Thyroid dysfunction and kidney disease

被引:272
作者
Iglesias, P. [1 ]
Diez, J. J. [1 ]
机构
[1] Hosp Ramon & Cajal, Dept Endocrinol, E-28034 Madrid, Spain
关键词
RENAL-CELL CARCINOMA; IMMUNE-COMPLEX GLOMERULONEPHRITIS; REVERSIBLE PRIMARY HYPOTHYROIDISM; NEPHROTIC SYNDROME; PERITONEAL-DIALYSIS; TUBULOINTERSTITIAL NEPHRITIS; SUBCLINICAL HYPOTHYROIDISM; AUTOIMMUNE-THYROIDITIS; LOW TRIIODOTHYRONINE; INCREASED PREVALENCE;
D O I
10.1530/EJE-08-0837
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 it 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 I, or 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 (T-3) without elevation of reverse T-3 (rT(3)). Some authors have reported associations between thyroid cancer and kidney tumors and each of these organs can develop metastases into the other. Finally, data front recent research suggest that TH, especially T-3, can be considered its a marker for survival in patients with kidney disease.
引用
收藏
页码:503 / 515
页数:13
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