Endocrine Abstracts

There are a several known interactions between kidney functions, thyroid and metabolic balance. Hypothyroidism is associated with reduced GFR and hyperthyroidism results in increased GFR and increased RAA activation. Chronic kidney disease is characterized by low T3 syndrome, increased primary hypothyroidism and subclinical hypothyroidism. The hyperthyroidism increases CKD progression while hypothyroid state lowers it. Proteinuria, especially in nephrotic syndrome, often results in urinary loss of thyroid hormones bound to the various binding proteins which results in reduction in the serum total thyroid hormone levels. Isolated cases of hyperthyroidism have been associated with tubulointerstitial nephritis. Thyroid dysfunction is also associated with glomerulonephritis by a common autoimmune etiology. There are known several mechanisms like the presence of circulating immune complex among patients with thyroid disease, the association of Hashimoto’s thyroiditis and membranous nephropathy with immune complex deposition in the glomerular as well as thyroid epithelial basement membrane. There is also common occurrence of thyroid and renal disease in association with other autoimmune diseases such as type 1 diabetes mellitus. We retrospectively analyzed the data (thyroid function, metabolic syndrome occurrence, type of diabetes) of 126 patient hospitalized in our clinic from 2013 to 2016 who underwent renal biopsy (52 women, 62 men and 6 children). The most common indications for renal biopsy were nephrotic syndrome in 47 patients (37.3%), non-nephrotic proteinuria in 31 patients (24.6%), worsening renal function in 22 patients (17.5%), coexistence of proteinuria with hematuria in 16 patients (12.7%), nephritic syndrome in 9 patients (7.1%) as well as an isolated hematuria in 1 patient (0.8%). Membranous glomerulonephritis was the most common histological diagnosis observed in biopsies, and was diagnosed in 19 patients (15.1%). Our analysis proved higher occurrence of hypothyroidism (8.7%), hyperthyroidism (2.38%) and goiter (3.17%) in comparison to general population. Interestingly there was no higher occurrence of obesity and overweight (40.4%) and type 1 and 2 diabetes, but many patient had steroid-induced diabetes (16%). It is important to monitor every patient with renal dysfunction due to higher prevalence of thyroid pathology.