Low thyroid function is not associated with an accelerated deterioration in renal function

Christiaan L. Meuwese, Merel Van Diepen, Anne R. Cappola, Mark J. Sarnak, Michael G. Shlipak, Douglas C. Bauer, Linda P. Fried, Massimo Iacoviello, Bert Vaes, Jean Degryse, Kay Tee Khaw, Robert N. Luben, Bjørn O. Åsvold, Trine Bjøro, Lars J. Vatten, Anton J.M. De Craen, Stella Trompet, Giorgio Iervasi, Sabrina Molinaro, Graziano CeresiniLuigi Ferrucci, Robin P.F. Dullaart, Stephan J.L. Bakker, J. Wouter Jukema, Patricia M. Kearney, David J. Stott, Robin P. Peeters, Oscar H. Franco, Henry Völzke, John P. Walsh, Alexandra Bremner, José A. Sgarbi, Rui M.B. MacIel, Misa Imaizumi, Waka Ohishi, Friedo W. Dekker, Nicolas Rodondi, Jacobijn Gussekloo, Wendy P.J. Den Elzen

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. Methods: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. Results: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval)-4.07 (-6.37 to-1.78) and-2.40 (-3.78 to-1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. Conclusions: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

Original languageEnglish
Pages (from-to)650-659
Number of pages10
JournalNephrology Dialysis Transplantation
Issue number4
StatePublished - 1 Apr 2019
Externally publishedYes


  • CKD
  • chronic renal failure
  • creatinine clearance
  • epidemiology
  • thyroid function


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