, Volume 59, Issue 3, pp 694–697 | Cite as

Impact of subclinical hypothyroidism with TSH ≤10 mIU/L on glomerular filtration rate in adult women without known kidney disease

  • Pedro Weslley Souza RosarioEmail author
  • Maria Regina Calsolari
Research Letter


Subclinical hypothyroidism (SCH) is a common condition in adults, especially in women. Although not considered by current guidelines in the treatment decision of SCH [1, 2, 3, 4, 5], concern exists regarding the association with decreased glomerular filtration rate (GFR). However, in the absence of overt hypothyroidism (TSH >20 mIU/L or low T4), TSH elevation might be a consequence of decreased GFR and does not reflect true thyroid dysfunction [1, 6]. Although SCH has a negative impact on GFR, this has been suggested particularly in patients with established kidney disease [7, 8, 9, 10, 11, 12] or associated conditions that are also known to compromise renal function, such as diabetes mellitus and arterial hypertension [7, 8, 10, 13]. The repercussion of SCH on GFR in adults without known kidney disease or risk conditions for renal dysfunction is less studied [14].

A reasonable consensus on the need for treatment exists for individuals with SCH and TSH >10 mIU/L, except for...



This work was supported by the Brazilian National Council for Scientific and Technological Development (CNPq).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

The study was approved by the local Research Ethics Committee and the subjects gave written informed consent.


