Eşme Mert, Bulur Oktay, Atak Mehmet Can, Balcı Cafer, Dal Kürşat, Ertuğrul Derun Taner, Dikmen Zeliha Günnur, Halil Meltem Gülhan, Cankurtaran Mustafa, Balam Doğu Burcu
Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Department of Internal Medicine, Keçiören Training and Research Hospital, Ankara, Turkey
Turk J Med Sci. 2021 Jun 28;51(3):1267-1272. doi: 10.3906/sag-2011-257.
BACKGROUND/AIM: Renal function of patients with hypothyroidism increases after reaching euthyroid state. There is no data regarding geriatric age group. The aim of the study was determined to investigate whether renal function of geriatric patients with hypothyroidism increases after they become euthyroid.
Patients who were sixty-five years or older were retrospectively screened in two centers. TSH, T3, T4, creatinine, and eGFR calculated by CKD-EPI formula were recorded under the presence of accompanying hypothyroidism. The same variables were recorded after the patients became euthyroid.
285 patients were included in the study, the median age was 73(65–84), and 234 patients were female. Patients were examined in four groups according to TSH values. There were 160 (56.1%) patients with TSH 5–9.9 uIU/mL, 60(21.1%) patients with TSH between 10–19.9 uIU/mL, 41(14.4 %) patients with TSH between 20–49.9 uIU/mL and 24(8.4%) patients with TSH> 50uIU/mL. There was a significant and negative correlation between the initial TSH values and the first calculated eGFR values (p: 0.001; r: –0.191). The median eGFR of the patients in hypothyroid cases was 66.59 (14.62–116.07), while the median eGFR value of patients was 69.6 (12.91–109.31) in the euthyroid state. This value obtained after thyroid replacement was significantly improved when compared to the first eGFR (p: 0.001). In logistic regression analysis, pretreatment TSH value was found to independently affect eGFR (p: 0.009; Exb: 1.017).
It has been observed that hypothyroidism treatment increases eGFR in geriatric patients. Similar results were obtained after studies with younger patients in the literature. This study is a study in which only geriatric age group patients were examined. It should be kept in mind that hypothyroidism which is not corrected in geriatric patients may also contribute to a decrease in eGFR.
背景/目的:甲状腺功能减退患者甲状腺功能恢复正常后肾功能会有所改善。目前尚无关于老年人群的数据。本研究旨在调查老年甲状腺功能减退患者甲状腺功能恢复正常后肾功能是否会改善。
对两个中心65岁及以上的患者进行回顾性筛查。记录伴有甲状腺功能减退时的促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、肌酐以及用慢性肾脏病流行病学合作(CKD-EPI)公式计算的估算肾小球滤过率(eGFR)。患者甲状腺功能恢复正常后记录相同变量。
285例患者纳入研究,中位年龄为73岁(65 - 84岁),女性234例。根据TSH值将患者分为四组。TSH为5 - 9.9 μIU/mL的患者有160例(56.1%),TSH在10 - 19.9 μIU/mL之间的患者有60例(21.1%),TSH在20 - 49.9 μIU/mL之间的患者有41例(14.4%),TSH > 50 μIU/mL的患者有24例(8.4%)。初始TSH值与首次计算的eGFR值之间存在显著负相关(p:0.001;r:–0.191)。甲状腺功能减退患者的eGFR中位数为66.59(14.62 - 116.07),甲状腺功能正常状态下患者的eGFR中位数为69.6(12.91 - 109.31)。与首次eGFR相比,甲状腺替代治疗后获得的该值有显著改善(p:0.001)。在逻辑回归分析中,发现治疗前TSH值独立影响eGFR(p:0.009;Exb:1.017)。
观察到甲状腺功能减退治疗可提高老年患者的eGFR。文献中对年轻患者研究后也得到了类似结果。本研究仅对老年人群患者进行了检查。应记住,老年患者未纠正的甲状腺功能减退也可能导致eGFR降低。