Browse > Article

Prevalence of Hypothyroidism in Patients with Chronic Kidney Disease  

Lee, Da-Hyen (Department of Nephrology, National Medical Center)
Jeon, Young-Deok (Department of Nephrology, National Medical Center)
Lee, Seung-Hun (Department of Nephrology, National Medical Center)
Mun, Ga-Seul (Department of Nephrology, National Medical Center)
Na, Su-Sie (Department of Nephrology, National Medical Center)
Cha, Huk-Hwan (Department of Nephrology, National Medical Center)
Publication Information
The Korean Journal of Medicine / v.81, no.3, 2011 , pp. 334-339 More about this Journal
Abstract
Background/Aims: Primary thyroid disease is prevalent in chronic renal disease, especially in patients requiring chronic dialysis. However, the relationship between kidney function and the prevalence of primary thyroid disease has not been studied in Korea, a nation where the dietary iodine intake is excessive. Methods: Retrospective data from 2201 consecutive adult patients who visited a health promotion center over the last 5 years were analyzed; specifically, 54 patients with chronic kidney disease not requiring hemodialysis and 64 adults treated with hemodialysis. The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease equation. Multivariable logistic regression was used to evaluate the independent association between the prevalence of primary hypothyroidism and estimated GFR. Results: The prevalence of overt hypothyroidism increased from 0.5% at an estimated GFR > 90 mL/min/$1.73\;m^{2}$ to 6.3% in end-stage renal disease requiring chronic dialysis (p < 0.001 for trend). Compared with participants with an estimated GFR > 60 mL/min/$1.73\;m^{2}$, those with an estimated GFR < 60 mL/min per $1.73\;m^{2}$ had an increased odds of overt hypothyroidism after adjusting for age, gender, fasting blood glucose (FBS), and the total cholesterol (TC) and triglyceride (TG) concentrations. Conclusions: These findings suggest that overt primary hypothyroidism is relatively common (6.3%) among persons with chronic kidney disease requiring chronic dialysis, and it is independently associated with a progressively lower estimated GFR.
Keywords
Chronic renal insufficiency; Hypothyroidism;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Levey AS, Coresh J, Balk E, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003;139:137-147.   DOI   ScienceOn
2 U.S. Renal Data System. USRDS 2009 annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Bethesda: National Institute of Diabetes and Digestive and Kidney Diseases, 2007.
3 Kiberd B. The chronic kidney disease epidemic: stepping back and looking forward. J Am Soc Nephrol 2006;17:2967-2973.   DOI   ScienceOn
4 Amato AA, Santos GM, Neves F de A. Thyroid hormone action in chronic kidney disease. Curr Opin Endocrinol Diabetes Obes 2008;15:459-465, doi: 10.1097/MED.0b013e32830eb85e.   DOI   ScienceOn
5 Kaptein EM, Quion-Verde H, Chooljian CJ, et al. The thyroid in end-stage renal disease. Medicine (Baltimore) 1988;67:187-197.   DOI   ScienceOn
6 Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int 2005;67:1047-1052.   DOI   ScienceOn
7 Song IS, Kim KH, Oh SJ, Jung HS, Lee JH, Yoon KI. The effects of hemodialysis and kidney transplantation on the thyroid function in patients with chronic renal failure. Korean J Med 1996;51:79-87.
8 Lee HH, Kim DJ, Kim JA, et al. Change of the thyroid function in continuous ambulatory peritoneal dialysis patients. Korean J Nephrol 2003;22:96-101.
9 Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T (4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002;87:489-499.   DOI   ScienceOn
10 Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease, scientific review and guidelines for diagnosis and management. JAMA 2004;291:228-238.   DOI   ScienceOn
11 Wilson GR, Curry RW Jr. Subclinical thyroid disease. Am Fam Physician 2005;72:1517-1524.
12 Garber JR, Hennessey JV, Lieberman JA 3rd, Morris CM, Talbert RL. Clinical update: managing the challenges of hypothyroidism. J Fam Pract 2006;55:S1-S8.
13 Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med 2000;160:526-534.   DOI   ScienceOn
14 Tunbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7:481-493.   DOI
15 Schectman JM, Kallenberg GA, Shumacher RJ, Hirsch RP. Yield of hypothyroidism in symptomatic primary care patients. Arch Intern Med 1989;149:861-864.   DOI   ScienceOn
16 Helfand M, Crapo LM. Screening for thyroid disease. Ann Intern Med 1990;112:840-849.   DOI   ScienceOn
17 Ripoli A, Pingitore A, Favilli B, et al. Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study. J Am Coll Cardiol 2005;45:439-445. Erratum in: J Am Coll Cardiol 2005;45:968.   DOI   ScienceOn
18 Bagchi N, Brown TR, Parish RF. Thyroid dysfunction in adults over age 55 years: a study in an urban US community. Arch Intern Med 1990;150:785-787.   DOI   ScienceOn
19 Sawin CT, Chopra D, Azizi F, Mannix JE, Bacharach P. The aging thyroid. Increased prevalence of elevated serum thyrotropin levels in the elderly. JAMA 1979;242:247-250.   DOI   ScienceOn
20 Papi G, Uberti ED, Betterle C, et al. Subclinical hypothyroidism. Curr Opin Endocrinol Diabetes Obes 2007;14:197-208.   DOI   ScienceOn
21 Lim VS. Thyroid function in patients with chronic renal failure. Am J Kidney Dis 2001;38(4 Suppl 1):S80-S84.
22 Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F. Low triiodothyronine: a new facet of inflammation in end stage renal disease. J Am Soc Nephrol 2005;16:2789-2795.   DOI   ScienceOn
23 Zoccali C, Benedetto F, Mallamaci F, et al. Low triiodothyronine and cardiomyopathy in patients with end stage renal disease. J Hypertens 2006;24:2039-2046.   DOI   ScienceOn
24 Zoccali C, Mallamaci F, Tripepi G, Cutrupi S, Pizzini P. Low triiodothyronine and survival in end-stage renal disease. Kidney Int 2006;70:523-528.
25 Carrero JJ, Qureshi AR, Axelsson J, et al. Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med 2007;262:690-701.   DOI   ScienceOn
26 Bando Y, Ushiogi Y, Okafuji K, Toya D, Tanaka N, Miura S. Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Exp Clin Endocrinol Diabetes 2002;110:408-415   DOI   ScienceOn
27 Sanai T, Inoue T, Okamura K, et al. Reversible primary hypothyroidism in Japanese patients undergoing maintenance hemodialysis. Clin Nephrol 2008;69:107-113.
28 Chonchol M, Lippi G, Salvagno G, Zoppini G, Muggeo M, Targher G. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol 2008;3:1296-1300.   DOI   ScienceOn