Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 May 21:2014:bcr2014203895.
doi: 10.1136/bcr-2014-203895.

Salt-losing nephropathy in hypothyroidism

Aileen Azul Bautista  1 , Jose Eduardo De Leon Duya  2 , Mark Anthony Santiago Sandoval  1
Affiliations
Case Reports

Salt-losing nephropathy in hypothyroidism

Aileen Azul Bautista et al. BMJ Case Rep. .

Abstract

A 35-year-old man presented with recurrent lower extremity weakness associated with polyuria later progressing to generalised weakness with difficulty in breathing. The patient was hypotensive and dry, with normal thyroid and chest examination, weak lower extremity and carpopedal spasm. Workup revealed hypokalaemia, hyponatraemia, hypocalcaemia, hypomagnesaemia, hypochloraemia and hypophosphataemia. Arterial blood gas showed respiratory alkalosis with good oxygenation. Twenty-four-hour urine collection showed normal volume with electrolyte wasting. Thyroid function test revealed overt hypothyroidism with negative antithyroid peroxidase. The patient was well after treatment with levothyroxine, volume and electrolyte replacement and was discharged. Thyroid hormones are related to the expression of the Na-K-ATPase, Na-Pi cotransporter, Mg-ATPase and Na-Ca exchanger pumps in the renal tubules. Sodium, potassium, phosphate, calcium, magnesium and water losses result from decreased expression of these pumps.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Initial ECG.
See this image and copyright information in PMC

References

    1. Koul PA, Wahid A. Distal renal tubular acidosis and hypokalemic paralysis in a patient with hypothyroidism. Saudi J Kidney Dis Transpl 2011;22:1014–16 - PubMed
    1. Fang JT, Huang CC. Distal renal tubular acidosis associated with non-autoimmune hypothyroidism. Nephrol Dial Transplant 1996;11:1146–7 - PubMed
    1. Hall JE, Guyton A. Guyton & Hall textbook of medical physiology. 12th edn Philadelphia: W.B. Saunders Company, 2010:310–39, 367–9
    1. Katz AI, Lindheimer MD. Renal sodium- and potassium-activated adenosine triphosphatase and sodium reabsorption in the hypothyroid rat. J Clin Invest 1973;52:796–804 - PMC - PubMed
    1. Hoek IV, Daminet S. Interactions between thyroid and kidney function in pathological conditions of these organ systems: a review. Gen Comp Endocrinol 2009;160: 205–15 - PubMed

Publication types