title: Prevalence of hypothyroidism in diabetic kidney disease and effect of thyroid hormone replacement on estimate glomerular filtration rate.
abstract: OBJECTIVE
  To determine the prevalence of subclinical and overt hypothyroidism in diabetic kidney disease (DKD) and effect of thyroid hormone replacement on progression of DKD.
  
  
  METHODS
  A prospective cohort study on 41 adult DKD patients who were screened for hypothyroidism. Hypothyroid DKD patients were started on levothyroxine replacement and were reviewed after 3 and 6 months.
  
  
  RESULTS
  Of the total population, 14 (34.1%) cases were hypothyroid, among whom 12 (29.3%) cases were subclinical, and 2 (4.8%) were overt hypothyroidism. Prevalence of hypothyroidism and mean thyroid stimulating hormone levels increased with increasing severity of DKD. There were 2 (14.3%) hypothyroid cases in stage 3b, 4 (28.5%) cases in stage 4, and 8 (57.2%) in stage 5 DKD. The mean estimate glomerular filtration rate (ml/min/1.73 m2) at baseline was 13.6 ± 13.3 which increased to 16.4 ± 14.5 and 21.2 ± 15.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT), respectively (P< 0.001).
  
  
  CONCLUSIONS
  Hypothyroidism is commonly associated with DKD. Prevalence of hypothyroidism increased with declining renal function. THRT significantly improved renal function in DKD patients with hypothyroidism after 3 and 6 months of therapy.
authors.affiliation: Department of Medicine, MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India.
authors.forename: Sarita
authors.initials: S
authors.lastname: Bajaj
authors.affiliation: Department of Medicine, MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India.
authors.forename: Naincy
authors.initials: N
authors.lastname: Purwar
authors.affiliation: Department of Medicine, MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Medicine, MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India.
authors.forename: Poonam
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Medicine, MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India.
authors.forename: Anubha
authors.initials: A
authors.lastname: Srivastava
keywords: Diabetic kidney disease; estimate glomerular filtration rate; hypothyroidism