Correlation between thyroid function and proteinuria in patients with chronic kidney disease stages 3 and 4.

IF 1.8 4区医学 Q3 UROLOGY & NEPHROLOGY

International Urology and Nephrology Pub Date : 2025-07-05 DOI:10.1007/s11255-025-04646-4

Karina Schiavoni Scandelai, Pietra Desiree Bourdon Fuentes Azevedo Vianna, João Pedro Barbosa Sanches, Rachel Bregman, Ana Beatriz Winter Tavares

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引用次数: 0

Abstract

Purpose: Proteinuria in the nephrotic range is associated with loss of thyroxine-binding protein, levothyroxine, or both, which may lead to subclinical hypothyroidism. The aim of this study was to correlate thyroid function and proteinuria in patients with stages 3 and 4 chronic kidney disease (CKD), in addition to evaluating whether thyroid function differs in these stages of CKD.

Methods: Observational, cross-sectional study including 150 patients with stages 3 and 4 CKD. Thyroid stimulating hormone (TSH), free T4 (FT4) and the urine protein-creatinine ratio (PCR) were analyzed. Proteinuria was defined as ≥ 200 mg/g.

Results: Sixty-four patients (42.6%) had stage 3 CKD, and 86 patients (59.4%) had stage 4 CKD. The median age was 68 years (IQR 61-76), the median TSH was 2.9 µIU/mL (IQR 1.89-4.04), the median FT4 was 1.26 ng/dL (IQR 1.10-1.41), and the median PCR was 315.5 mg/g (IQR 108.3-830). Ninety-one patients (60.6%) had proteinuria. In the total sample and in CKD stage 3, there was a statistically significant positive correlation between PCR and TSH, and a negative correlation between PCR and FT4. There were significant differences in the median age (p = 0.004), estimated glomerular filtration rate (p = 0.002), TSH (p = 0.001) and FT4 (p = 0.05) between the PCR < and ≥ 200 mg/g groups.

Conclusion: The results demonstrated a significant correlation between thyroid function and PCR, which corroborates that urinary protein loss can alter thyroid function in CKD stages 3 and 4. Thyroid function did not differ between CKD stages 3 and 4. STUDY DATASET IS AVAILABLE ON CLINICALTRIALS.

Gov id: NCT04658524.

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慢性肾病3期和4期患者甲状腺功能与蛋白尿的相关性

目的：肾病范围内的蛋白尿与甲状腺素结合蛋白、左甲状腺素或两者的丢失有关，这可能导致亚临床甲状腺功能减退。本研究的目的是在3期和4期慢性肾脏疾病（CKD）患者中，甲状腺功能和蛋白尿的相关性，以及评估这些阶段的CKD中甲状腺功能是否存在差异。方法：观察性横断面研究，包括150例3期和4期CKD患者。分析促甲状腺激素（TSH）、游离T4 （FT4）及尿蛋白-肌酐比值（PCR）。蛋白尿定义为≥200mg /g。结果：64例（42.6%）为3期CKD， 86例（59.4%）为4期CKD。中位年龄为68岁（IQR 61-76），中位TSH为2.9 μ IU/mL (IQR 1.89-4.04)，中位FT4为1.26 ng/dL (IQR 1.10-1.41)，中位PCR为315.5 mg/g （IQR 108.3-830）。蛋白尿91例（60.6%）。在总样本和CKD 3期中，PCR与TSH呈显著正相关，与FT4呈显著负相关。两组患者的中位年龄（p = 0.004）、肾小球滤过率（p = 0.002）、TSH （p = 0.001）和FT4 （p = 0.05）差异均有统计学意义。结论：甲状腺功能与PCR有显著相关性，证实尿蛋白丢失可改变CKD 3期和4期患者的甲状腺功能。甲状腺功能在CKD 3期和4期之间没有差异。研究数据集可用于临床试验。政府信息：NCT04658524。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Urology and Nephrology 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

5.00%

发文量

329

审稿时长

1.7 months

期刊介绍： International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.