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Thyroid Awareness Month Thyroid Dysfunction and its Impact on Kidneys and Treatment Strategies

(By Dr. Rahul Patibandla, Consultant Nephrologist at NephroPlus)

Thyroid dysfunction, a common endocrine disorder, has long been recognized for its impact on human body function. However, its complex relationship with kidney health is a growing topic of interest and investigation in the field of nephrology. As a nephrologist, understanding the relationship between thyroid function and kidney physiology is very important for comprehensive patient care.

Both hypothyroidism and hyperthyroidism cause significant changes in kidney function. On the other hand, clinical studies on thyroid dysfunction and its relation to kidney function are scarce.

The thyroid gland, located in the neck, controls thyroid hormone production, primarily thyroxine (T4) and triiodothyronine (T3). These hormones play an important role in regulating metabolism, growth, and function of various organ systems, including the kidneys.

According to research, there appears to be a two-way relationship between thyroid dysfunction and kidney health. relationship. Thyroid hormones influence renal blood flow, glomerular filtration rate (GFR), and tubular function. Thyroid hormone levels, whether hypothyroidism or hyperthyroidism, can have serious effects on the kidneys.

Hypothyroidism, defined by low thyroid hormone levels, has been linked to a variety of kidney manifestations. Observed effects include reduction in renal blood flow and GFR, alterations in electrolyte balance, and impaired response to diuretics. These modifications can cause fluid retention and electrolyte imbalance, and ultimately, contribute to the development of kidney disease.

Hyperthyroidism, on the other hand, is characterized by excessive thyroid hormone production and impacts kidney function. In some cases, an increase in GFR, alterations in tubular electrolyte management, and the possibility of kidney stone formation are seen. Additionally, hyperthyroidism can aggravate certain kidney diseases, such as glomerulonephritis.

Chronic kidney disease (CKD), a worldwide health concern, further complicates the relationship between thyroid function and kidney health. Thyroid hormone levels are often disturbed in patients with CKD, a condition known as “nonthyroidal disease syndrome.” Or “euthyroid sick syndrome.” Thyroid hormone alterations in CKD patients may contribute to metabolic imbalances, cardiovascular complications, and worsen kidney disease progression, consistent with changes seen in inpatient thyroid function tests administered in the medical intensive care unit during episodes of acute illness. Refers.

Although not a true syndrome, it represents significant alterations in the hypothalamic-pituitary-thyroid axis in approximately 75% of hospitalized patients. This condition is often seen in patients suffering from severe acute illness, calorie restriction or after major surgery. Low or normal T4 and thyroid-stimulating hormone levels along with low total T3 and free T3 levels are the most common hormone patterns in euthyroid sick syndrome.

The complex relationship between thyroid dysfunction and kidney health emphasizes the importance of comprehensive evaluation and management in clinical practice. Thyroid function testing should be included in the evaluation of patients with kidney disorders, and vice versa. Collaboration between nephrologists and endocrinologists is important to optimize patient care, especially when thyroid and kidney disorders co-exist.

Treatment strategies for thyroid dysfunction can have an impact on kidney function and vice versa. To minimize the impact of thyroid-related abnormalities on kidney health and vice versa, careful monitoring and tailored interventions are required. Additionally, lifestyle changes such as a balanced diet, regular exercise and medication adherence are important in the management of both thyroid and kidney conditions.

Therefore, the field of nephrology needs to pay attention to the complex relationship between thyroid dysfunction and kidney health. Understanding the bidirectional effects of thyroid hormones on renal physiology and pathology is important to provide comprehensive care to patients suffering from kidney diseases. More research and collaborative approaches are needed to unravel the complexities of this association and improve patient outcomes.

(Disclaimer: The opinions, beliefs and views expressed by various authors and forum participants on this website are personal and do not reflect the opinions, beliefs and views of ABP News Network Pvt. Ltd.)

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