Thyroid dysfunction and kidney disease

Thyroid hormones (TH) are essential for an adequate growth and development of the kidney. Conversely, the kidney is not only an organ for metabolism and elimination of TH, but also a target organ of some of the iodothyronines' actions. Thyroid dysfunction causes remarkable changes in glomerular...

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Bibliographic Details
Published in:European journal of endocrinology 2009-04, Vol.160 (4), p.503-515
Main Authors: Iglesias, P, Díez, J J
Format: Article
Language:English
Subjects:
Animals
Antithyroid Agents - adverse effects
Antithyroid Agents - therapeutic use
Biological and medical sciences
Endocrinopathies
Fundamental and applied biological sciences. Psychology
Humans
Kidney - physiopathology
Kidney Diseases - complications
Kidney Diseases - physiopathology
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Renal Dialysis
Review
Thyroid Diseases - complications
Thyroid Diseases - drug therapy
Thyroid Diseases - physiopathology
Thyroid Function Tests
Thyroid Gland - drug effects
Thyroid Gland - physiology
Thyroid Hormones - physiology
Thyroid. Thyroid axis (diseases)
Vertebrates: endocrinology
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Summary:Thyroid hormones (TH) are essential for an adequate growth and development of the kidney. Conversely, the kidney is not only an organ for metabolism and elimination of TH, but also a target organ of some of the iodothyronines' actions. Thyroid dysfunction causes remarkable changes in glomerular and tubular functions and electrolyte and water homeostasis. Hypothyroidism is accompanied by a decrease in glomerular filtration, hyponatremia, and an alteration of the ability for water excretion. Excessive levels of TH generate an increase in glomerular filtration rate and renal plasma flow. Renal disease, in turn, leads to significant changes in thyroid function. The association of different types of glomerulopathies with both hyper- and hypofunction of the thyroid has been reported. Less frequently, tubulointerstitial disease has been associated with functional thyroid disorders. Nephrotic syndrome is accompanied by changes in the concentrations of TH due primarily to loss of protein in the urine. Acute kidney injury and chronic kidney disease are accompanied by notable effects on the hypothalamus–pituitary–thyroid axis. The secretion of pituitary thyrotropin (TSH) is impaired in uremia. Contrary to other non-thyroidal chronic disease, in uraemic patients it is not unusual to observe the sick euthyroid syndrome with low serum triodothyronine (T3) without elevation of reverse T3 (rT3). Some authors have reported associations between thyroid cancer and kidney tumors and each of these organs can develop metastases into the other. Finally, data from recent research suggest that TH, especially T3, can be considered as a marker for survival in patients with kidney disease.
ISSN:0804-4643
1479-683X
DOI:10.1530/EJE-08-0837