Thyroid Dysfunction and Cardiovascular Disease in Chronic Kidney Disease

  • Carmine Zoccali
  • Francesca Mallamaci


Chronic renal insufficiency alters thyroid hormone synthesis, distribution, and elimination and disturbs central (hypothalamo-pituitary) control of thyroid function. About one out five patients with a GFR < 60 mL/min/1.73 m2 shows subclinical or clinical hypothyroidism. Inflammation is a relevant player in the low T3 levels, which is the most frequent alteration in thyroid function in chronic kidney disease (CKD). There is still no definitive experimental proof that thyroid dysfunction is causally implicated in the high risk for death and cardiovascular events in this condition. Observational studies point to thyroid dysfunction as a relevant player in cardiomyopathy and the high risk of death and cardiovascular events of CKD patients. Mechanistic studies and exploratory intervention trials testing upstream pathways regulating thyroid hormone in CKD patients are needed to assess the nature of the association between thyroid dysfunction and clinical outcomes unraveled by observational studies in this very high risk population.


Thyroid dysfunction Low T3 Subclinical hypothyroidism Chronic kidney disease (CKD) Dialysis Hemodialysis Cardiovascular risk Mortality LVH LV dysfunction 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Carmine Zoccali
    • 1
  • Francesca Mallamaci
    • 1
    • 2
  1. 1.IFC-CNR, Epidemiologia Clinica e Fisiopatologia delle Malattie Renali e dell’Ipertensione ArteriosaReggio CalabriaItaly
  2. 2.Unità Operativa di Nefrologia, Dialisi e Trapianto Renale Ospedali Riuniti and IBIM-CNRReggio CalabriaItaly

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