I found this new paper of interest for several reasons.
In the context of a seemingly T3-phobic health system, this statement rings very loud bells:
Higher FT4, but not TSH and FT3, was associated with increased risk of incident CKD and rapid eGFR decline in middle-aged and elderly Chinese.
Of course, there could be something about the Chinese genetic make-up which is of significance, but I rather suspect not.
Although very much on the anecdotal end of the scale, it feels as if we have a lot of reference to people feeling as if their water balances are not quite right.
And kidneys are the often-ignored location for at least some thyroid hormone conversion.
Thyroid hormones associate with risk of incident chronic kidney disease and rapid decline in renal function: a prospective investigation
Xiaolin Huang†, Lin Ding†, Kui Peng, Lin Lin, Tiange Wang, Zhiyun Zhao, Yu Xu, Jieli Lu, Yuhong Chen, Weiqing Wang, Yufang Bi, Guang Ning and Min XuEmail author
Journal of Translational Medicine201614:336
© The Author(s) 2016
Received: 14 August 2016
Accepted: 9 November 2016
Published: 3 December 2016
Thyroid hormones have been associated with renal dysfunction in cross-sectional studies. However, prospective studies exploring the effect of thyroid hormones on renal function decline were sparse and got contradictive results. We aimed to prospectively explore the associations of thyroid hormones with incident chronic kidney disease (CKD) and rapid decline in estimated glomerular filtration rate (eGFR) in Chinese adults.
Full paper freely available here:
Added: 2016/12/08 18:30
Eur J Endocrinol. 2016 Dec;175(6):653-660.
The association of thyroid function and the risk of kidney function decline: a population-based cohort study.
Chaker L1,2,3, Sedaghat S3, Hoorn EJ2, Elzen WP4, Gussekloo J5, Hofman A3,6, Ikram MA3,7, Franco OH3, Dehghan A3, Peeters RP8,2,3.
1Rotterdam Thyroid Center.
2Department of Internal Medicine.
3Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
4Department of Clinical Chemistry and Laboratory Medicine.
5Department of Public Health and Primary CareLeiden University Medical Center, Leiden, The Netherlands.
6Harvard T H Chan School of Public HealthBoston, Massachusetts, USA.
7Department of NeurologyErasmus University Medical Center, Rotterdam, The Netherlands.
8Rotterdam Thyroid Center email@example.com.
Thyroid dysfunction has been associated with kidney function decline, but mainly in cross-sectional studies. Therefore, we aimed to determine the association between thyroid and kidney function in a prospective population-based cohort study longitudinally.
Prospective cohort study.
Participants aged ≥45 years from the Rotterdam Study with thyroid and kidney function assessment were included. Kidney function and new onset chronic kidney disease (CKD) were defined using estimated glomerular filtration ate (eGFR), with CKD defined as eGFR <60 mL/min/1.73 m2 according to the CKD-EPI formula.
We included 5103 participants (mean age of 63.6 years) with a mean follow-up of 8.1 years. Cross-sectionally, higher TSH levels were associated with lower eGFR (Beta (β): -1.75 mL/min; 95% confidence interval (CI): -2.17, -1.33), in multivariable models adjusting for several cardiovascular risk factors including smoking, hypertension and history of coronary heart disease among others. In contrast, longitudinally, higher TSH levels were associated with less annual eGFR decline (β: -0.06 mL/min; CI: -0.11, -0.01) and lower CKD incidence (odds ratio 0.85, CI; 0.75, 0.96). Compared with euthyroid participants, subclinical hyperthyroid individuals had an increased risk for CKD whereas hypothyroid individuals had a decreased risk (P for trend = 0.04).
Hyperactive thyroid function is associated with increased risk of kidney function decline while hypothyroidism is associated with a decreased CKD risk. More insight is needed in the pathophysiological pathways connecting high thyroid function and kidney function decline.
© 2016 European Society of Endocrinology.
[PubMed - in process]