Graves T K, Olivier N B, Nachreiner R F, Kruger J M, Walshaw R, Stickle R L
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824.
Am J Vet Res. 1994 Dec;55(12):1745-9.
We measured glomerular filtration rate (GFR) estimated by plasma disappearance of 99mTc-labeled diethylenetriaminepentaacetic acid, serum concentrations of thyroxine (T4), creatinine, and urea nitrogen, and urine specific gravity in 13 cats with naturally acquired hyperthyroidism before and 30 days after treatment by bilateral thyroidectomy, and in a group of 11 control cats. Mean (+/- SD) serum T4 concentration decreased from a pretreatment value of 120.46 (+/- 39.21) nmol/L to a posttreatment value of 12.15 (+/- 6.26) nmol/L (P < 0.0001; reference range, 10 to 48 nmol/L). Treatment of hyperthyroidism resulted in a decrease in mean (+/- SD) glomerular filtration rate, from 2.51 (+/- 0.69) ml/kg of body weight/min to a posttreatment value of 1.40 (+/- 0.41) ml/kg/min (P < 0.0001). Mean serum creatinine concentration increased from 1.26 (+/- 0.34) mg/dl to 2.05 (+/- 0.60) mg/dl (P < 0.01). Mean serum urea nitrogen concentration increased from 26.62 (+/- 6.83) mg/dl to a mean postthyroidectomy concentration of 34.92 (+/- 8.95) mg/dl (P < 0.01). All changes were significant. Two cats developed overt renal azotemia after treatment of hyperthyroidism. Our results provide further evidence that treatment of hyperthyroidism can result in impaired renal function. In addition, our results suggest that, in some instances, thyrotoxicosis might mask underlying chronic renal insufficiency.
我们测定了13只自然发生甲状腺功能亢进的猫在双侧甲状腺切除术前及术后30天的肾小球滤过率(GFR)(通过99mTc标记的二乙三胺五乙酸的血浆清除率估算)、血清甲状腺素(T4)、肌酐和尿素氮浓度以及尿比重,并与11只对照猫进行了比较。血清T4浓度平均值(±标准差)从治疗前的120.46(±39.21)nmol/L降至治疗后的12.15(±6.26)nmol/L(P<0.0001;参考范围为10至48 nmol/L)。甲状腺功能亢进的治疗导致肾小球滤过率平均值(±标准差)降低,从2.51(±0.69)ml/(kg体重·min)降至治疗后的1.40(±0.41)ml/(kg/min)(P<0.0001)。血清肌酐浓度平均值从1.26(±0.34)mg/dl升至2.05(±0.60)mg/dl(P<0.01)。血清尿素氮浓度平均值从26.62(±6.83)mg/dl升至甲状腺切除术后的平均值34.92(±8.95)mg/dl(P<0.01)。所有变化均具有统计学意义。两只猫在甲状腺功能亢进治疗后出现明显的肾性氮质血症。我们的结果进一步证明,甲状腺功能亢进的治疗可导致肾功能受损。此外,我们的结果表明,在某些情况下,甲状腺毒症可能掩盖潜在的慢性肾功能不全。