Low thyroid function is not associated with an accelerated deterioration in renal function

Meuwese, C. L. et al. (2019) Low thyroid function is not associated with an accelerated deterioration in renal function. Nephrology Dialysis Transplantation, 34(4), pp. 650-659. (doi: 10.1093/ndt/gfy071) (PMID:29684213)

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Abstract

Background: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. Methods: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. Results: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) −4.07 (−6.37 to −1.78) and −2.40 (−3.78 to −1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50–4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. Conclusions: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

Item Type:Articles
Additional Information:The Busselton Health Study had no financial support to disclose. The Cardiovascular Health Study (CHS) was supported by contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083 and N01HC85086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). The European Prospective Investigation of Cancer (EPIC)-Norfolk study was supported by research grants from the Medical Research Council UK and Cancer Research UK. The Health, Aging and Body Composition (Health ABC) study was supported by NIA Contracts N01-AG-6-2101; N01-AG-6-2103; N01-AG-6-2106; NIA grant R01-AG028050 and NINR grant R01-NR012459. This research was funded in part by the Intramural Research Program at the NIA. The InCHIANTI study was supported as a target project ICS 110.1|RS97.71 by the Italian Ministry of Health, and in part by the US National Institute on Aging, contracts 263-MD-9164-13 and 263-MD-821336. The Nord-Trøndelag Health (HUNT) study is a collaborative effort of HUNT Research Center (Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology), the Norwegian Institute of Public Health, Central Norway Health Authority and the Nord-Trøndelag County Council. Thyroid function testing in the HUNT Study was financially supported by WallacOy (Turku, Finland). The Leiden 85-plus study was partly funded by the Dutch Ministry of Health, Welfare and Sports. The original PROSPER study was supported by an unrestricted, investigator-initiated grant from Bristol-Myers Squibb. The Rotterdam Study was funded by the following: Erasmus MC and Erasmus University, Rotterdam, the Netherlands; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Dutch Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The Radiation Effects Research Foundation (RERF), Hiroshima and Nagasaki, Japan, is a public interest foundation funded by the Japanese Ministry of Health, Labour and Welfare (MHLW) and the US Department of Energy (DOE). SHIP is part of the Research Network of Community Medicine at the University Medicine Greifswald, Germany (www.community-medicine.de), which is funded by the German Federal State of Mecklenburg–West Pomerania. The BELFRAIL study is funded by an unconditional grant from the Fondation Louvain. The Fondation Louvain is the support unit of the Université Catholique de Louvain in charge of developing education and research projects of the university by collecting gifts from corporate, foundations and alumni. The Brazilian thyroid study was supported by an unrestricted grant from São Paulo State Research Foundation (Fundação de Amparo a Pesquisa do Estado de São Paulo) Grant 6/59737-9 (to R.M.B.M.). The Prevention of Renal and Vascular End-Stage Disease (PREVEND) study has been made possible by grants from the Dutch Kidney Foundation. The work from N.R. was supported by grants from the Swiss National Science Foundation (SNSF 320030-150025 and 320030-172676 both to N.R.).
Keywords:Nephrology, transplantation.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Stott J, Professor David
Authors: Meuwese, C. L., van Diepen, M., Cappola, A. R., Sarnak, M. J., Shlipak, M. G., Bauer, D. C., Fried, L. P., Iacoviello, M., Vaes, B., Degryse, J., Khaw, K.-T., Luben, R. N., Åsvold, B. O., Bjøro, T., Vatten, L. J., de Craen, A. J.M., Trompet, S., Iervasi, G., Molinaro, S., Ceresini, G., Ferrucci, L., Dullaart, R. P.F., Bakker, S. J.L., Jukema, J. W., Kearney, P. M., Stott, D. J., Peeters, R. P., Franco, O. H., Völzke, H., Walsh, J. P., Bremner, A., Sgarbi, J. A., Maciel, R. M.B., Imaizumi, M., Ohishi, W., Dekker, F. W., Rodondi, N., Gussekloo, J., and den Elzen, W. P.J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Nephrology Dialysis Transplantation
Publisher:Oxford University Press
ISSN:0931-0509
ISSN (Online):1460-2385
Published Online:18 April 2018

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