Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat

Title:Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat

Volume: 15 Issue: 5

Author(s): F. Di Mario, R. Pofi, A. Gigante*, L. Rivoli, E. Rosato, A. M. Isidori, R. Cianci and B. Barbano

Affiliation:

• Department of Clinical Medicine, Sapienza, University of Rome, Viale dell’Università, 37, 00185 Rome,Italy

Keywords: Nephrotic syndrome, hypothyroidism, glomerulonephritis, thyroid hormones, replacement, treatment.

Abstract: Background: Hypothyroidism, characterised by low/normal free thyroxine (FT₄) and free triiodothyronine (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.

Cite this article as:

Mario Di F., Pofi R., Gigante A.*, Rivoli L., Rosato E., Isidori M. A., Cianci R. and Barbano B., Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat, Current Vascular Pharmacology 2017; 15 (5) . https://dx.doi.org/10.2174/1570161115999170207114706