Skip to main content

Advertisement

SpringerLink
Log in

The effect of TSH change per year on the risk of incident chronic kidney disease in euthyroid subjects

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

The objective of this study is to evaluate the predictive values of baseline thyroid-stimulating hormone and the rate of thyroid-stimulating hormone change within the euthyroid state on the development of chronic kidney disease. We conducted a longitudinal study in 17,067 Korean adults with normal thyroid function and no history of thyroid disease. Incident chronic kidney disease was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2. The rate of thyroid-stimulating hormone change was determined by subtracting the baseline thyroid-stimulating hormone level from the thyroid-stimulating hormone level measured at the last visit prior to the diagnosis of chronic kidney disease or at the final visit in subjects without chronic kidney disease, divided by the observation period (years). Subjects were stratified into quintiles according to rates of thyroid-stimulating hormone change. During 86,583 person-years of follow-up (median follow-up 5.2 years), there were 561 incident cases of chronic kidney disease. The risk of incident chronic kidney disease was significantly higher in subjects with rapid increases (quintile 5) or decreases (quintile 1) in thyroid-stimulating hormone levels compared to the reference group (quintile 3). In fully adjusted models, the hazard ratios of quintiles 1 and 5 were 3.15 (95 % confidence interval 2.34 to 4.24; p < 0.001) and 3.37 (95 % confidence interval 2.52 to 4.51; p < 0.001), respectively. However, there was no significant association between baseline thyroid-stimulating hormone and risk of incident chronic kidney disease. The development of chronic kidney disease is associated with the rate of changes in thyroid-stimulating hormone level rather than with baseline thyroid-stimulating hormone levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. M.S. Parmar, Chronic renal disease. BMJ. 325(7355), 85–90 (2002)

    Article  PubMed  PubMed Central  Google Scholar 

  2. G. Eknoyan, N. Lameire, K. Eckardt, B. Kasiske, D. Wheeler, A. Levin, P. Stevens, R. Bilous, E. Lamb, J. Coresh, KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney. Int. 3, 5–14 (2013)

    Article  Google Scholar 

  3. C.S. Fox, M.G. Larson, E.P. Leip, B. Culleton, P.W. Wilson, D. Levy, Predictors of new-onset kidney disease in a community-based population. JAMA. 291(7), 844–850 (2004). doi:10.1001/jama.291.7.844

    Article  CAS  PubMed  Google Scholar 

  4. M.K. Haroun, B.G. Jaar, S.C. Hoffman, G.W. Comstock, M.J. Klag, J. Coresh, Risk factors for chronic kidney disease: A prospective study of 23,534 men and women in Washington County, Maryland. J. Am. Soc. Nephrol. 14(11), 2934–2941 (2003)

    Article  PubMed  Google Scholar 

  5. F. Celsing, E. Blomstrand, J. Melichna, N. Terrados, N. Clausen, P.E. Lins, E. Jansson, Effect of hyperthyroidism on fibre-type composition, fibre area, glycogen content and enzyme activity in human skeletal muscle. Clin. Physiol. 6(2), 171–181 (1986)

    Article  CAS  PubMed  Google Scholar 

  6. G. Basu, A. Mohapatra, Interactions between thyroid disorders and kidney disease. Indian J. Endocrinol. Metab. 16(2), 204–213 (2012). doi:10.4103/2230-8210.93737

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. A. Woodward, S. McCann, M. Al-Jubouri, The relationship between estimated glomerular filtration rate and thyroid function: An observational study. Ann. Clin. Biochem. 45(Pt 5), 515–517 (2008). doi:10.1258/acb.2008.007248

    Article  PubMed  Google Scholar 

  8. G. Lippi, M. Montagnana, G. Targher, G.L. Salvagno, G.C. Guidi, Relationship between thyroid status and renal function in a general population of unselected outpatients. Clin. Biochem. 41(7-8), 625–627 (2008). doi:10.1016/j.clinbiochem.2008.01.014

    Article  CAS  PubMed  Google Scholar 

  9. J.C. Lo, G.M. Chertow, A.S. Go, C.Y. Hsu, Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney. Int. 67(3), 1047–1052 (2005). doi:10.1111/j.1523-1755.2005.00169.x

    Article  PubMed  Google Scholar 

  10. L.H. Mariani, J.S. Berns, The renal manifestations of thyroid disease. J. Am. Soc. Nephrol. 23(1), 22–26 (2012). doi:10.1681/ASN.2010070766

    Article  CAS  PubMed  Google Scholar 

  11. M.J. Diekman, M.P. Harms, E. Endert, W. Wieling, W.M. Wiersinga, Endocrine factors related to changes in total peripheral vascular resistance after treatment of thyrotoxic and hypothyroid patients. Eur. J. Endocrinol. 144(4), 339–346 (2001)

