{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:37:56Z","timestamp":1771591076475,"version":"3.50.1"},"reference-count":20,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Hypothyroidism is associated with reversible decline in kidney function as measured by estimated glomerular filtration rate (eGFR). eGFR and proteinuria are the most important markers for clinical assessment of kidney function. Though hypothyroidism is associated with proteinuria in cross-sectional data, the impact of treatment on proteinuria is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study explores the effect of thyroid hormone replacement therapy on eGFR and 24-hour urine protein excretion in patients with severe primary hypothyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and Participants<\/jats:title>\n                  <jats:p>This study was a prospective, observational cohort study in adults with severe primary hypothyroidism (serum thyrotropin [TSH]\u2005&amp;gt;\u200550 \u00b5IU\/mL). Individuals with preexisting or past kidney disease, kidney or urinary tract abnormalities, calculi or surgery, diabetes mellitus, or hypertension were excluded. The participants received thyroid hormone replacement therapy. Thyroid functions, eGFR, 24-hour urine protein excretion, and biochemical parameters were measured at baseline and 3 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>This study took place at a single center, a tertiary care referral and teaching hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 44 enrolled participants, 43 completed 3 months of follow-up. At 3 months, serum TSH levels decreased and thyroxine levels increased (P\u2005&amp;lt;\u2005.001 for both). Significant increases in eGFR (mean difference, 18.25 \u00b1 19.49 mL\/min\/1.73 m2; 95% CI, 12.25 to 24.25, P\u2005&amp;lt;\u2005.001) and declines in 24-hour urine protein excretion (mean difference, \u201368.39 \u00b1 125.89 mg\/day; 95% CI, \u2013107.14 to \u201329.65, P\u2005=\u2005.001) were observed. Serum cholesterol and low-density lipoprotein levels also significantly decreased (P\u2005&amp;lt;\u2005.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Thyroid hormone replacement therapy in patients with severe primary hypothyroidism improves eGFR and decreases 24-hour urine protein excretion, thereby suggesting reversible alterations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa871","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T17:36:47Z","timestamp":1606498607000},"page":"e749-e756","source":"Crossref","is-referenced-by-count":13,"title":["Proteinuria in Severe Hypothyroidism: A Prospective Study"],"prefix":"10.1210","volume":"106","author":[{"given":"Vijay Singh","family":"Gondil","sequence":"first","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aarthi","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashu","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashok Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwani","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3522-1121","authenticated-orcid":false,"given":"Vivek","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Rathi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harbir Singh","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivekanand","family":"Jha","sequence":"additional","affiliation":[{"name":"George Institute for Global Health, Delhi, India"},{"name":"University of New South Wales, Sydney, Australia"},{"name":"Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishan Lal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"issue":"5","key":"2021122206015191600_CIT0001","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/MED.0000000000000275","article-title":"The interaction between thyroid and kidney disease: an overview of the evidence","volume":"23","author":"Rhee","year":"2016","journal-title":"Curr Opin Endocrinol Diabetes Obes."},{"issue":"4","key":"2021122206015191600_CIT0002","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1530\/EJE-08-0837","article-title":"Thyroid dysfunction and kidney disease","volume":"160","author":"Iglesias","year":"2009","journal-title":"Eur J Endocrinol."},{"issue":"4","key":"2021122206015191600_CIT0003","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1159\/000441425","article-title":"Guidelines for classification of acute kidney diseases and disorders","volume":"131","author":"Barry","year":"2015","journal-title":"Nephron."},{"issue":"5","key":"2021122206015191600_CIT0004","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1159\/000328324","article-title":"Correlation of clinical changes with regard to thyroxine replacement therapy in hypothyroid patients: focusing on the change of renal function","volume":"34","author":"Chou","year":"2011","journal-title":"Kidney Blood Press Res."},{"issue":"1","key":"2021122206015191600_CIT0005","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1038\/s41598-018-19693-4","article-title":"Subclinical and overt hypothyroidism is associated with reduced glomerular filtration rate and proteinuria: a large cross-sectional population study","volume":"8","author":"Chang","year":"2018","journal-title":"Sci Rep."