passages.id: 17317
passages.type: title and abstract
passages.text: Relationship between serum thyrotropin levels and intrarenal hemodynamic parameters in euthyroid subjects.
  OBJECTIVE: Low thyroid function may be associated with a reduced glomerular filtration rate (GFR) calculated on the basis of creatinine metabolism. Thyroid hormone directly affects serum creatinine in muscle and low thyroid function might exert a similar direct effect in the kidney. The goal of the study was to evaluate this possibility by assessment of the inulin-based GFR and to examine the mechanism underlying the reduction of GFR. PATIENTS AND METHODS: Renal and glomerular hemodynamics were assessed by simultaneous measurements of plasma clearance of para-aminohippurate (CPAH) and inulin (Cin) in 26 patients with serum creatinine <1.00 mg/dl and without thyroid disease. All subjects were normotensive with or without antihypertensive treatment and were kept in a sodium-replete state. Renal and glomerular hemodynamics were calculated using Gomez`s formulae. RESULTS: Serum thyroid stimulating hormone (TSH), including within the normal range (0.69-4.30 μIU/ml), was positively correlated with vascular resistance at the afferent arteriole (Ra) (r = 0.609, p = 0.0010), but not at the efferent arteriole (Re). Serum TSH was significantly and negatively correlated with renal plasma flow (RPF), renal blood flow (RBF), and glomerular filtration rate (GFR) (r = -0.456, p = 0.0192; r = -0.438, p = 0.0252; r = -0.505, p = 0.0086, respectively). In multiple regression analysis, serum TSH was significantly positively associated with Ra after adjustment for age and mean blood pressure. CONCLUSIONS: These findings suggest that low thyroid function, even within the normal range, is associated with reduced RPF, RBF and GFR, which might be caused by a preferential increase of Ra.