Author(s):
Dhivya S, Sukanya Gangopadhyay, Pradeep Kumar S, Gautam Sarkar
Email(s):
sukanya.gangopadhyay@gmail.com
DOI:
10.5958/2231-5713.2020.00040.9 
Address:
Dhivya S¹, Sukanya Gangopadhyay²*, Pradeep Kumar S³, Gautam Sarkar4
¹Senior Resident, Department of Biochemistry, VMMC and Safdarjung Hospital, New Delhi - 110029.
²Associate Professor, Department of Biochemistry, VMMC and Safdarjung Hospital, New Delhi - 110029,
Ex-Assistant Professor, Department of Biochemistry, Subharti Medical College, Meerut, Uttar Pradesh - 250005.
³Senior Resident, Department of GI Surgery, AIIMS, New Delhi – 110023.
4Ex-Professor and Head, Department of Biochemistry, Subharti Medical College, Meerut, Uttar Pradesh – 250005.
*Corresponding Author
Published In:
Volume - 10,
Issue - 4,
Year - 2020
ABSTRACT:
Introduction: Hypothyroidism is a rising concern in India especially among women of all ages. Every year new cases are being diagnosed either independently or in combination with other medical and gynecological problems. With the further advent of our knowledge on hypothyroidism, it has been noticed that the renal function could be affected in such patients. Aim and objective: The aim of the present study was done to understand the effect of hypothyroidism on renal function in untreated or poorly treated hypothyroid subjects with the objective of comparing serum creatinine levels and estimated glomerular filtration rate (eGFR) in hypothyroid females with healthy age-matched controls. Materials and methods: Serum samples of 30 female patients received in our immunology lab with Thyroid Stimulating Hormone (TSH) more than 5mIU/L were analyzed for creatinine levels and the GFR was calculated concerning their age by using Modification of Diet in Renal Disease Study (MDRD) formula online. The same was repeated in 30 healthy female controls. Results and observations: The mean TSH value was significantly more in the cases (cases 8.15±2.5mIU/L; controls 3.11±0.88mIU/L; p-value < 0.0001) as purposefully high TSH samples were selected. Mean serum creatinine was significantly raised in the cases (cases 0.9±0.13mg/dl; controls 0.67±0.07mg/dl; p-value < 0.0001). The mean calculated GFR was 108.32±13.41mL/min/1.73m² in controls whereas in cases it was significantly low at 77.19±13.36mL/min/1.73m² (p-value < 0.0001). Conclusion: The mean serum creatinine was on the higher side of the normal range and mean calculated GFR was low in untreated or poorly treated hypothyroid females in Meerut, Uttar Pradesh. Hypothyroid women should regularly undergo renal assessment as a precautionary measure.
Cite this article:
Dhivya S, Sukanya Gangopadhyay, Pradeep Kumar S, Gautam Sarkar. Serum creatinine and eGFR are affected in female hypothyroid patients with poor Thyroid control. Asian J. Pharm. Tech. 2020; 10(4):241-244. doi: 10.5958/2231-5713.2020.00040.9
Cite(Electronic):
Dhivya S, Sukanya Gangopadhyay, Pradeep Kumar S, Gautam Sarkar. Serum creatinine and eGFR are affected in female hypothyroid patients with poor Thyroid control. Asian J. Pharm. Tech. 2020; 10(4):241-244. doi: 10.5958/2231-5713.2020.00040.9 Available on: https://ajptonline.com/AbstractView.aspx?PID=2020-10-4-4
REFERENCES:
1. Subasree S. Prevalence of Thyroid Disroders in India: An Overview. Research J. Pharm. and Tech. 2014;7(10):1165-8.
2. Menon A, Thenmozhi MS. Correlation between Thyroid Function and Obesity. Research J. Pharm. and Tech. 2016; 9(10):1568-70.