},{"issue":"6","key":"2021122206015191600_CIT0006","first-page":"440","article-title":"Renal impairment resulting from hypothyroidism","volume":"1","author":"Connor","year":"2008","journal-title":"NDT Plus."},{"issue":"1","key":"2021122206015191600_CIT0007","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1186\/s13256-019-2216-3","article-title":"Severe hypothyroidism presenting as reversible proteinuria: two case reports","volume":"13","author":"Weerakkody","year":"2019","journal-title":"J Med Case Rep."},{"issue":"1","key":"2021122206015191600_CIT0008","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1681\/ASN.2010070766","article-title":"The renal manifestations of thyroid disease","volume":"23","author":"Mariani","year":"2012","journal-title":"J Am Soc Nephrol."},{"issue":"1","key":"2021122206015191600_CIT0009","doi-asserted-by":"crossref","first-page":"E99","DOI":"10.1210\/jc.2010-1521","article-title":"Weight loss after therapy of hypothyroidism is mainly caused by excretion of excess body water associated with myxoedema","volume":"96","author":"Karmisholt","year":"2011","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021122206015191600_CIT0010","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jpeds.2007.10.050","article-title":"Long-term effects of primary hypothyroidism on renal function in children","volume":"152","author":"Elgadi","year":"2008","journal-title":"J Pediatr."},{"issue":"1","key":"2021122206015191600_CIT0011","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1159\/000075628","article-title":"Isotopic renal function studies in severe hypothyroidism and after thyroid hormone replacement therapy","volume":"24","author":"Karanikas","year":"2004","journal-title":"Am J Nephrol."},{"issue":"3","key":"2021122206015191600_CIT0012","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ygcen.2008.12.008","article-title":"Interactions between thyroid and kidney function in pathological conditions of these organ systems: a review","volume":"160","author":"van Hoek","year":"2009","journal-title":"Gen Comp Endocrinol."},{"issue":"11","key":"2021122206015191600_CIT0013","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1681\/ASN.2009020171","article-title":"Measured GFR as a confirmatory test for estimated GFR","volume":"20","author":"Stevens","year":"2009","journal-title":"J Am Soc Nephrol."},{"issue":"5","key":"2021122206015191600_CIT0014","doi-asserted-by":"crossref","first-page":"488","DOI":"10.4158\/EP14532.OR","article-title":"Hyperkalemia develops in some thyroidectomized patients undergoing thyroid hormone withdrawal in preparation for radioactive iodine ablation for thyroid carcinoma","volume":"21","author":"Horie","year":"2015","journal-title":"Endocr Pract."},{"issue":"6","key":"2021122206015191600_CIT0015","first-page":"661","article-title":"Hyperuricemia and gout in thyroid endocrine disorders","volume":"19","author":"Giordano","year":"2001","journal-title":"Clin Exp Rheumatol."},{"issue":"1","key":"2021122206015191600_CIT0016","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s11739-019-02065-9","article-title":"Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity","volume":"15","author":"Desideri","year":"2020","journal-title":"Intern Emerg Med."},{"issue":"9","key":"2021122206015191600_CIT0017","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/qjmed\/95.9.559","article-title":"The relationship between the thyroid gland and the liver","volume":"95","author":"Malik","year":"2002","journal-title":"QJM."},{"key":"2021122206015191600_CIT0018","doi-asserted-by":"crossref","first-page":"5753039","DOI":"10.1155\/2017\/5753039","article-title":"Benefits of levothyroxine replacement therapy on nonalcoholic fatty liver disease in subclinical hypothyroidism patients","volume":"2017","author":"Liu","year":"2017","journal-title":"Int J Endocrinol."},{"issue":"2","key":"2021122206015191600_CIT0019","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.cld.2018.12.006","article-title":"Endocrine diseases and the liver: an update","volume":"23","author":"Malespin","year":"2019","journal-title":"Clin Liver Dis."},{"issue":"4","key":"2021122206015191600_CIT0020","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1067\/mhj.2002.120766","article-title":"Effects of thyroid replacement therapy on arterial blood pressure in patients with hypertension and hypothyroidism","volume":"143","author":"Dernellis","year":"2002","journal-title":"Am Heart J."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa871\/34974274\/dgaa871.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/2\/e749\/41849377\/dgaa871.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/2\/e749\/41849377\/dgaa871.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T06:10:22Z","timestamp":1640153422000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/106\/2\/e749\/6007653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,27]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,11,27]]},"published-print":{"date-parts":[[2021,1,23]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa871","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2,1]]},"published":{"date-parts":[[2020,11,27]]}}}