Thyroid function in patients with idiopathic nephrotic syndrome

Singh, Sukh Mahendra; Mishra, Om P.; Mandal, Partha Pratim; Patel, Prem; Sharma, Shiv Shankar; Saini, Harish; Chandrasekhar, Sreenidhi; Singh, Manjit

doi:10.1007/s11255-020-02778-3

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…In this study, we found 91/420 (21.7%) patients with pMN suffered from thyroid dysfunction, and subclinical hypothyroidism 48/420 (11.4%) was the dominant disorder. These results were consistent with other studies in patients with proteinuria [ 3 , 6 , 7 ]. However, Li et found 260/317 (82.0%) patients with nephrotic syndrome showed abnormal thyroid function, consisting of 61 (19.2%) patients with subclinical hypothyroidism, 83 (26.2%) patients with overt hypothyroidism, and 116 patients (36.6%) with euthyroid sick syndrome [ 4 ].…”

Section: Discussionsupporting

confidence: 94%

“…The level of TSH also associated with the serum albumin. Similar results were found in almost all the previous studies [ 1 , 3 , 4 , 6 , 7 ]. These findings seemed to indicate that the thyroid dysfunction in patients with pMN might be also secondary to the loss of thyroid hormones from urine, as thought in studies of patients with proteinuria [ 3 , 14 , 15 , 17 ].…”

Section: Discussionsupporting

confidence: 92%

“…It is commonly known that hypothyroidism usually occurs in patients with proteinuria, in particular nephrotic syndrome. In addition to a series of cases [ 1 , 2 ], several cohort studies also reported that patients with massive proteinuria may develop subclinical hypothyroidism or overt hypothyroidism [ 3 – 7 ]. Li et al found the incidence of thyroid dysfunction, including subclinical hypothyroidism, overt hypothyroidism and low T3/T4 syndrome in patients with nephrotic syndrome could be as high as 82.0% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Significance of thyroid dysfunction in the patients with primary membranous nephropathy

Cao

Mao

et al. 2022

BMC Nephrol

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Background Thyroid dysfunction is common in patients with nephrotic syndrome, especially patients with primary membranous nephropathy (pMN). In view of both MN and thyroid dysfunction are associated with autoimmunity, the current study aimed to elucidate the significance of thyroid dysfunction in patients with pMN. Methods Four hundred and twenty patients with biopsy-proven pMN from 2018–2021 were retrospectively enrolled. Clinical and pathological parameters, and treatment response of patients with and without thyroid dysfunction were analyzed. Results Ninety-one (21.7%) patients with pMN suffered from thyroid dysfunction, among which subclinical hypothyroidism (52.7%) was the main disorder. Compared to patients with normal thyroid function, patients with thyroid dysfunction presented with a higher level of proteinuria, a lower level of serum albumin, a higher level of serum creatinine and more severe tubulointerstitial injury at the time of biopsy. But the positive rate and level of circulating anti-phospholipase A2 receptor (PLA2R) antibody were comparable between these two groups. Though following the similar treatment, the percentage of no response to treatment were significantly higher in the patients with thyroid dysfunction (38.6 vs. 20.0%, P = 0.003). Similar to the urinary protein and the positivity of anti-PLA2R antibody, multivariate COX analysis showed thyroid dysfunction was also identified as an independent risk factor for the failure to remission (HR = 1.91, 95%CI, 1.07–3.40, P = 0.029). Conclusion In conclusion, thyroid dysfunction is common in the patients with pMN and might predict a severe clinical manifestation and a poor clinical outcome, which indicated that the thyroid dysfunction might be involved in the disease progression of pMN.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Significance of thyroid dysfunction in the patients with primary membranous nephropathy

Cao

Mao

et al. 2022

BMC Nephrol

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“…Subclinical hypothyroidism has been associated with hypertension, dyslipidemia, and cardiovascular morbidities through endothelial dysfunction. 20 Jagadeeswari showed that hypothyroidism was more common in children with NS. FT 4 and FT 3 levels in patients with NS were significantly lower than the control group, while TSH level was high.…”

Section: Resultsmentioning

confidence: 99%

Disease-Associated Systemic Complications in Childhood Nephrotic Syndrome: A Systematic Review

