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Purpose <p>Proteinuria in the nephrotic range is associated with loss of thyroxine<b>-</b>binding protein, levothyroxine, or both, which may lead to subclinical hypothyroidism. The aim of this study was to correlate thyroid function and proteinuria in patients with stages 3 and 4 chronic kidney disease (CKD), in addition to evaluating whether thyroid function differs in these stages of CKD.</p> Methods <p>Observational, cross-sectional study including 150 patients with stages 3 and 4 CKD. Thyroid stimulating hormone (TSH), free T4 (FT4) and the urine protein-creatinine ratio (PCR) were analyzed. Proteinuria was defined as ≥ 200&#xa0;mg/g.</p> Results <p>Sixty-four patients (42.6%) had stage 3 CKD, and 86 patients (59.4%) had stage 4 CKD. The median age was 68&#xa0;years (IQR 61–76), the median TSH was 2.9 µIU/mL (IQR 1.89–4.04), the median FT4 was 1.26&#xa0;ng/dL (IQR 1.10–1.41), and the median PCR was 315.5&#xa0;mg/g (IQR 108.3–830). Ninety-one patients (60.6%) had proteinuria. In the total sample and in CKD stage 3, there was a statistically significant positive correlation between PCR and TSH, and a negative correlation between PCR and FT4. There were significant differences in the median age (<i>p</i> = 0.004), estimated glomerular filtration rate (<i>p</i> = 0.002), TSH (<i>p</i> = 0.001) and FT4 (<i>p</i> = 0.05) between the PCR &lt; and ≥ 200&#xa0;mg/g groups.</p> Conclusion <p>The results demonstrated a significant correlation between thyroid function and PCR, which corroborates that urinary protein loss can alter thyroid function in CKD stages 3 and 4. Thyroid function did not differ between CKD stages 3 and 4.</p> Study dataset is available on ClinicalTrials.gov ID <p>NCT04658524</p>

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Correlation between thyroid function and proteinuria in patients with chronic kidney disease stages 3 and 4

  • 期刊论文

  • 发表日期：

    2025年7月5日

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  • Karina Schiavoni Scandelai,
  • Pietra Desiree Bourdon Fuentes Azevedo Vianna,
  • João Pedro Barbosa Sanches,
  • Rachel Bregman,
  • Ana Beatriz Winter Tavares

摘要

Purpose

Proteinuria in the nephrotic range is associated with loss of thyroxine-binding protein, levothyroxine, or both, which may lead to subclinical hypothyroidism. The aim of this study was to correlate thyroid function and proteinuria in patients with stages 3 and 4 chronic kidney disease (CKD), in addition to evaluating whether thyroid function differs in these stages of CKD.

Methods

Observational, cross-sectional study including 150 patients with stages 3 and 4 CKD. Thyroid stimulating hormone (TSH), free T4 (FT4) and the urine protein-creatinine ratio (PCR) were analyzed. Proteinuria was defined as ≥ 200 mg/g.

Results

Sixty-four patients (42.6%) had stage 3 CKD, and 86 patients (59.4%) had stage 4 CKD. The median age was 68 years (IQR 61–76), the median TSH was 2.9 µIU/mL (IQR 1.89–4.04), the median FT4 was 1.26 ng/dL (IQR 1.10–1.41), and the median PCR was 315.5 mg/g (IQR 108.3–830). Ninety-one patients (60.6%) had proteinuria. In the total sample and in CKD stage 3, there was a statistically significant positive correlation between PCR and TSH, and a negative correlation between PCR and FT4. There were significant differences in the median age (p = 0.004), estimated glomerular filtration rate (p = 0.002), TSH (p = 0.001) and FT4 (p = 0.05) between the PCR < and ≥ 200 mg/g groups.

Conclusion

The results demonstrated a significant correlation between thyroid function and PCR, which corroborates that urinary protein loss can alter thyroid function in CKD stages 3 and 4. Thyroid function did not differ between CKD stages 3 and 4.

Study dataset is available on ClinicalTrials.gov ID

NCT04658524