Prevalence of thyroid autoimmunity and subclinical hypothyroidism in persons with chronic kidney disease not requiring chronic dialysis.
BACKGROUND
The prevalence of thyroid autoimmunity and subclinical primary hypothyroidism in persons with chronic kidney disease (CKD) not requiring chronic dialysis is not well defined.


METHODS
We studied 1000 consecutive adult outpatients who were referred by their general practitioner for blood testing over the last 2 years. We excluded those with abnormal serum free thyroxine (FT4) levels (n=85). No participants required chronic renal replacement therapy. Thyroid autoimmunity was defined as increased concentrations of serum anti-thyroid antibodies. Subclinical primary hypothyroidism was defined as a serum thyrotropin (TSH) concentration >4 mIU/L. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2).


RESULTS
Overall, 53 (5.8%) subjects had eGFR <60 mL/min/1.73 m(2). Of these, 98 (10.7%) had subclinical hypothyroidism, and 213 (23.3%) subjects had increased anti-thyroid antibodies. Approximately 26% and 34% of those with eGFR <60 mL/min/1.73 m(2) had laboratory evidence of subclinical hypothyroidism or thyroid autoimmunity, respectively. In subgroup analysis stratified by TSH and thyroid autoimmunity, decreasing eGFR values appeared to be more strongly related with the increase in TSH rather than antithyroid antibodies.


CONCLUSIONS
Thyroid autoimmunity and subclinical primary hypothyroidism are highly prevalent in persons with CKD not requiring chronic dialysis.
Targher
Giovanni
G
Section of Endocrinology, Department of Biomedical and Surgical Sciences, University Hospital of Verona, Verona, Italy. giovanni.targher@univr.it
Chonchol
Michel
M
Zoppini
Giacomo
G
Salvagno
Gianluca
G
Pichiri
Isabella
I
Franchini
Massimo
M
Lippi
Giuseppe
G
D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications*; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications*; D007677:Kidney Function Tests; D015995:Prevalence; D006435:Renal Dialysis; D013960:Thyroid Function Tests