Thyroid Function in patients with nephrotic syndrome

Abstract

Nephrotic syndrome is a common pediatric kidney disease characterized by leakage of protein from the blood to the urine through damaged glomeruli. It is classically defined as nephrotic range proteinuria, hypoalbuminemia and edema. In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of significant loss of thyroxine (T4) and triiodothyronine (T3) in the presence of proteinuria. This study aimed to evaluate the thyroid function in children with nephrotic syndrome and its correlation with the state of patients ( relapse or remission ). Methods: A comparative study was carried out on total of 60 patients with nephrotic syndrome (divided into two equal groups of 30 with remission and 30 with relapse ) in the age group from 1-18 years who admitted to department of nephrology in Babylon teaching hospital for Maternity and children from November 2020 to May 2021, serum albumin, serum cholesterol, thyroid stimulating hormone (TSH) and thyroxine( T4 )were done to all patients and the result compared. Result: The mean age of patients was (5.74 ± 3.77) years; most patients (N=42, 70.0%) were male. Hypothyroidism represents (N=19, 31.7%) of patients with nephrotic syndrome, while patients with normal thyroid function (euthyroid) represented (N=41, 68.3%). Significant differences existed between the means of TSH and T4 according to the patient's state (remission or relapse). There was a significant association between the state of patients and thyroid function tests. Among patients with relapse (N=19, 63.3%) presented with hypothyroidism and (N=11, 36.7%) of patients presented with normal thyroid function (euthyroid state), while among those with remission, all patients (N=30, 100%) presented with normal thyroid function (euthyroid state). In conclusion, hypothyroidism is more common in nephrotic syndrome patients during relapse, so it's important to assess thyroid function during relapse. Keywords: Thyroid, nephrotic syndrome, Nephrotic syndrome