine, Sapienza University of Rome, Rome, Department of Clinical Medicine, Sapienza University of Rome, Rome

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