Batman A, Canat M M, Saygili E S, Besler E, Yildiz D, Ozturk F Yener, Altuntas Y
Koc University Hospital - Endocrinology and Metabolism, Yeni Sanayi Mah, Tacin Cd., 68200 Aksaray Merkez/Aksaray, Turkey.
University of Health Sciences Turkey, Sariyer Etfal Training and Research Hospital - Department of Endocrinology and Metabolism, Istanbul.
Acta Endocrinol (Buchar). 2023 Oct-Dec;19(4):456-462. doi: 10.4183/aeb.2023.456. Epub 2024 Jun 24.
This study aims to investigate the factors affecting development of acute kidney injury (AKI) in patients with severe hypothyroidism.
This retrospective observational study involved patients with primary hypothyroidism and thyroid stimulating hormone (TSH) levels of more than 50 mIU/L at their review in the endocrinology outpatient clinic, between January 2015 and April 2021. Factors affecting the development of AKI were examined by logistic regression analysis.
A total of 100 patients, 20 (11 male (M), 9 female (F)) in the AKI (case) group and 80 (23 M, 57 F) patients in control group, were included in our study. The median age of the case group (56 years, interquartile range (IQR) 44.3-68.5) was significantly higher than the control group (49 years, IQR 32.3-60; p = 0.027), and the ratio of males to females was significantly higher in the case group (p = 0.001). Multivariate logistic regression analyses showed that hypothyroidism diagnosed after the age of 60 years (odds ratio (OR) 59.674, 95% confidence intervals (CI) 5.955-598.031; p = 0.001), free triiodothyronine (FT3) < 1.3 pg/mL (OR 17.151, 95% CI 2.491-118.089; p = 0.004) and creatine kinase (CK) > 1000 U/L (OR 1.522, 95% CI 1.602-82.848; p = 0.015) were predictors for the development of AKI in patients with severe hypothyroidism.
We recommend close follow-up and monitoring of patients with AKI caused by severe hypothyroidism if patients who are diagnosed at age > 60 years, CK > 1000 U/L or FT3 < 1.3 pg/mL.
本研究旨在探讨影响重度甲状腺功能减退患者急性肾损伤(AKI)发生发展的因素。
本回顾性观察性研究纳入了2015年1月至2021年4月期间在内分泌门诊复诊时原发性甲状腺功能减退且促甲状腺激素(TSH)水平超过50 mIU/L的患者。通过逻辑回归分析研究影响AKI发生的因素。
本研究共纳入100例患者,其中AKI(病例)组20例(男性11例,女性9例),对照组80例(男性23例,女性57例)。病例组的中位年龄(56岁,四分位间距(IQR)44.3 - 68.5)显著高于对照组(49岁,IQR 32.3 - 60;p = 0.027),且病例组男女比例显著更高(p = 0.001)。多因素逻辑回归分析显示,60岁以后诊断为甲状腺功能减退(比值比(OR)59.674,95%置信区间(CI)5.955 - 598.031;p = 0.001)、游离三碘甲状腺原氨酸(FT3)< 1.3 pg/mL(OR 17.151,95% CI 2.491 - 118.089;p = 0.004)以及肌酸激酶(CK)> 1000 U/L(OR 1.522,95% CI 1.602 - 82.848;p = 0.015)是重度甲状腺功能减退患者发生AKI的预测因素。
我们建议,对于年龄> 60岁、CK > 1000 U/L或FT3 < 1.3 pg/mL的重度甲状腺功能减退所致AKI患者进行密切随访和监测。