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Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients

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Abstract

To determine the optimal method of evaluating kidney function in patients with thyroid dysfunction, this study compared the estimated glomerular filtration rate derived from serum creatinine, cystatin C, or β2-microglobulin with inulin or creatinine clearance in two pediatric patients, one with hypothyroidism and the other with hyperthyroidism. It was observed that the kidney function decreased in a hypothyroid child and enhanced in a hyperthyroid child, with their kidney function becoming normalized by treatment with drugs, which normalized their thyroid function. Kidney function cannot be accurately evaluated using cystatin C-based or β2-microglobulin-based estimated glomerular filtration rate in patients with thyroid dysfunction, as these tests overestimated glomerular filtration rate in a patient with hypothyroidism and underestimated glomerular filtration rate in a patient with hyperthyroidism, perhaps through a metabolic rate-mediated mechanism. In both our patients, 24-h urinary creatinine secretion was identical before and after treatment, suggesting that creatinine production is not altered in patients with thyroid dysfunction. Therefore, kidney function in patients with thyroid dysfunction should be evaluated using creatinine-based estimated glomerular filtration rate.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Aichi Children’s Health and Medical Center, 426 7-chome, Morioka-cho, Obu, Aichi, 474-8710, Japan

    Osamu Uemura, Naoyuki Iwata, Takuhito Nagai, Satoshi Yamakawa, Satoshi Hibino, Masaki Yamamoto, Masaru Nakano & Kazuki Tanaka

  2. Department of Clinical Medicine, Japanese Red Cross Toyota College of Nursing, 12-33 Nanamagari, Hakusan-cho, Toyota, Aichi, 471-8565, Japan

    Osamu Uemura

Authors
  1. Osamu Uemura
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  2. Naoyuki Iwata
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  3. Takuhito Nagai
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  4. Satoshi Yamakawa
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  5. Satoshi Hibino
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  6. Masaki Yamamoto
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  7. Masaru Nakano
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  8. Kazuki Tanaka
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Correspondence to Osamu Uemura.

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This article does not contain any studies with human participants performed by any of the authors.

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Informed consent of the patients involved was provided about the publication of this article.

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Uemura, O., Iwata, N., Nagai, T. et al. Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients. CEN Case Rep 7, 169–173 (2018). https://doi.org/10.1007/s13730-018-0320-7

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  • DOI: https://doi.org/10.1007/s13730-018-0320-7

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