A STUDY TO EVALUATE THE EFFECT OF L-THYROXIN SUPPLEMENTATION ON SERUM CREATININE AND INSULIN-LIKE GROWTH FACTOR-1 IN HYPOTHYROID SUBJECTS : A LONGITUDINAL STUDY FROM EASTERN INDIA

Dr. Trinanjan Sanyal

Abstract


The aim our study is to detect any renal compromise if at all present in hypothyroid state and whether such compromise is correctable by LT4 replacement. Longitudinal, self-controlled study was performed with 60 Drug-naïve (untreated) primary hypothyroid patients aged between 18 to 60 years with normal urinary findings, no recent therapy with cephalosporines (within two weeks) and with a normal creatinine level (upto 1.3mg/dl). Fasting blood samples were taken for Sr. IGF1 & Sr. creatinine. Then the patients were advice to take daily L-thyroxine (1.6 microgram/kg/day) and reviewed at least after 12 weeks and fasting blood samples were taken for Sr. creatinine and Sr. IGF1 provided the patients achieved euthyroid state. Sr. creatinine, IGF1 and eGFR values before and after levothyroxine therapy were compared statistically. Before and after treatment changes were TSH (86.33 ± 51.9 to 2.60 ± 1.34), IGF-1(182.6 ± 129 to 204.2 ± 118.9) Sr. creatinine (0.92 ± 0.23 to 0.77 ± 0.16) and eGFR (88.39 ± 33.82 to 104.8 ± 26.39). A significant negative correlation between change in TSH and change in eGFR with positive correlation between change in IGF1 & change in eGFR were found. We conclude from our study to consider evaluation of thyroid functions in all CKD patients and to treat hypothyroidism with an expectation of improvement of renal function that may delay the progression of the disease to ESRD and a mild renal compromise if found in hypothyroid state should not be unnecessarily investigated before adequate thyroid hormone replacement.

 


Keywords


Renal Compromise, Hypothyroid, TSH, Serum creatinine, eGFR.

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