Low thyroid function is not associated with an accelerated deterioration in renal function

Thyroid Studies Collaboration

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. METHODS: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. RESULTS: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. CONCLUSIONS: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

Original languageEnglish (US)
Pages (from-to)650-659
Number of pages10
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Glomerular Filtration Rate
Thyroid Gland
Thyroid Hormones
Kidney
Linear Models
Hypothyroidism
Chronic Renal Insufficiency
Diet Therapy
Thyrotropin
Hyperthyroidism
Thyroxine
Meta-Analysis
Creatinine
Age Groups
Cross-Sectional Studies
Confidence Intervals

Keywords

  • chronic renal failure
  • CKD
  • creatinine clearance
  • epidemiology
  • thyroid function

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

@article{381cedf90660415dac7b334233881f83,
title = "Low thyroid function is not associated with an accelerated deterioration in renal function",
abstract = "BACKGROUND: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. METHODS: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. RESULTS: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95{\%} confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. CONCLUSIONS: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.",
keywords = "chronic renal failure, CKD, creatinine clearance, epidemiology, thyroid function",
author = "{Thyroid Studies Collaboration} and Meuwese, {Christiaan L.} and {van Diepen}, Merel and Cappola, {Anne R.} and Sarnak, {Mark J.} and Shlipak, {Michael G.} and Bauer, {Douglas C.} and Fried, {Linda P} and Massimo Iacoviello and Bert Vaes and Jean Degryse and Khaw, {Kay Tee} and Luben, {Robert N.} and {\AA}svold, {Bj{\o}rn O.} and Trine Bj{\o}ro and Vatten, {Lars J.} and {de Craen}, {Anton J.M.} and Stella Trompet and Giorgio Iervasi and Sabrina Molinaro and Graziano Ceresini and Luigi Ferrucci and Dullaart, {Robin P.F.} and Bakker, {Stephan J.L.} and Jukema, {J. Wouter} and Kearney, {Patricia M.} and Stott, {David J.} and Peeters, {Robin P.} and Franco, {Oscar H.} and Henry V{\"o}lzke and Walsh, {John P.} and Alexandra Bremner and Sgarbi, {Jos{\'e} A.} and Maciel, {Rui M.B.} and Misa Imaizumi and Waka Ohishi and Dekker, {Friedo W.} and Nicolas Rodondi and Jacobijn Gussekloo and {den Elzen}, {Wendy P.J.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1093/ndt/gfy071",
language = "English (US)",
volume = "34",
pages = "650--659",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Low thyroid function is not associated with an accelerated deterioration in renal function

AU - Thyroid Studies Collaboration

AU - Meuwese, Christiaan L.

AU - van Diepen, Merel

AU - Cappola, Anne R.

AU - Sarnak, Mark J.

AU - Shlipak, Michael G.

AU - Bauer, Douglas C.

AU - Fried, Linda P

AU - Iacoviello, Massimo

AU - Vaes, Bert

AU - Degryse, Jean

AU - Khaw, Kay Tee

AU - Luben, Robert N.

AU - Åsvold, Bjørn O.

AU - Bjøro, Trine

AU - Vatten, Lars J.

AU - de Craen, Anton J.M.

AU - Trompet, Stella

AU - Iervasi, Giorgio

AU - Molinaro, Sabrina

AU - Ceresini, Graziano

AU - Ferrucci, Luigi

AU - Dullaart, Robin P.F.

AU - Bakker, Stephan J.L.

AU - Jukema, J. Wouter

AU - Kearney, Patricia M.

AU - Stott, David J.

AU - Peeters, Robin P.

AU - Franco, Oscar H.

AU - Völzke, Henry

AU - Walsh, John P.

AU - Bremner, Alexandra

AU - Sgarbi, José A.

AU - Maciel, Rui M.B.

AU - Imaizumi, Misa

AU - Ohishi, Waka

AU - Dekker, Friedo W.

AU - Rodondi, Nicolas

AU - Gussekloo, Jacobijn

AU - den Elzen, Wendy P.J.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - BACKGROUND: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. METHODS: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. RESULTS: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. CONCLUSIONS: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

AB - BACKGROUND: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. METHODS: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. RESULTS: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. CONCLUSIONS: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

KW - chronic renal failure

KW - CKD

KW - creatinine clearance

KW - epidemiology

KW - thyroid function

UR - http://www.scopus.com/inward/record.url?scp=85064579058&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064579058&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfy071

DO - 10.1093/ndt/gfy071

M3 - Article

VL - 34

SP - 650

EP - 659

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 4

ER -