Assessment of Thyroid Function in Patients with Variable Degree of Proteinuria

Abstract

Introduction: Patients with proteinuria may suffer from substantial losses of thyroxine-binding globulin that may affect the thyroid status. Proteinuric patients with thyroid dysfunction need to be identified for appropriate measure to reduce morbidity and mortality. Methods: All protein uric patients other than those with diabetes mellitus, lupus nephritis, pre-diagnosed thyroid disease and patients with transient proteinuria were our study subjects. Then quantification of protein by 24 hours’ urinary total protein (UTP) was done in every subject. Patients having proteinuria less than 1 gm/24 hrs/1.73 m² of body surface area (BSA) were excluded. From 140 study subjects finally 94 were selected by inclusion and exclusion criteria. They were further divided into non-nephrotic (42 patients) and nephrotic (52 patients) group. Twenty-nine healthy age and sex matched controls were taken. Thyroid hormone parameters, Serum albumin and lipid profile were done in each subject. Results: The mean age of the control group was 31±9 years, that of non-nephrotic group was 35±14  years and in the nephrotic group was 36±16 years. The mean urinary total protein in control group was 0.07±0.04 gm/24 hrs, in non-nephrotic group 1.58±0.82 gm/24 hrs and in nephrotic group it was 8.28±3.37 gm/24 hrs. The mean thyroid stimulating hormone (TSH) was found 2.02±1.26 mIU/L in control group, 3.57±2.04 mIU/L in non-nephrotic group and 5.65±3.95 mIU/L in nephrotic group. The mean free triidothyronine (FT₃) in control group was 4.20±0.42pmol/L, in non–nephrotic group 3.81±1.00 pmol/L and in nephrotic group 3.63±0.95 pmol/L. The mean free thyroxine (FT₄) value was 13.97±2.76 pmol/L, 14.16±5.23 pmoL/L, 13.03±3.45pmol/L in control, non-nephrotic and nephrotic group respectively. Conclusion: Thyroid dysfunction especially subclinical hypothyroidism and low T₃ were more common in proteinuric patients.