    Article  CAS  PubMed  Google Scholar 

  12. A.D. Toft, N.A. Boon, Thyroid disease and the heart. Heart. 84(4), 455–460 (2000)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Y. Zhang, Y. Chang, S. Ryu, J. Cho, W.Y. Lee, E.J. Rhee, M.J. Kwon, R. Pastor-Barriuso, S. Rampal, W.K. Han, H. Shin, E. Guallar, Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals: The Kangbuk samsung health study. Int. J. Epidemiol. 43(5), 1624–1632 (2014). doi:10.1093/ije/dyu126

    Article  PubMed  Google Scholar 

  14. B.O. Asvold, T. Bjoro, L.J. Vatten, Association of thyroid function with estimated glomerular filtration rate in a population-based study: The HUNT study. Eur. J. Endocrinol. 164(1), 101–105 (2011). doi:10.1530/EJE-10-0705

    Article  PubMed  Google Scholar 

  15. M.T. Sun, F.C. Hsiao, S.C. Su, D. Pei, Y.J. Hung, Thyrotropin as an independent factor of renal function and chronic kidney disease in normoglycemic euthyroid adults. Endocr. Res. 37(3), 110–116 (2012). doi:10.3109/07435800.2011.640374

    Article  PubMed  Google Scholar 

  16. S.H. Song, I.S. Kwak, D.W. Lee, Y.H. Kang, E.Y. Seong, J.S. Park, The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone. Nephrol. Dial. Transplant. 24(5), 1534–1538 (2009). doi:10.1093/ndt/gfn682

    Article  CAS  PubMed  Google Scholar 

  17. American Diabetes, A., Standards of medical care in diabetes--2014. Diabetes. Care. 37(Suppl 1), S14–S80 (2014). doi:10.2337/dc14-S014

    Article  Google Scholar 

  18. S.Y. Sohn, H.J. Kim, H.W. Jang, S.W. Kim, J.H. Chung, Lack of association between high serum thyroid-stimulating hormone level and risk of papillary thyroid microcarcinomas. Head Neck 36(1), 43–46 (2014). doi:10.1002/hed.23252

    Article  PubMed  Google Scholar 

  19. A.S. Levey, L.A. Stevens, C.H. Schmid, Y.L. Zhang, A.F. Castro 3rd, H.I. Feldman, J.W. Kusek, P. Eggers, F. Van Lente, T. Greene, J. Coresh, A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150(9), 604–612 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  20. S. Naf, X. Escote, M. Ballesteros, R.E. Yanez, I. Simon-Muela, P. Gil, G. Albaiges, J. Vendrell, A. Megia, Serum activin A and follistatin levels in gestational diabetes and the association of the activin a-follistatin system with anthropometric parameters in offspring. PLoS. One. 9(4), e92175 (2014). doi:10.1371/journal.pone.0092175

    Article  PubMed  PubMed Central  Google Scholar 

  21. G. Karanikas, M. Schutz, M. Szabo, A. Becherer, K. Wiesner, R. Dudczak, K. Kletter, Isotopic renal function studies in severe hypothyroidism and after thyroid hormone replacement therapy. Am. J. Nephrol. 24(1), 41–45 (2004). doi:10.1159/000075628

    Article  CAS  PubMed  Google Scholar 

  22. C. Villabona, M. Sahun, M. Roca, J. Mora, N. Gomez, J.M. Gomez, R. Puchal, J. Soler, Blood volumes and renal function in overt and subclinical primary hypothyroidism. Am. J. Med. Sci. 318(4), 277–280 (1999)

    Article  CAS  PubMed  Google Scholar 

  23. Thyroid Function Testing. Thyroid hormone metabolism. Springer, New York, (2010)

    Google Scholar 

  24. R. Hoermann, J.E. Midgley, R. Larisch, J.W. Dietrich, Integration of peripheral and glandular regulation of triiodothyronine production by thyrotropin in untreated and thyroxine-treated subjects. Horm. Metab. Res. 47(9), 674–680 (2015). doi:10.1055/s-0034-1398616

    Article  CAS  PubMed  Google Scholar 

  25. B.O. Asvold, L.J. Vatten, K. Midthjell, T. Bjoro, Serum TSH within the reference range as a predictor of future hypothyroidism and hyperthyroidism: 11-year follow-up of the HUNT study in Norway. J. Clin. Endocrinol. Metab. 97(1), 93–99 (2012). doi:10.1210/jc.2011-1724

