Abnormal Thyroid-Stimulating Hormone and Chronic Kidney Disease in Elderly Adults in Taipei City.
To examine whether older people with abnormal thyroid function are more likely to develop chronic kidney disease (CKD) over a 5-year follow-up period.



Retrospective cohort study.



Health examination data from the Taipei Databank for Public Health Analysis.



Individuals aged 65 and older (N = 41,454).



Thyroid-stimulating hormone (TSH) levels were repeatedly measured, and subjects were categorized into four thyroid function groups (hyperthyroid, euthyroid, subclinical hypothyroid, overt hypothyroid). The risk of incident CKD was evaluated using a stepwise Cox proportional hazards regression model adjusted for sex, baseline age, hypertension, diabetes mellitus (DM), dyslipidemia, hyperuricemia, anemia, obesity, liver function, smoking, and alcohol.



Higher TSH levels were associated with greater risk of subsequent CKD. Individuals with subclinical hypothyroidism (hazard ratio (HR) = 1.15, 95% confidence interval (CI) = 1.05-1.26) and those with overt hypothyroidism (HR = 1.27, 95% CI = 1.04-1.55) were more likely than those who were euthyroid to have CKD. Women were more likely to have CKD than men (HR = 1.11, 95% CI = 1.06-1.16). When stratified by gender, subclinical hypothyroidism in women was associated with an increased risk of developing CKD (HR = 1.22; 95% CI = 1.08-1.39). When stratified by DM, subclinical hypothyroidism and overt hypothyroidism were associated with an increased risk of developing CKD in nondiabetics (HR = 1.19; 95% CI = 1.07-1.31; and HR = 1.34; 95% CI = 1.08-1.65, respectively).



This cohort study of elderly persons in Taipei City found a significant association between hypothyroidism and development of CKD in women and individuals without DM.
Division of Family Medicine, Department of Community Medicine, Taipei City Hospital, Taipei, Taiwan.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Mei-Hsing
MH
Chuang
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei City Hospital, Taipei, Taiwan.
Kuo-Meng
KM
Liao
Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Yao-Min
YM
Hung
Division of Nephrology, Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California.
Paul Yung-Pou
PY
Wang
Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Yi-Chang
YC
Chou
Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Pesus
P
Chou
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*
D013972:Thyrotropin
chronic kidney disease; glomerular filtration rate; hypothyroidism; proteinuria; thyroid-stimulating hormone