3. Anandkumar S, Jessly Chacko, Theertha C. K, M. Usha. Thyroid Disorder: An Overview. Res. J. Pharmacology and Pharmacodynamics.2020; 12(1):01-04.
4. Copeland KC, Nair KS. Recombinant human insulin-like growth factor-I increases forearm blood flow. J ClinEndocrinol Metab.1994;79(1):230–2.
5. Guler HP, Schmid C, Zapf J, Froesch ER. Effects of recombinant insulin-like growth factor I on insulin secretion and renal function in normal human subjects. ProcNatlAcadSci U S A. 1989;86(8):2868–72.
6. Guler HP, Eckardt KU, Zapf J, Bauer C, Froesch ER. Insulin-like growth factor I increase glomerular filtration rate and renal plasma flow in man. ActaEndocrinol (Copenh). 1989;121(1):101–6.
7. Klanke B, Simon M, Rockl W, Weich HA, Stolte H, Grone HJ. Effects of vascular endothelial growth factor (VEGF)/vascular permeability factor (VPF) on haemodynamics and permselectivity of the isolated perfused rat kidney. Nephrol Dial Transplant.1998; 13:875–85.
8. Fukumura D, Gohongi T, Kadambi A, Izumi Y, Ang J, Yun CO, et al. Predominant role of endothelial nitric oxide synthase in vascular endothelial growth factor-induced angiogenesis and vascular permeability. ProcNatlAcadSci U S A.2001; 98(5):2604–9.
9. Kreisman SH, Hennessey JV. Consistent reversible elevations of serum creatinine levels in severe hypothyroidism. Arch Intern Med.1999; 159(1):79–82.
10. Asvold BO, Bjøro T, Vatten LJ. Association of thyroid function with estimated glomerular filtration rate in a population-based study: the HUNT study. EurJ Endocrinol.2011;164(1):101-5.
11. Shin DH, Lee MJ, Lee HS, Oh HJ, Ko KI, Kim CH, et al. Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism. Thyroid.2013; 23:654-661.
12. Vargas F, Moreno JM, Rodriguez-Gomez I, Wangensteen R, Osuna A, Alvarez-Guerra M, et al. Vascular and renal function in experimental thyroid disorders. Eur J Endocrinol.2006; 154(2): 197-212.
13. Park CW, Shin YS, Ahn SJ, Kim SY, Choi EJ, Chang YS, et al. Thyroxine treatment induces upregulation of renin-angiotensinaldosterone system due to decreasing effective plasma volume in patients with primary myxoedema. Nephrol Dial Transplant.2001;16(9):1799-806.
14. Karanikas G, Schütz M, Szabo M, Becherer A, Wiesner K, Dudczak R, et al. Isotopic renal function studies in severe hypothyroidism and after thyroid hormone replacement therapy. Am J Nephrol.2004; 24(1):41-5.
15. Nakahama H, Sakaguchi K, Horita Y, Sasaki O, Nakamura S, Inenaga T, et al. Treatment of severe hypothyroidism reduced serum creatinine levels in two chronic renal failure patients. Nephron.2001;88(3):264-7.
16. Kumar J, Gordillo R, Kaskel FJ, Druschel CM, Woroniecki RP. Increased prevalence of renal and urinary tract anomalies in children with congenital hypothyroidism. J Pediatr.2009;154(2): 263–266.
17. Bradley SE, Coelho JB, Sealey JE, Edwards KD, Stéphan F. Changes in glomerulotubulardimensions, single nephron glomerular filtration rates and the renin-angiotensin system inhypothyroid rats. Life Sci.1982;30(7-8): 633–639.
18. Canavan JP, Holt J, Easton J, Smith K, Goldspink DF. Thyroid-induced changes in the growth of the liver, kidney, and diaphragm of neonatal rats. J Cell Physiol.1994; 161(1): 49–54.
19. Slotkin TA, Seidler FJ, Kavlock RJ, Bartolome JV. Thyroid hormone differentially regulates cellular development in neonatal rat heart and kidney. Teratology.1992; 45(3): 303–312.
