Hypothyroidism and nephrotic syndrome: why, when and how to treat.

Hypothyroidism and nephrotic syndrome: why, when and how to treat. Curr Vasc Pharmacol. 2017 Feb 07;: Authors: Di Mario F, Pofi R, Gigante A, Rivoli L, Rosato E, Isidori AM, Cianci R, Barbano B Abstract Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free tri-iodothyronine (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. In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies. PMID: 28176633 [PubMed - as supplied by publisher]
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research