Kidney Week

Abstract: FR-PO282

The Relationship Between Thyroid Status and Kidney Function Among 24 Million Patients in the National OptumLabs Data Warehouse

Session Information

• CKD: Epidemiology and Risk Factors
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• You, Amy Seung, University of California, Irvine, Orange, California, United States

Amy Seung You,

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Sim, John J., Kaiser Permanente Southern California, Los Angeles, California, United States

John J. Sim,

• Brent, Gregory, VA Greater Los Angeles Healthcare, Los Angeles, California, United States

Gregory Brent,

• Dunning, Stephan C., OptumLabs, Eden Prairie, Minnesota, United States

Stephan C. Dunning,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Nguyen, Danh V., University of California, Irvine, Orange, California, United States

Danh V. Nguyen,

• Rhee, Connie, University of California Irvine, Huntington Beach, California, United States

Connie Rhee,

Background

Experimental data suggest hypothyroidism contributes to the development of chronic kidney disease (CKD) due to alterations in kidney structure and function. We thus examined the relationship between thyroid status defined by serum thyrotropin (TSH) levels with estimated glomerular filtration rates (eGFRs) in a large US cohort.

Methods

We examined the association of thyroid status with kidney function using the OptumLabs^® Data Warehouse (OLDW), which contains administrative claims data including medical claims and eligibility information from a large national US health insurance plan and electronic health record data from a nationwide network of provider groups. In patients who underwent ≥1 TSH and ≥1 eGFR measure(s) within 90-days over 2007-2017, we examined associations between TSH and severe, moderate-to-severe, and moderate kidney dysfunction (eGFR <30, <45, and <60 ml/min/1.73m², respectively) using logistic regression.

Results

In 24,103,735 patients who met eligibility criteria, 18.6% had eGFRs consistent with moderate, moderate-to-severe, or severe kidney dysfunction. Incrementally higher TSH levels of >3.0-5.0, >5.0-10.0, and >10.0mIU/L were associated with increasingly higher risk of severe kidney dysfunction (ref: 0.5-3.0mIU/L): adjusted ORs (95%CI) 1.12 (1.11-1.3), 1.63 (1.61-1.64), and 2.14 (2.10-2.18), respectively. Lower TSH levels in the hyperthyroid range (<5.0mIU/L) were also associated with severe kidney dysfunction: adjusted OR (95%CI) 1.82 (1.81-1.84). Sensitivity analyses showed similar findings for moderate-to-severe and moderate kidney dysfunction.

Conclusion

In a nationally representative cohort of patients, both hypo- and hyperthyroidism were associated with kidney dysfunction. Further studies are needed to determine underlying mechanisms, and whether correction of thyroid status improves kidney function in this population.

Funding

• Commercial Support – OptumLabs