20. Chonchol M, Lippi G, Salvagno G, Zoppini G, Muggeo M, Targher G. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am SocNephrol. 2008; 3(5):1296-300.
21. Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int.2005; 67(3):1047-1052.
22. Kaptein EM. Thyroid function in renal failure. ContribNephrol.1986; 50:64-72.
23. Maheshwari P, Mohan R, Shanmugarajan TS. KAP Study on Thyroid Disorders (Hypothyroidism and Hyperthyroidism) in a Tertiary Care Hospital. Research J. Pharm. and Tech. 2017; 10(1): 41-3.
24. Gagandeep Kaur Sidhu, Rahima.R.Malek, Asha Khubchandani, Sohil.H.Mansuri, Miku.S.Pate, Ruhan.H.Oza. A Study of Serum Urea, Creatinine and Uric Acid Levels InHypothyroid Patients. Int J Res Med.2016; 5(2); 115-118.
25. Mamatha B.V, Rakshitha M.N, Kashinath R.T, Laya Rose Thomas. Evaluation of serum urea and creatinine levels in subclinical hypothyroidism – A case control study. Medica Innovatica.2016; 5(2):3-6.
26. Khan A H, Majumder I. Serum creatinine and uric acid levels of hypothyroid patients. Bangladesh J Med Biochem.2010; 3(2):61-63.
27. Vaneet Kaur, Kamaljit Singh and MinniVerma. Changes in biochemical markers of renal function in subclinical and overt hypothyroidism. International Journal of Bioassays. 2015;4(04):3799-3802.
28. ChristophSchmid, MichaelBrandle, Cornelia Zwimpfer, Ju¨rgen Zapf, and Peter Wiesli. Effect of Thyroxine Replacement on Creatinine, Insulin-Like Growth Factor 1, Acid-Labile Subunit, and VascularEndothelial Growth Factor. Clinical chemistry.2004; 50(1):228-231.
29. Mohammmed GF, Sultan SM, Sadullah YQ. The relationship between Creatinine and patients with Renal Failure associated with anemia. Research J. Pharm. and Tech. 2020; 13(4):1633-5.
30. Thokada SS, Kandregula H, Mugada VK. Prevalence of Sub-Clinical Hypothyroidism among Diabetes Mellitus Patients with Vascular Complications. Asian J. Res. Pharm. Sci. 2018; 8(4): 253-7.
31. Kapadia KB, Bhatt PA, Shah JS. Association between altered thyroid state and insulin resistance. J PharmacolPharmacother. 2012; 3(2):156-60.
32. Valcavi R, Dieguez C, Preece M, Taylor A, Portioli I, Scanlon MF. Effect of thyroxine replacement therapy on plasma insulin-like growth factor 1 levels and growth hormone responses to growth hormone releasing factor in hypothyroid patients. ClinEndocrinol (Oxf).1987; 27(1):85–90.
33. Yuji Hataya, Shuta Igarashi, Takafumi Yamashita, Yasato Komatsu. Thyroid hormone replacement therapy for primary hypothyroidism leads to significant improvement of renal function in chronic kidney disease patients. Clinical and Experimental Nephrology.2013; 17(4):525–531.
34. Ajaykumar N, Shanthi M, Parameshwari R. The Effect of L-Thyroxine on Metabolic Parameters in Newly Diagnosed Primary Hypothyroidism. International Journal of Pharmaceutical Science Invention.2013; 2(8):14-8.
35. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41.
36. Asmah BJ, Wan Nazaimoon WM, Norazmi K, Tan TT, Khalid BA. Plasma renin and aldosterone in thyroid diseases. HormMetab Res.1997; 29(11):580-3.
37. Iglesias P, Díez JJ: Thyroid dysfunction and kidney disease. Eur J Endocrinol.2009; 160(4): 503–515.