Русский
Renal function and cardio-renal relationship in patients with primary hypothyroidism and concurrent arterial hypertension
A.V. Nikolaeva, L.T. Pimenov
Aim. To investigate renal function and cardio-renal syndrome in patients with primary hypothyroidism and concurrent arterial hypertension.
Material and methods. A total of 59 female patients aged from 45 to 75 years with primary manifest hypothyroidism of various etiologies were examined. The patients were divided into 2 groups depending on the level of blood pressure (BP). All patients underwent a complete physical examination and were tested for serum creatinine, uric acid, cholesterol, triglycerides, LDL and HDL, glomerular filtration rate (GFR) by the endogenous creatinine clearance based on a 24-hour urine sample, clearance of uric acid and 24-hour albuminuria. Patients were tested for renal functional reserve after protein loading. Main hemodynamic parameters such as left ventricular mass index, the relative thickness of left ventricular wall, ejection fraction and endothelial function were
measured.
Results. Patients with manifest hypothyroidism and concurrent arterial hypertension had greater renal functional impairment than patients with normal blood pressure. They had a significantly greater decrease in GFR, higher diurnal albuminuria and decreased clearance of uric acid. All patients were found to have hemodynamic changes such as left ventricular hypertrophy, diastolic dysfunction, endothelium-dependent endothelial dysfunction and increased intima-media thickness. There was a significant negative correlation between GFR and the level of blood thyroid stimulating hormone, GFR and total blood cholesterol level, age and GFR, GFR and systolic and diastolic blood pressure.
Conclusion. Patients with primary hypothyroidism and concurrent arterial hypertension need to be followed for changes in the renal filtration function and characteristics of the cardiovascular system. Achieving target blood pressure is of utmost importance to preserve renal function and prevent chronic kidney disease.
Material and methods. A total of 59 female patients aged from 45 to 75 years with primary manifest hypothyroidism of various etiologies were examined. The patients were divided into 2 groups depending on the level of blood pressure (BP). All patients underwent a complete physical examination and were tested for serum creatinine, uric acid, cholesterol, triglycerides, LDL and HDL, glomerular filtration rate (GFR) by the endogenous creatinine clearance based on a 24-hour urine sample, clearance of uric acid and 24-hour albuminuria. Patients were tested for renal functional reserve after protein loading. Main hemodynamic parameters such as left ventricular mass index, the relative thickness of left ventricular wall, ejection fraction and endothelial function were
measured.
Results. Patients with manifest hypothyroidism and concurrent arterial hypertension had greater renal functional impairment than patients with normal blood pressure. They had a significantly greater decrease in GFR, higher diurnal albuminuria and decreased clearance of uric acid. All patients were found to have hemodynamic changes such as left ventricular hypertrophy, diastolic dysfunction, endothelium-dependent endothelial dysfunction and increased intima-media thickness. There was a significant negative correlation between GFR and the level of blood thyroid stimulating hormone, GFR and total blood cholesterol level, age and GFR, GFR and systolic and diastolic blood pressure.
Conclusion. Patients with primary hypothyroidism and concurrent arterial hypertension need to be followed for changes in the renal filtration function and characteristics of the cardiovascular system. Achieving target blood pressure is of utmost importance to preserve renal function and prevent chronic kidney disease.
Keywords: renal filtration function, primary hypothyroidism, lipid metabolism, cardio-renal syndrome, arterial hypertension, cardiovascular disease
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