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      Thyroid dysfunction and kidney disease: An update.

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          Abstract

          Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment. Kidney disease may also cause thyroid dysfunction by several mechanisms. Nephrotic syndrome has been associated to changes in serum thyroid hormone concentrations. Different forms of glomerulonephritis and tubulointerstitial disease may be linked to thyroid derangements. A high prevalence of thyroid hormone alteration has been reported in acute kidney injury. Thyroid dysfunction is highly prevalent in chronic kidney disease patients. Subclinical hypothyroidism and low triiodothyronine syndrome are common features in patients with chronic kidney disease. Patients treated by both hemodialysis and peritoneal dialysis, and renal transplantation recipients, exhibit thyroid hormone alterations and thyroid disease with higher frequency than that found in the general population. Drugs used in the therapy of thyroid disease may lead to renal complications and, similarly, drugs used in kidney disorders may be associated to thyroid alterations. Lastly, low thyroid hormones, especially low triiodothyronine levels, in patients with chronic kidney disease have been related to a higher risk of cardiovascular disease and all-cause mortality. Interpretation of the interactions between thyroid and renal function is a challenge for clinicians involved in the treatment of patients with thyroid and kidney disease.

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          Author and article information

          Journal
          Rev Endocr Metab Disord
          Reviews in endocrine & metabolic disorders
          Springer Nature
          1573-2606
          1389-9155
          Mar 2017
          : 18
          : 1
          Affiliations
          [1 ] Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain. piglo65@gmail.com.
          [2 ] Department of Nephrology, Hospital La Paz, Madrid, Spain.
          [3 ] Department of Health Sciences, Universidad Autónoma de Madrid, Madrid, Spain.
          [4 ] Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain.
          [5 ] Department of Medicine, University de Alcalá de Henares, Madrid, Spain.
          Article
          10.1007/s11154-016-9395-7
          10.1007/s11154-016-9395-7
          27864708
          a1de4464-3445-430e-8960-fb6b690ed1a6
          History

          Cardiovascular disease,Dialysis,Hyperthyroidism,Hypothyroidism,Kidney,Mortality,Thyroid,Thyroid cancer

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