Optimizing Care for Primary Glomerulonephritis: The Role of Thyroid Evaluation.

Abstract

Background: The coexistence of primary glomerulonephritis and autoimmune thyroid disease has not been investigated.

Objective: This study aimed to assess thyroid morphology using sonography, determine the prevalence of autoimmune thyroid disorders, and evaluate thyroid function status in patients diagnosed with primary glomerulonephritis.

Materials and methods: This single-center cross-sectional and observational study included 58 consecutive patients with primary glomerulonephritis and 58 healthy controls (HC). All participants underwent thyroid examination through laboratory tests and thyroid ultrasonography. The findings were subsequently compared between the two groups.

Results: Among the patients, 17.2% (n = 10) exhibited subclinical hypothyroidism, while 8.6% (n = 5) had overt hypothyroidism. None of the HCs showed overt hypothyroidism, whereas 3.4% (n = 2) of them exhibited subclinical hypothyroidism. Patients displayed significantly lower free triiodothyronine (FT3) levels than HCs (p < 0.001). A linear correlation was observed between patients' thyroid-stimulating hormone (TSH) levels and the degree of proteinuria (p = 0.044). Furthermore, thyroid volume (p < 0.001), hypoechogenicity (p < 0.001), heterogeneous structure (p < 0.001), pseudonodular hypoechoic infiltration (p = 0.05), and the presence of nodules (p < 0.001) were notably higher in patients compared to HCs.

Conclusion: The prevalence of both overt and subclinical hypothyroidism, along with the frequency of nodular goiter, was found to be elevated in patients with primary glomerulonephritis. Considering that primary glomerulonephritis predominantly afflicts young individuals, and these patients bear the lifelong burden of chronic kidney disease, we underscore the significance of routine thyroid function tests and sonographic examinations for the early detection of thyroid disorders.