Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free tri-iodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine-binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition. In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies.
Hypothyroidism and nephrotic syndrome: why, when and how to treat / Di Mario, Francesca; Pofi, Riccardo; Gigante, Antonietta; Rivoli, Laura; Rosato, Edoardo; Isidori, Andrea; Cianci, Rosario; Barbano, Biagio. - In: CURRENT VASCULAR PHARMACOLOGY. - ISSN 1570-1611. - STAMPA. - 15:5(2017), pp. 398-403. [10.2174/1570161115999170207114706]
Hypothyroidism and nephrotic syndrome: why, when and how to treat
Di Mario, Francesca;Pofi, Riccardo;Gigante, Antonietta;Rosato, Edoardo;Isidori, Andrea;Cianci, Rosario;Barbano, Biagio
2017
Abstract
Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free tri-iodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine-binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition. In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies.File | Dimensione | Formato | |
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