title: Serum T3 level can predict cardiovascular events and all-cause mortality rates in CKD patients with proteinuria.
abstract: BACKGROUND
  Patients with proteinuria frequently show changes in thyroid hormone levels. Serum T3 depression predicts a negative outcome in chronic kidney disease (CKD) patients and may be associated with cardiovascular complications or chronic inflammation. Few studies have explored the relationship between thyroid hormone dysregulation and clinical outcome in patients with proteinuria.
  
  
  METHODS
  We reviewed thyroid function test results obtained from 211 patients with 24 h urinary protein excretion greater than 150 mg/day and found a correlation of thyroid hormone level with cardiovascular events and mortality.
  
  
  RESULTS
  T3 decreased with age (p = 0.001) and 24 h urine albumin (p = 0.028). Free T4 decreased in accordance with 24 h urine protein and serum creatinine (p = 0.034 and p = 0.033, respectively). In the Kaplan-Meier survival analysis, lower cumulative survival, higher cardiovascular events, and mortality were found in the low T3 group compared with the normal T3 group (p = 0.000, p = 0.013, and p = 0.001, respectively). In Cox regression analysis, we observed that, with low T3, decreased sodium, and old age, the incidence of cardiovascular complications (p = 0.000, p = 0.016, and p = 0.000, respectively), cardiovascular mortality (p = 0.000, p = 0.048, and p = 0.001, respectively), and all-cause mortality (p = 0.000, p = 0.017, and p = 0.000, respectively) increased.
  
  
  CONCLUSIONS
  In CKD patients with proteinuria, low T3 concentration predicted all-cause mortality and cardiovascular event independently of the severity of proteinuria.
authors.affiliation: Department of Nephrology, Wonju College of Medicine, Yonsei University, Wonju, Gangwon-do, South Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Yang
authors.forename: Seung Tae
authors.initials: ST
authors.lastname: Han
authors.forename: Shin Han
authors.initials: SH
authors.lastname: Song
authors.forename: Min Keun
authors.initials: MK
authors.lastname: Kim
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Seung Ok
authors.initials: SO
authors.lastname: Choi
authors.forename: Byoung-Geun
authors.initials: BG
authors.lastname: Han
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000097:blood* / Q000150:complications; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D015415:Biomarkers; D014284:Triiodothyronine; D013974:Thyroxine