TY - JOUR
T1 - Subclinical hypothyroidism is independently associated with poor renal outcomes in patients with chronic kidney disease
AU - Tsuda, Susumu
AU - Nakayama, Masaru
AU - Matsukuma, Yuta
AU - Yoshitomi, Ryota
AU - Haruyama, Naoki
AU - Fukui, Akiko
AU - Nakano, Toshiaki
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
N1 - Funding Information:
The authors would like to express their gratitude to the 569 participants of the study and to the cardiologists who performed the echocardiography. The authors would also thank Mark Cleasby, Ph.D., from Edanz Group (https://en-author-services.edanzgroup.com/ac ) for editing a draft of this manuscript.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
PY - 2021/7
Y1 - 2021/7
N2 - Purpose: It remains unclear whether subclinical hypothyroidism (SCH) is associated with renal prognosis in patients with chronic kidney disease (CKD). Therefore, we prospectively investigated the association of SCH with renal outcomes in CKD. Methods: We conducted a prospective observational study of 480 euthyroid patients and 89 patients with SCH. The endpoints were defined as a composite of doubling of serum creatinine (SCr), end-stage renal disease (ESRD), or death, and a composite of doubling of SCr or ESRD was added as an alternative outcome. Logistic regression analyses were used to identify the factors associated with SCH. In addition, a Cox proportional hazards model was performed to determine whether SCH was associated with poor renal outcomes. Results: During a median follow-up period of 26.1 months, doubling of SCr, ESRD, or death and doubling of SCr or ESRD occurred in 244 and 213 patients, respectively. In univariable logistic regression analyses, SCH was significantly associated with older age, lower hemoglobin, higher proteinuria, lower estimated glomerular filtration rate (eGFR), and higher log B-type natriuretic peptide (BNP). Multivariable Cox analyses showed that SCH was associated with poorer renal outcomes after adjustment for covariates, including eGFR and log BNP [doubling of SCr, ESRD, or death: hazard ratio (HR) 1.61, 95% confidence interval (CI), 1.16–2.23; doubling of SCr or ESRD: HR 1.53, 95% CI 1.07–2.20], compared with euthyroidism. Conclusions: In CKD, SCH is independently associated with poor renal outcomes, suggesting that screening for SCH might be needed to accurately predict renal prognosis.
AB - Purpose: It remains unclear whether subclinical hypothyroidism (SCH) is associated with renal prognosis in patients with chronic kidney disease (CKD). Therefore, we prospectively investigated the association of SCH with renal outcomes in CKD. Methods: We conducted a prospective observational study of 480 euthyroid patients and 89 patients with SCH. The endpoints were defined as a composite of doubling of serum creatinine (SCr), end-stage renal disease (ESRD), or death, and a composite of doubling of SCr or ESRD was added as an alternative outcome. Logistic regression analyses were used to identify the factors associated with SCH. In addition, a Cox proportional hazards model was performed to determine whether SCH was associated with poor renal outcomes. Results: During a median follow-up period of 26.1 months, doubling of SCr, ESRD, or death and doubling of SCr or ESRD occurred in 244 and 213 patients, respectively. In univariable logistic regression analyses, SCH was significantly associated with older age, lower hemoglobin, higher proteinuria, lower estimated glomerular filtration rate (eGFR), and higher log B-type natriuretic peptide (BNP). Multivariable Cox analyses showed that SCH was associated with poorer renal outcomes after adjustment for covariates, including eGFR and log BNP [doubling of SCr, ESRD, or death: hazard ratio (HR) 1.61, 95% confidence interval (CI), 1.16–2.23; doubling of SCr or ESRD: HR 1.53, 95% CI 1.07–2.20], compared with euthyroidism. Conclusions: In CKD, SCH is independently associated with poor renal outcomes, suggesting that screening for SCH might be needed to accurately predict renal prognosis.
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U2 - 10.1007/s12020-021-02611-6
DO - 10.1007/s12020-021-02611-6
M3 - Article
C2 - 33474711
AN - SCOPUS:85100149335
SN - 0969-711X
VL - 73
SP - 141
EP - 150
JO - Endocrine
JF - Endocrine
IS - 1
ER -