title: Kidney failure in the elderly due to hypothyroidism: a case report.
abstract: BACKGROUND
  Hypothyroidism is more prevalent in the elderly and its symptoms can be confused with other changes due to aging. Doctors caring for the elderly need to be attentive to this diagnostic possibility. This case report case is notable not only because it presents a rare complication of hypothyroidism (kidney failure), but also because patients with chronic kidney failure of any etiology may suffer increased renal dysfunction as a result.
  
  
  METHODS
  This was a 66-year-old male outpatient with a history of generalized edema over the preceding eight years, with periods of worsening, that was intractable to treatment with diuretics. Physical examination revealed bradycardia (heart rate: 52 bpm), pallor, dry and infiltrated skin, macroglossia, edema in the lower limbs and a palpable thyroid with hard consistency. Laboratory tests showed: creatinine 3.9 mg/dl; urea 95 mg/dl; potassium 6.0 mEq/l; thyroid-stimulating hormone > 100 mUI/ml; triiodothyronine 0.01 ng/dl; free thyroxin 0.01 ng/dl; antithyroglobulin 31 IU/ml (normal values: < 40 IU/ml); antithyroperoxidase 85 IU/ml (normal values: < 15 IU/ml); creatinine clearance 30 ml/min/1.73 m(2); and proteinuria 122 mg/24 h. After five months of treatment with thyroxin (100 mcg/day), the patient returned without any symptoms and presented the following test results: urea 48 mg/dl; creatinine 1.4 mg/dl; creatinine clearance 67 ml/min/1.73 m(2); potassium 4.2 mEq/l; thyroid-stimulating hormone: 20.85 mUI/ml; free thyroxin: 0.71 ng/dl. Hypothyroidism alone can cause renal impairment or worsen renal function in preexisting illnesses. Its treatment can stabilize the clinical condition, or possibly improve it.
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo "Francisco Morato de Oliveira", São Paulo, Brazil.
authors.forename: Graziela Cristina Pichinin Ledo
authors.initials: GC
authors.lastname: Silva
authors.forename: Jaqueline Brotto
authors.initials: JB
authors.lastname: Carneiro
authors.forename: Cecília Carboni
authors.initials: CC
authors.lastname: Tardelli
authors.forename: Maviane
authors.initials: M
authors.lastname: Risso
authors.forename: Mauricio de Miranda
authors.initials: Mde M
authors.lastname: Ventura
mesh_terms: D000368:Aged; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D013972:Thyrotropin / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D013972:Thyrotropin