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Kidney Week

Abstract: TH-PO1107

Impact of Thyroid Hormones on Kidney Function in Patients with a Renal Transplant – A Retrospective Data Analysis

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Schairer, Benjamin, Medical University of Vienna, Vienna, Austria
  • Punzengruber, Georg, Medical University of Vienna, Vienna, Austria
  • Winnicki, Wolfgang, Medical University of Vienna, Vienna, Austria
  • Herkner, Harald, Medical University of Vienna, Vienna, Austria
  • Sengoelge, Gurkan, Medical University of Vienna, Vienna, Austria
Background

High levels of thyroid-stimulating-hormone (TSH) correlate with reduced estimated glomerular filtration rate (eGFR) and an increased risk of developing chronic kidney disease (CKD), even in euthyroid patients. Thyroid-hormone-replacement-therapy has been shown to delay progression of end-stage renal disease in sub-clinically hypothyroid patients with CKD. However, the presence of such a link after kidney transplantation (NTX) has not been previously investigated. This study tested whether TSH levels are associated with eGFR in patients with a renal transplant.

Methods

398 patients who received an NTX between 2003 and 2016 in Vienna, Austria, were included in this retrospective study. Thyroid and kidney function parameters were collected at 12 and 24 months post NTX. Linear regression models estimated the association between thyroid- and renal function. Functional variables at both time-points or their differences over time were used to avoid within-individual correlations in a longitudinal setting. Multivariable linear regression models were employed to adjust main effect estimates due to potential confounding factors: BUN/creatinine ratio, tacrolimus plasma levels, CRP, BMI, gender, age.

Results

A linear regression analysis comparing the changes in eGFR and TSH between months 12 and 24 post NTX showed a significant inverse correlation (p=0,0183). For every 1-unit increase in the change of TSH over 12 months eGFR decreased by 1,39 ml/min in the same time frame. The strongest confounder in this comparison was BUN/creatinine ratio. TSH had no impact on eGFR when values 12 and 24 months post NTX were compared: p=0,6296 or p=0,8578, respectively.

Conclusion

Normothyroid renal graft recipients with increasing TSH values between the months 12 and 24 post NTX had less stable, even decreasing eGFR levels. The single thyroid and kidney function values at selected time-points did not show a correlation. Prospective randomized placebo-controlled studies are underway to clarify whether treatment with thyroid hormones reaching low-normal TSH levels could enhance eGFR of patients with a kidney graft.