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      Treatment of Severe Hypothyroidism Reduced Serum Creatinine Levels in Two Chronic Renal Failure Patients

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          Short-term hypothyroidism has been associated with a reversible rise in serum creatinine levels in patients with normal renal function. A remarkable decline in serum creatinine levels associated with a treatment of severe and prolonged hypothyroidism has rarely been reported so far. We present here 2 patients with chronic renal failure in whom treatment for hypothyroidism resulted in a significant and sustained reduction of their serum creatinine levels. These cases indicate that because hypothyroidism may aggravate the serum creatinine levels, TSH should be considered in screening procedures of patients with chronic renal failure presenting with recent accelerated aggravation of renal function. Hypothyroidism per se, one of its complications or one of its associated autoimmune diseases might play a role in modifying the underlying renal problem.

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          Consistent reversible elevations of serum creatinine levels in severe hypothyroidism.

          Changes in routine clinical chemical indicators of renal function in the hypothyroid state are not well characterized, and are infrequently discussed in standard internal medicine or subspeciality textbooks. We evaluated 24 consecutive patients with iatrogenic hypothyroidism induced prior to radioiodine scanning for monitoring of thyroid carcinoma. Serum creatinine and thyroid function tests were measured prior to, during, and subsequent to the period of induced hypothyroidism. Among 29 episodes with paired prior euthyroid and hypothyroid serum creatinine values, the hypothyroid value was greater in 26 (89.7%), and equal in 3 (10.3%), less in none; the mean hypothyroid value was significantly greater (103 vs 76 micromol/L [1.17 vs 0.87 mg/dL]) (P<.001). Among 36 episodes with paired hypothyroid and subsequent euthyroid serum creatinine values, the hypothyroid value was greater in 33 (91.7%), equal in 2 (5.6%), and less in 1 (2.8%); the mean hypothyroid value was again significantly greater (102 vs 75 pmol/L [1.15 vs 0.85 mg/dL]) (P<.001). There was no significant difference between prior and subsequent euthyroid serum creatinine values. Serum creatinine values above the stated normal range occurred in 6 of 36 hypothyroid episodes. There is a consistent and reversible elevation of serum creatinine values in the hypothyroid state. Frankly abnormal serum creatinine levels will occur in some cases.
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            Hyponatremia of hypothyroidism. Appropriate suppression of antidiuretic hormone levels

             C Macaron,  O Famuyiwa (1978)
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              Increased serum creatinine in the absence of renal failure in profound hypothyroidism


                Author and article information

                S. Karger AG
                22 June 2001
                : 88
                : 3
                : 264-267
                aDivision of Hypertension and Nephrology, National Cardiovascular Center, Suita; bDepartment of Internal Medicine, Sumitomo Hospital, Osaka Japan
                46000 Nephron 2001;88:264–267
                © 2001 S. Karger AG, Basel

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                Tables: 2, References: 16, Pages: 4
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