Abstract
Elevated levels of thyroid-stimulating-hormone (TSH) are associated with reduced glomerular filtration rate (GFR) and increased risk of developing chronic kidney disease even in euthyroid patients. Thyroid hormone replacement therapy has been shown to delay progression to end-stage renal disease in sub-clinically hypothyroid patients with renal insufficiency. However, such associations after kidney transplantation were never investigated. In this study the association of thyroid hormones and estimated GFR (eGFR) in euthyroid patients after kidney transplantation was analyzed. In total 398 kidney transplant recipients were assessed retrospectively and association between thyroid and kidney function parameters at and between defined time points, 12 and 24 months after transplantation, was studied. A significant inverse association was shown for TSH changes and eGFR over time between months 12 and 24 post transplantation. For each increase of TSH by 1 µIU/mL, eGFR decreased by 1.34 mL/min [95% CI, −2.51 to −0.16; p = 0.03], corresponding to 2.2% eGFR decline, within 12 months. At selected time points 12 and 24 months post transplantation, however, TSH was not associated with eGFR. In conclusion, an increase in TSH between 12 and 24 months after kidney transplantation leads to a significant decrease in eGFR, which strengthens the concept of a kidney-thyroid-axis.
Highlights
Interactions between thyroid hormones and kidney function have been suggested in previous studies
It was hypothesized that correction of subclinical hypothyroidism by thyroid hormone replacement therapy (THRT) would stabilize and increase renal function measured by estimated GFR (eGFR) over time
The association between TSH, T3, FT4 and T4 and eGFR was tested at 12 and 24 months after renal transplantation. It was examined whether TSH, T3, FT4 and T4 concentration at 12 months after transplantation affects the course of eGFR within the following 12 months
Summary
Interactions between thyroid hormones and kidney function have been suggested in previous studies. Data from animal studies show that thyroid hormones are important players in the development and growth of kidneys[1,2]. Thyroid hormone replacement therapy has been shown to preserve renal function and attenuate the decline of eGFR in patients with CKD and subclinical hypothyroidism[15,16]. Many CKD effects on thyroid function (low-T3 syndrome, subclinical hypothyroidism) normalize after kidney transplantation (KTx)[17]. We analyzed data from 398 euthyroid CKD patients who received kidney transplants between 2003 and 2016 to investigate the effect of the thyroid function parameters TSH, triiodothyronine (T3), free thyroxine (FT4) and thyroxine (T4) and their dynamics on eGFR course
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
