Low thyroid function is not associated with an accelerated deterioration in renal function

Journal Article · Wed Apr 18 00:00:00 EDT 2018 · Nephrology Dialysis Transplantation

DOI:https://doi.org/10.1093/ndt/gfy071· OSTI ID:1505648

Meuwese, Christiaan L. ^[1]; van Diepen, Merel ^[1]; Cappola, Anne R. ^[2]; Sarnak, Mark J. ^[3]; Shlipak, Michael G. ^[4]; Bauer, Douglas C. ^[5]; Fried, Linda P. ^[6]; Iacoviello, Massimo ^[7]; Vaes, Bert ^[8]; Degryse, Jean ^[8]; Khaw, Kay-Tee ^[9]; Luben, Robert N. ^[9]; Åsvold, Bjørn O. ^[10]; Bjøro, Trine ^[11]; Vatten, Lars J. ^[12]; de Craen, Anton J. M. ^[13]; Trompet, Stella ^[14]; Iervasi, Giorgio ^[15]; Molinaro, Sabrina ^[16]; Ceresini, Graziano ^[17] ; Ferrucci, Luigi ^[18]; Dullaart, Robin P. F. ^[19]; Bakker, Stephan J. L. ^[19]; Jukema, J. Wouter ^[20]; Kearney, Patricia M. ^[21]; Stott, David J. ^[22]; Peeters, Robin P. ^[23]; Franco, Oscar H. ^[24]; Völzke, Henry ^[25]; Walsh, John P. ^[26]; Bremner, Alexandra ^[27]; Sgarbi, José A. ^[28]; Maciel, Rui M. B. ^[29]; Imaizumi, Misa ^[30]; Ohishi, Waka ^[30]; Dekker, Friedo W. ^[1]; Rodondi, Nicolas ^[31]; Gussekloo, Jacobijn ^[32]; den Elzen, Wendy P. J. ^[33]

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1. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
2. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
3. Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA, USA
4. Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA
5. Department of Medicine, University of California, San Francisco, CA, USA, Department of Epidemiology and Biostatistics, University of San Francisco, CA, USA
6. Mailman School of Public Health and Columbia University Medical Center, New York, NY, USA
7. University Cardiology Unit, Cardiothoracic Department, University Policlinic Hospital, Bari, Italy
8. Institute of Health and Society, Université catholique de Louvain (UCL), Brussels, Belgium, Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium
9. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
10. Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway, Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
11. Department of Medical Biochemistry, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
12. Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
13. Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
14. Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands, Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
15. National Council Research Institute of Clinical Physiology, Tuscany Region G. Monasterio Foundation, Pisa, Italy
16. National Council Research Institute of Clinical Physiology, Pisa, Italy
17. Department of Clinical and Experimental Medicine, Geriatric Endocrine Unit, University Hospital of Parma, Parma, Italy
18. National Institute on Aging, Baltimore, MD, USA
19. Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
20. Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
21. School of Public Health, University College Cork, Cork, Ireland
22. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
23. Department of Internal Medicine, Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands, Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
24. Department of Internal Medicine, Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
25. Institute for Community Medicine, SHIP/Clinical-Epidemiological Research & German Centre of Cardiovascular Research, University of Greifswald, Greifswald, Germany
26. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Medical School, The University of Western Australia, Crawley, Western Australia
27. School of Population Health, The University of Western Australia, Crawley, Western Australia
28. Division of Endocrinology, Faculdade de Medicina de Marília, Marília, Brazil
29. Division of Endocrinology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
30. Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
31. Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland, Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
32. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
33. Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands

Abstract Background Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. Methods Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. Results A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) −4.07 (−6.37 to −1.78) and −2.40 (−3.78 to −1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50–4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. Conclusions Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

• Sponsoring Organization: USDOE
• OSTI ID: 1505648
• Journal Information: Nephrology Dialysis Transplantation, Journal Name: Nephrology Dialysis Transplantation Vol. 34 Journal Issue: 4; ISSN 0931-0509
• Publisher: Oxford University Press
• Country of Publication: Country unknown/Code not available
• Language: English