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논문분류	춘계학술대회 초록집
제목	Unresolved Subclinical Hypothyroidism is Independently Associated with Progression of Chronic Kidney Disease
저자	Yoo A Choi1, Jung Eun Lee1, Kyung Jin Yun1, Eun Oh Kim1, Ihn Suk Lee2, Sang Ju Lee1, Yoon Kyung Chang1, Chul Woo Yang1, Jong Min Lee2, Hye Soo Kim2, Suk Young Kim1, Hyeon Seok Hwang1
출판정보	2013; 2013(1):
키워드
초록	Background: Patients with chronic kidney disease (CKD) often have subclinical hypothyroidism. However, few reports have investigated changes in the status of subclinical hypothyroidism in CKD patients and its clinical significance in CKD progression. Methods: We included 168 patients with nondialysis-dependent CKD stages 2-4. The normalization of subclinical hypothyroidism during follow-up was assessed, and the association between transitions in subclinical hypothyroid status and the rate of decline of the estimated glomerular filtration rate (eGFR) was investigated. Results: At baseline, 127 patients were euthyroid and 41 (24.4%) patients were diagnosed with subclinical hypothyroidism. Of these 41 patients, 21 (51.2%) spontaneously resolved to euthyroid during follow-up. The rate of eGFR decline of patients with resolved subclinical hypothyroidism was similar to that of euthyroid patients. The patients with unresolved subclinical hypothyroidism showed a steeper renal function decline than patients with euthyroidism or resolved subclinical hypothyroidism (all p<0.05). The proportion of CKD patients progressing to end-stage renal disease was significantly greater in those with unresolved subclinical hypothyroidism than in those who were euthyroid (p=0.006). In multivariate linear regression for rate of eGFR decrease, unresolved subclinical hypothyroidism (β=-0.23, p=0.001), baseline renal function (β=-0.34, p=0.001) and level of proteinuria (β=-0.44, p=0.001) were independently associated with the rate of renal function decline. Conclusions: Half of the CKD patients with subclinical hypothyroidism did not resolve to euthyroidism, and this lack of resolution was independently associated with rapid renal function decline.
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