What is the role of thyroid hormone replacement therapy (THRT) in the treatment of chronic kidney disease (CKD)?

Updated: Jul 21, 2021
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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In a study of 113 patients with CKD stages 2-4 and subclinical hypothyroidism, thyroid hormone replacement therapy (THRT) with L-thyroxine delayed the rate of decline in kidney function to end-stage renal disease (ESRD). [75, 76] On average, before patients were treated with THRT, their estimated GFR declined by 4.31 ± 0.51 mL/min per 1.73 m2 each year; following treatment, the estimated GFR decline slowed to 1.08 ± 0.36 mL/min per 1.73 m2 each year. [75, 76]

Based on the slope of the decline in estimated GFR prior to THRT, linear regression analysis predicted that 53 of the 113 patients (46.9%) would reach stage 5 CKD—where they would require dialysis or a kidney transplant—within 10 years. However, using the altered slope of the decline of estimated GFR after patients received therapy, it was estimated that only 10 patients (8.8%) would reach this outcome in 10 years. Thus, THRT delayed reaching stage 5 CKD in 43 of the predicted 53 patients (81%). [75, 76]

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