Acute renal failure due to amiodarone-induced hypothyroidism.
Renal alterations in hypothyroidism include decreased glomerular filtration rate and renal plasma flow. We herein report a case of amiodarone -induced hypothyroidism associated with a rapid decrease of renal function, reversible upon amiodarone withdrawal. A 72-year-old man presented to our clinic in August 2007 reporting a recent deterioration of renal function. Ten weeks before he was admitted to another hospital for a supraventricular tachyarrhythmia treated with carvedilol 12.5 mg/day and amiodarone 400 mg/day. On admission, laboratory tests revealed altered renal function (serum creatinine 6 mg/dl, blood urea nitrogen 78 mg/dl) and severe hypothyroidism (free T4 0.27 pg/ml, free T3 1.49 pg/ml, TSH 183.36 mU/l). Amiodarone and carvedilol were stopped, while levothyroxine 75 mcg/die was started. After three months renal function had completely recovered to 1.9 mg/dl, BUN 28 mg/dl, with concurrent improvement of thyroid function free T4 14.2 pg/ml, free T3 6.4 pg/ml, TSH 15.5 mU/l.
Luciani
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Department of Nephrology, Sant'Andrea University Hospital, University of Rome "La Sapienza", Rome, Italy. rluciani@ospedalesantandrea.it
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D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000150:complications*; D007677:Kidney Function Tests; D008297:Male; D013617:Tachycardia, Supraventricular / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone