Thyroid Dysfunction in patients with Nephrotic Syndrome

Background: Nephrotic syndrome is a nonspecific kidney disorder characterised by Proteinuria, hypoalbuminaemia, oedema To measure FT3, FT4 and TSH in patient with nephrotic syndrome and Level of proteinuria with Thyroid hormone level. Methods: After fulfilling inclusion and exclusion criteria 50 diagnosed cases of idiopathic NS admitted in Nephrology unit of Rajshahi Medical College Hospital were included in this study. Thyroid status was evaluated in all the patients. In patients with NS mean (± SD) of FT4, FT3 and TSH were 39.34 (±29.49), 1.05 (±0.83) and 11.34 (±18.15) respectively. Significant positivecorrelation was found between serum albumin and serum FT4 (r = +0.733,p <0.001) and also with total FT3 (r = +0.762,p <0.001). But no correlation was found betweenserum albumin and serum TSH (r = - 0.670, p<0.001) in patients with NS. So, it was found that nephrotic range proteinuria is associated with thyroid hormoneloss in urine and this can lead to significant reduction in serum FT4, FT3 and significant increase in serum TSH. Patients with NS can develop subclinical hypothyroidism or even overt hypothyroidism. Conclusion: Thyroid hormones are necessary for the growth and development of kidney. On the contrarydifferent form of kidney diseases are associated with various types of thyroid dysfunctions. This association between renal disease and thyroid dysfunction has been known for years.In patients with nephrotic syndrome(NS) large amount of protein is lost in urine along with thyroid hormones and hormone binding proteins. This hormone loss may lead to low FT4, FT3 and sometimes high TSH level.