title: The association of thyroid function and the risk of kidney function decline: a population-based cohort study.
abstract: OBJECTIVE
  Thyroid dysfunction has been associated with kidney function decline, but mainly in cross-sectional studies. Therefore, we aimed to determine the association between thyroid and kidney function in a prospective population-based cohort study longitudinally.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Participants aged ≥45 years from the Rotterdam Study with thyroid and kidney function assessment were included. Kidney function and new onset chronic kidney disease (CKD) were defined using estimated glomerular filtration ate (eGFR), with CKD defined as eGFR <60 mL/min/1.73 m2according to the CKD-EPI formula.
  
  
  RESULTS
  We included 5103 participants (mean age of 63.6 years) with a mean follow-up of 8.1 years. Cross-sectionally, higher TSH levels were associated with lower eGFR (Beta (β): -1.75 mL/min; 95% confidence interval (CI): -2.17, -1.33), in multivariable models adjusting for several cardiovascular risk factors including smoking, hypertension and history of coronary heart disease among others. In contrast, longitudinally, higher TSH levels were associated with less annual eGFR decline (β: -0.06 mL/min; CI: -0.11, -0.01) and lower CKD incidence (odds ratio 0.85, CI; 0.75, 0.96). Compared with euthyroid participants, subclinical hyperthyroid individuals had an increased risk for CKD whereas hypothyroid individuals had a decreased risk (P for trend = 0.04).
  
  
  CONCLUSIONS
  Hyperactive thyroid function is associated with increased risk of kidney function decline while hypothyroidism is associated with a decreased CKD risk. More insight is needed in the pathophysiological pathways connecting high thyroid function and kidney function decline.
authors.affiliation: Rotterdam Thyroid Center.|Department of Internal Medicine.|Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Layal
authors.initials: L
authors.lastname: Chaker
authors.affiliation: Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sedaghat
authors.affiliation: Department of Internal Medicine.
authors.forename: Ewout J
authors.initials: EJ
authors.lastname: Hoorn
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine.
authors.forename: Wendy P J Den
authors.initials: WP
authors.lastname: Elzen
authors.affiliation: Department of Public Health and Primary CareLeiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.affiliation: Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.|Harvard T H Chan School of Public HealthBoston, Massachusetts, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.|Department of NeurologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Abbas
authors.initials: A
authors.lastname: Dehghan
authors.affiliation: Rotterdam Thyroid Center r.peeters@erasmusmc.nl.|Department of Internal Medicine.|Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D013961:Thyroid Gland / Q000502:physiology*; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D013963:Thyroid Hormones