    Article  PubMed  Google Scholar 

  26. R. Hoermann, J.E. Midgley, R. Larisch, J.W. Dietrich, Homeostatic control of the thyroid-pituitary axis: Perspectives for diagnosis and treatment. Front. Endocrinol. 6, 177 (2015). doi:10.3389/fendo.2015.00177

    Article  Google Scholar 

  27. R. Larisch, A. Giacobino, W. Eckl, H.G. Wahl, J.E. Midgley, R. Hoermann, Reference range for thyrotropin. Post hoc assessment. Nuklearmedizin. 54(3), 112–117 (2015). doi:10.3413/Nukmed-0671-14-06

    Article  PubMed  Google Scholar 

  28. M.I. Surks, G. Goswami, G.H. Daniels, The thyrotropin reference range should remain unchanged. J. Clin. Endocrinol. Metab. 90(9), 5489–5496 (2005). doi:10.1210/jc.2005-0170

    Article  CAS  PubMed  Google Scholar 

  29. A.S. Levey, L.A. Stevens, C.H. Schmid, Y.L. Zhang, A.F. Castro 3rd, H.I. Feldman, J.W. Kusek, P. Eggers, F. Van Lente, T. Greene, J. Coresh, E.P.I. Ckd, A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150(9), 604–612 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  30. E.T. de los Santos, G.H. Starich, E.L. Mazzaferri, Sensitivity, specificity, and cost-effectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch. Intern. Med. 149(3), 526–532 (1989)

    Article  Google Scholar 

  31. D.S. Ross, H.B. Burch, D.S. Cooper, M.C. Greenlee, P. Laurberg, A.L. Maia, S. Rivkees, M. Samuels, J.A. Sosa, M.N. Stan, M. Walter, 2016 American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. (2016). doi:10.1089/thy.2016.0229

  32. M.I. Surks, I.J. Chopra, C.N. Mariash, J.T. Nicoloff, D.H. Solomon, American thyroid association guidelines for use of laboratory tests in thyroid disorders. JAMA. 263(11), 1529–1532 (1990)

    Article  CAS  PubMed  Google Scholar 

  33. P.N. Taylor, S. Razvi, S.H. Pearce, C.M. Dayan, Clinical review: A review of the clinical consequences of variation in thyroid function within the reference range. J. Clin. Endocrinol. Metab. 98(9), 3562–3571 (2013). doi:10.1210/jc.2013-1315

    Article  CAS  PubMed  Google Scholar 

  34. C.H. Jung, M.J. Lee, Y.M. Kang, J.Y. Hwang, E.H. Kim, J.Y. Park, H.K. Kim, W.J. Lee, The risk of chronic kidney disease in a metabolically healthy obese population. Kidney. Int. 88(4), 843–850 (2015). doi:10.1038/ki.2015.183

    Article  CAS  PubMed  Google Scholar 

  35. T.D. Jeong, W. Lee, S. Chun, S.K. Lee, J.S. Ryu, W.K. Min, J.S. Park, Comparison of the MDRD study and CKD-EPI equations for the estimation of the glomerular filtration rate in the Korean general population: The fifth Korea national health and nutrition examination survey (KNHANES V-1), 2010. Kidney. Blood. Press. Res. 37(4-5), 443–450 (2013). doi:10.1159/000355724

    Article  CAS  PubMed  Google Scholar 

  36. E.Y. Lee, Y.M. Lee, K.H. Choi, H.C. Lee, B.W. Lee, B.S. Kim, Comparison of two creatinine-based equations for predicting decline in renal function in type 2 diabetic patients with nephropathy in a korean population. Int. J. Endocrinol. 2013, 848963 (2013). doi:10.1155/2013/848963

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors are very grateful to Sin-Ho Jung and Kiyoun Kim of the Biostatistics and Clinical Epidemiology Center of Samsung Medical Center for statistical assistance in the analysis of the data for this study.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Da Young Lee, Ji Eun Jun, Tae Hyuk Kim, Sang-Man Jin, Kyu Yeon Hur, Sun Wook Kim, Jae Hoon Chung, Moon-Kyu Lee & Jae Hyeon Kim

  2. Department of Endocrinology and Metabolism, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Da Young Lee

  3. Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jae Hwan Jee

  4. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea

    Jae Hyeon Kim

Authors
  1. Da Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae Hwan Jee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ji Eun Jun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tae Hyuk Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sang-Man Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyu Yeon Hur
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sun Wook Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jae Hoon Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Moon-Kyu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jae Hyeon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jae Hyeon Kim.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, D.Y., Jee, J.H., Jun, J.E. et al. The effect of TSH change per year on the risk of incident chronic kidney disease in euthyroid subjects. Endocrine 55, 503–512 (2017). https://doi.org/10.1007/s12020-016-1138-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-016-1138-8

Keywords

Search

Navigation