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. 2023 Feb 10;13(4):669.
doi: 10.3390/diagnostics13040669.

Association between Urinary Creatinine Excretion and Hypothyroidism in Patients with Chronic Kidney Disease

Natsumi Matsuoka-Uchiyama  1 , Kenji Tsuji  1 , Kensaku Takahashi  1 , Kazuhiko Fukushima  1 , Hidemi Takeuchi  1 , Shinji Kitamura  1 , Kenichi Inagaki  1 , Haruhito A Uchida  2 , Jun Wada  1
Affiliations

Association between Urinary Creatinine Excretion and Hypothyroidism in Patients with Chronic Kidney Disease

Natsumi Matsuoka-Uchiyama et al. Diagnostics (Basel). .

Abstract

While hypothyroidism increases serum creatinine (Cr) levels, it is uncertain whether the elevation is mediated via a decline in the glomerular filtration rate (GFR) or the reflection of enhanced Cr production from the muscles or both. In the present study, we explored an association between urinary Cr excretion rate (CER) and hypothyroidism. A total of 553 patients with chronic kidney disease were enrolled in a cross-sectional study. Multiple linear regression analysis was performed to explore the association between hypothyroidism and urinary CER. The mean urinary CER was 1.01 ± 0.38 g/day and 121 patients (22%) had hypothyroidism. The multiple linear regression analysis revealed explanatory variables with urinary CER, including age, sex, body mass index, 24 h Cr clearance (24hrCcr), and albumin while hypothyroidism was not considered an independent explanatory variable. In addition, scatter plot analysis with regression fit line representing the association between estimated GFR calculated using s-Cr (eGFRcre) and 24hrCcr revealed that eGFRcre and 24hrCcr had strong correlations with each other in hypothyroid patients as well as euthyroid patients. Collectively, hypothyroidism was not considered an independent explanatory variable for urinary CER in the present study and eGFRcre is a useful marker to evaluate kidney function regardless of the presence of hypothyroidism.

Keywords: hypothyroidism; kidney function; urinary creatinine excretion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the screening and enrollment of study patients.
Figure 2
Figure 2
The association between urinary creatinine excretion rate and variables. Urinary CER, urinary creatinine excretion rate; eGFRcre, estimated glomerular filtration rate calculated by serum creatinine; BMI, body mass index; 24hrCcr, 24 h creatinine clearance; FT4, free thyroxine; TSH, thyroid-stimulating hormone; FT3, free triiodothyronine.
Figure 3
Figure 3
The association between eGFRcre and 24hCcr. (A) The association between eGFRcre and 24hCcr in all cases. (B) The association between eGFRcre and 24hCcr in euthyroid cases. (C) The association between eGFRcre and 24hCcr in total hypothyroid cases. eGFRcre, estimated glomerular filtration rate calculated by serum creatinine; 24hrCcr, 24 h creatinine clearance.
Figure 4
Figure 4
The mechanisms influencing serum creatinine levels under hypothyroidism. Cr, creatinine; s-Cr, serum creatinine; RAAS, renin–angiotensin–aldosterone system.
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