Hilmanto

Mawardi

Lestari

et al. 2022

IJNRD

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Introduction Nephrotic syndrome (NS) is one of the most common childhood kidney diseases. During the active phase, the disease pathogenesis affects various biological functions linked to loss of proteins negatively, which can result in systemic complications. Complications of childhood NS are divided into two categories: disease-associated complications and drug-associated complications. However, complications in pediatric patients with NS, especially disease-associated complications are still limited. Although reported in the literature, information is not comprehensive and needs to be updated. This study aimed to systematically assess systemic complications in children with NS, especially disease-associated complications, to better understand how they impact outcomes. Methods We conducted a systematic search of several databases: BioMed Central Pediatrics, PubMed, Google Scholar, the National Library of Medicine, Cochrane Library, CINAHL/EBSCO, British Medical Journal , Science Direct, Scopus, and Elsevier’s ClinicalKey. We followed the PRISMA guidelines to plan, conduct, and report this review. We used the Joanna Briggs Institute’s critical appraisal tools for assuring the quality of the journal articles that were chosen. Results Eleven articles concerning complications in childhood NS were analyzed. Systemic disease-associated complications in covered were cardiovascular complications, infections, thyroid-hormone complication, kidney complications, and oral health complications. Conclusion NS is marked by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia, which can result in systemic disease-associated complications. Cardiovascular complications, infections, thyroid-hormone complications, kidney complications, and oral health complications are the main systemic complications in childhood NS. It is essential that health-care providers prevent these complications for proper maintenance of patients’ health.

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“…Hipotireoidismo foi detectado em 9,6% dos pacientes. O hipotireoidismo foi encontrado em 20-26,2% dos pacientes com SNCR e a maioria dos casos apresentou hipotireoidismo subclínico 25,26 . Perda de proteínas na urina, tais como proteína de ligação à tireoide, pré-albumina e albumina, resultam na diminuição do nível de proteína sérica, tireoglobulina e níveis de T3.…”

Section: Discussionunclassified

Desfechos de crianças com síndrome nefrótica idiopática córtico-resistente: um estudo observacional de centro único

et al. 2023

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RESUMO Introdução: A síndrome nefrótica idiopática córtico-resistente (SNICR) apresenta desfechos variáveis em crianças. O objetivo principal deste estudo foi avaliar a taxa de remissão cumulativa. Os objetivos secundários foram avaliar fatores que afetam status de remissão, sobrevida da função renal e efeitos adversos de medicamentos. Métodos: Foram incluídos 114 pacientes com SNCR. Utilizou-se protocolo de tratamento baseado em inibidores de calcineurina juntamente com prednisolona e inibidor da enzima conversora de angiotensina. Os pacientes foram acompanhados durante 5 anos. Resultados: A idade mediana foi 4,5 anos; 53,5% dos casos tinham entre 1 e 5 anos. 62 pacientes (54,4%) estavam em estágio inicial; 52 (45,6%) em estágio tardio da SNCR. A TFGecr mediana foi 83,5 mL/min/1,73 m2 na apresentação. Dos 110 pacientes, 63 (57,3%) alcançaram remissão [remissão completa 30 (27,3%), remissão parcial 33 (30%)], e 47 (42,7%) não apresentaram remissão. A sobrevida da função renal foi 87,3%; 14 casos (12,7%) progrediram para DRC (G3-8, G4-3, G5-1, G5D-2). A duração mediana do acompanhamento foi 36 meses (IIQ 24, 60). Idade no início, ciclosporina/tacrolimus, TFGecr e histopatologia (DLM/GESF) não afetaram a remissão. Igualmente, status de remissão, além da idade no início, protocolo de medicamentos e histopatologia não afetaram significativamente a função renal por 5 anos. Observou-se hipertensão, fácies cushingoide, baixa estatura, catarata e obesidade em 37,7; 29,8; 25,5; 17,5; e 0,7% dos casos, respectivamente. Conclusão: Aproximadamente metade dos casos alcançou remissão. Idade no início, uso de ciclosporina/tacrolimus e lesão histopatológica não afetaram o status de remissão nem a sobrevida da função renal a curto prazo na SNICR.

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Thyroid function in patients with idiopathic nephrotic syndrome

Cited by 10 publications

References 22 publications

Significance of thyroid dysfunction in the patients with primary membranous nephropathy

Significance of thyroid dysfunction in the patients with primary membranous nephropathy

Disease-Associated Systemic Complications in Childhood Nephrotic Syndrome: A Systematic Review

Desfechos de crianças com síndrome nefrótica idiopática córtico-resistente: um estudo observacional de centro único

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