Abstract
EVALUATION OF SERUM CREATININE, EGFR AND INSULIN-LIKE GROWTH FACTOR 1 IN HYPOTHYROID SUBJECTS BEFORE AND AFTER L-THYROXINE REPLACEMENT

Trinanjan Sanyal, Sujoy Ghosh and Subhankar Chowdhury

ABSTRACT

Aims of our study: To detect any renal compromise if at all present in hypothyroid state and whether such compromise is correctable by levothyroxine (LT4) replacement. Methodology: A longitudinal, self-controlled study was performed with 23 Drug-naïve (untreated) primary hypothyroid patients aged between 18 to 60 years with normal urinary findings, no recent therapy with cephalosporin (within two weeks) and with a normal creatinine level (up to 1.3mg/dl). Fasting blood samples were taken for serum IGF1 (insulin-like growth factor 1) & serum creatinine. Then the patients were advice to take daily L-thyroxin (1.6 microgram/kg/day) and reviewed at least after eight weeks and fasting blood samples were taken for serum creatinine and serum IGF1 provided the patients achieved euthyroid state. Serum creatinine, IGF-1 and eGFR values before and after levothyroxine therapy were compared statistically. Results: 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) Serum creatinine (0.92 ± 0.23 to 0.77 ± 0.16) and eGFR (88.39 ± 33.82 to 104.8 ± 26.39). All of the changes were significant. A significant negative correlation between change in TSH and change in serum creatinine but positive correlation between change in IGF1 & change in eGFR were found. Conclusion: 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: Serum Creatinine, Insulin-Like Growth Factor 1, Hypothyroid, L-thyroxine supplementation


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