Thyroid hormones associate with risk of incident chronic kidney disease and rapid decline in renal function: a prospective investigation

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

†Contributed equally

Journal of Translational Medicine201614:336

DOI: 10.1186/s12967-016-1081-8

© The Author(s) 2016

Received: 14 August 2016

Accepted: 9 November 2016

Published: 3 December 2016

Abstract

Background

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:

translational-medicine.biom...

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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.

Author information

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 r.peeters@erasmusmc.nl.

Abstract

OBJECTIVES:

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.

DESIGN:

Prospective cohort study.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

PMID: 27926474

DOI: 10.1530/EJE-16-0537

[PubMed - in process]

ncbi.nlm.nih.gov/pubmed/279...

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6 Replies

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  • There is no doubt in my mind that there is some way of dealing with fluids that goes haywire in my body on levo alone. For me it seemed the fluids that normally are involved in digestion and bowel function got trapped in my tissues, as both fluid retention and constipation resolved as one within a short time of taking 10mcg t3 (and in fact when I was overmedicated my gut activity was one of the first symptoms). Less frequently we see people discuss urinary complaints (frequency, urgency etc) around thyroid issues.

    Fascinating stuff, I look forward to reading more.

  • Very pertinent. I am one of those people that apparently my eGFR is just where I function rather than it having anything to do with my thyroid. I don't like to point out to my GP the fittest I have been this year in many years thyroid wise has seen marked improvement on my eGFR. I just cuddle that piece of info to myself.

    Having said that thinking I might have a kidney infection right now so not feeling so smug!

    Good to see more research being done. I've read a couple of papers from research done in India I think that highlight the importance of T3 too. Thanks for sharing.

  • Had problems with urine output prior to TT some days would not pass any until in the night, other days would be more normal ( would feel a bit better on those occasions)

    Seemed to store it around my belly , it wasn't fat because overnight with maybe 3 massive pees belly would albut disappear.

    TT Feb had some issues in that dept for a few months after but seem to be more regular throughout the day now🙂

    I can only imagine it reflects the improvemnet I ve had with my wellbeing on T4 and T3

    (I was told I was euthyroid at the discovery of the cancer , wish I knew what my levels were then, have tried to get them from the hospital, but no luck.

    Is that related do you think with the article posted ??

    I did report it to a GP because of discomfort it produced Guess what the answer was........... Oh you probably are going , just underestimate it .🤔🤔🤔 boom boom

    Don't miss the bit where I wrote that I'm better NOW on appropriate hormones 🙂

    Love doing the faces forgive me x

  • I have ckd stage 3 found by chance from thyroid tests I hv e never had a highft4 but low in all excpt tsh.. how complicated I t all gets

  • What do you do? Die a slow agonising death or take the thyroid hormones? Its another 'scare' tactic to try and stop those taking T3.

  • I cannot see anything at all trying to stop anyone taking T3. Indeed, it looks to me like evidence in favour of T3...

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