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. 2018 May;7(1):169-173.
doi: 10.1007/s13730-018-0320-7. Epub 2018 Feb 28.

Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients

Osamu Uemura  1   2 , Naoyuki Iwata  3 , Takuhito Nagai  3 , Satoshi Yamakawa  3 , Satoshi Hibino  3 , Masaki Yamamoto  3 , Masaru Nakano  3 , Kazuki Tanaka  3
Affiliations

Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients

Osamu Uemura et al. CEN Case Rep. 2018 May.

Abstract

To determine the optimal method of evaluating kidney function in patients with thyroid dysfunction, this study compared the estimated glomerular filtration rate derived from serum creatinine, cystatin C, or β2-microglobulin with inulin or creatinine clearance in two pediatric patients, one with hypothyroidism and the other with hyperthyroidism. It was observed that the kidney function decreased in a hypothyroid child and enhanced in a hyperthyroid child, with their kidney function becoming normalized by treatment with drugs, which normalized their thyroid function. Kidney function cannot be accurately evaluated using cystatin C-based or β2-microglobulin-based estimated glomerular filtration rate in patients with thyroid dysfunction, as these tests overestimated glomerular filtration rate in a patient with hypothyroidism and underestimated glomerular filtration rate in a patient with hyperthyroidism, perhaps through a metabolic rate-mediated mechanism. In both our patients, 24-h urinary creatinine secretion was identical before and after treatment, suggesting that creatinine production is not altered in patients with thyroid dysfunction. Therefore, kidney function in patients with thyroid dysfunction should be evaluated using creatinine-based estimated glomerular filtration rate.

Keywords: Creatinine; Cystatin C; Estimated glomerular filtration rate; Hyperthyroid; Hypothyroid; β2-microglobulin.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent of the patients involved was provided about the publication of this article.

Figures

Fig. 1
Fig. 1
The growth rate declined when the hypothyroidism was acquired at age about 9 years
Fig. 2
Fig. 2
Kidney function cannot be accurately measured using cystatin C-based or β2-microglobulin-based estimated glomerular filtration rate in patients with thyroid dysfunction, but evaluated using creatinine-based estimation. The cystatin C-based or β2-microglobulin-based evaluation overestimated glomerular filtration rate in case 1 with hypothyroidism (a), and underestimated glomerular filtration rate in case 2 with hyperthyroidism (b)
See this image and copyright information in PMC

References

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