Author:
Gu Qiu-hua,Cao Xin,Mao Xiao-ming,Jia Jun-ya,Yan Tie-kun
Abstract
Abstract
Background
Thyroid dysfunction is common in patients with nephrotic syndrome, especially patients with primary membranous nephropathy (pMN). In view of both MN and thyroid dysfunction are associated with autoimmunity, the current study aimed to elucidate the significance of thyroid dysfunction in patients with pMN.
Methods
Four hundred and twenty patients with biopsy-proven pMN from 2018–2021 were retrospectively enrolled. Clinical and pathological parameters, and treatment response of patients with and without thyroid dysfunction were analyzed.
Results
Ninety-one (21.7%) patients with pMN suffered from thyroid dysfunction, among which subclinical hypothyroidism (52.7%) was the main disorder. Compared to patients with normal thyroid function, patients with thyroid dysfunction presented with a higher level of proteinuria, a lower level of serum albumin, a higher level of serum creatinine and more severe tubulointerstitial injury at the time of biopsy. But the positive rate and level of circulating anti-phospholipase A2 receptor (PLA2R) antibody were comparable between these two groups. Though following the similar treatment, the percentage of no response to treatment were significantly higher in the patients with thyroid dysfunction (38.6 vs. 20.0%, P = 0.003). Similar to the urinary protein and the positivity of anti-PLA2R antibody, multivariate COX analysis showed thyroid dysfunction was also identified as an independent risk factor for the failure to remission (HR = 1.91, 95%CI, 1.07–3.40, P = 0.029).
Conclusion
In conclusion, thyroid dysfunction is common in the patients with pMN and might predict a severe clinical manifestation and a poor clinical outcome, which indicated that the thyroid dysfunction might be involved in the disease progression of pMN.
Funder
National Natural Science Foundation of China
Tianjin Key Medical Discipline Construction Project
Publisher
Springer Science and Business Media LLC
Reference27 articles.
1. Singhania G, Singhania N. Membranous nephropathy associated with profound hypothyroidism. Clin Case Rep. 2020;8(1):120–2.
2. Mario FD, Pofi R, Gigante A, Rivoli L, Rosato E, Isidori AM, Cianci R, Barbano B. Hypothyroidism and Nephrotic Syndrome: Why, When and How to Treat. Curr Vasc Pharmacol. 2017;15(5):398–403.
3. Kwong N, Medici M, Marqusee E, Wassner AJ. Severity of Proteinuria Is Directly Associated With Risk of Hypothyroidism in Adults. J Clin Endocrinol Metab. 2021;106(2):e757–62.
4. Li LZ, Hu Y, Ai SL, Cheng L, Liu J, Morris E, Li Y, Gou SJ, Fu P. The relationship between thyroid dysfunction and nephrotic syndrome: a clinicopathological study. Sci Rep. 2019;9(1):6421.
5. Jain D, Aggarwal HK, Pavan Kumar YM, Jain P. Evaluation of thyroid dysfunction in patients with nephrotic syndrome. Med Pharm Rep. 2019;92(2):139–44.
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