  1. 1.
    D.S. Cooper, B. Biondi, Subclinical thyroid disease. Lancet 379, 1142–1154 (2012)CrossRefGoogle Scholar
  2. 2.
    J.R. Garber, R.H. Cobin, H. Gharib, J.V. Hennessey, I. Klein, J.I. Mechanick, R. Pessah-Pollack, P.A. Singer, K.A. Woeber, American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults,Clinical practice guidelines for hypothyroidism in adults:cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid 22, 1200–1235 (2012).CrossRefGoogle Scholar
  3. 3.
    S.H. Pearce, G. Brabant, L.H. Duntas, F. Monzani, R.P. Peeters, S. Razvi, J.L. Wemeau, 2013 ETA guideline: management of subclinical hypothyroidism. Eur. Thyroid. J. 2, 215–228 (2013)CrossRefGoogle Scholar
  4. 4.
    G. Brenta, M. Vaisman, J.A. Sgarbi, L.M. Bergoglio, N.C. Andrada, P.P. Bravo, A.M. Orlandi, H. Graf, Task force on hypothyroidism of the Latin American Thyroid Society (LATS).: clinical practice guidelines for the management of hypothyroidism. Arq. Bras. Endocrinol. Metabol. 57, 265–291 (2013)CrossRefGoogle Scholar
  5. 5.
    R.P. Peeters, Subclinical Hypothyroidism. N. Engl. J. Med. 376, 2556–2565 (2017)CrossRefGoogle Scholar
  6. 6.
    E.M. Kaptein, J.S. LoPresti, M.J. Kaptein, Is an isolated TSH elevation in chronic nonthyroidal illness “subclinical hypothyroidism”? J. Clin. Endocrinol. Metab. 99, 4015–4026 (2014)CrossRefGoogle Scholar
  7. 7.
    D.H. Shin, M.J. Lee, S.J. Kim, H.J. Oh, H.R. Kim, J.H. Han, H.M. Koo, F.M. Doh, J.T. Park, S.H. Han, T.H. Yoo, S.W. Kang, Preservation of renal function by thyroid hormone replacement therapy in chronic kidney disease patients with subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 97, 2732–2740 (2012)CrossRefGoogle Scholar
  8. 8.
    D.H. Shin, M.J. Lee, H.S. Lee, H.J. Oh, K.I. Ko, C.H. Kim, F.M. Doh, H.M. Koo, H.R. Kim, J.H. Han, J.T. Park, S.H. Han, T.H. Yoo, S.W. Kang, Thyroid hormone replacement therapy attenuates the decline of renal function in chronic kidney disease patients with subclinical hypothyroidism. Thyroid 23, 654–661 (2013)CrossRefGoogle Scholar
  9. 9.
    C.M. Rhee, E.K. Alexander, I. Bhan, S.M. Brunelli, Hypothyroidism and mortality among dialysis patients. Clin. J. Am. Soc. Nephrol. 8, 593–601 (2013)CrossRefGoogle Scholar
  10. 10.
    Y. Lu, H. Guo, D. Liu, Z. Zhao, Preservation of renal function by thyroid hormone replacement in elderly persons with subclinical hypothyroidism. Arch. Med. Sci. 12, 772–777 (2016)CrossRefGoogle Scholar
  11. 11.
    S. Bajaj, N. Purwar, A. Gupta, P. Gupta, A. Srivastava, Prevalence of hypothyroidism in diabetic kidney disease and effect of thyroid hormone replacement on estimate glomerular filtration rate. Indian J. Endocrinol. Metab. 20, 795–798 (2016)CrossRefGoogle Scholar
  12. 12.
    S. Bajaj, N. Purwar, A. Gupta, P. Gupta, A. Srivastava, Prevalence of hypothyroidism in nondiabetic chronic kidney disease and effect of thyroxine replacement on estimated glomerular filtration rate. Indian J. Nephrol. 27, 104–107 (2017)CrossRefGoogle Scholar
  13. 13.
    P. Liu, R. Liu, X. Chen, Y. Chen, D. Wang, F. Zhang, Y. Wang, Can levothyroxine treatment reduce urinary albumin excretion rate in patients with early type 2 diabetic nephropathy and subclinical hypothyroidism? A randomized double-blind and placebo-controlled study. Curr. Med. Res. Opin. 31, 2233–2240 (2015)CrossRefGoogle Scholar
  14. 14.
    M. Adrees, J. Gibney, N. El-Saeity, G. Boran, Effects of 18 months of L-T4 replacement in women with subclinical hypothyroidism. Clin. Endocrinol. (Oxf.) 71, 298–303 (2009)CrossRefGoogle Scholar
  15. 15.
    P.W. Rosario, M.R. Calsolari, How selective are the new guidelines for treatment of subclinical hypothyroidism for patients with thyrotropin levels at or below 10 mIU/L? Thyroid 23, 562–565 (2013)CrossRefGoogle Scholar
  16. 16.
    P.W. Rosario, M. Carvalho, M.R. Calsolari, Natural history of subclinical hypothyroidism with TSH≤10 mIU/l: a prospective study. Clin. Endocrinol. (Oxf.). 84, 878–881 (2016)CrossRefGoogle Scholar
  17. 17.
    P.W. Rosario, A.C. Xavier, M.R. Calsolari, TSH reference values for adult Brazilian population. Arq. Bras. Endocrinol. Metabol. 54, 603–606 (2010)CrossRefGoogle Scholar
  18. 18.
    A. Earley, D. Miskulin, E.J. Lamb, A.S. Levey, K. Uhlig, Estimating equations for glomerular filtration rate in the era of creatinine standardization: a systematic review. Ann. Intern. Med. 156, 785–795 (2012)CrossRefGoogle Scholar
  19. 19.
    M. Kimmel, N. Braun, M.D. Alscher, Influence of thyroid function on different kidney function tests. Kidney Blood Press. Res. 35, 9–17 (2012)CrossRefGoogle Scholar
  20. 20.
    Y. Ye, X. Gai, H. Xie, L. Jiao, S. Zhang, Impact of thyroid function on serum cystatin C and estimated glomerular filtration rate: a cross-sectional study. Endocr. Pract. 19, 397–403 (2013)CrossRefGoogle Scholar
  21. 21.
    M. Simeoni, A. Cerantonio, I. Pastore, R. Liguori, M. Greco, D. Foti, E. Gulletta, A. Brunetti, G. Fuiano, The correct renal function evaluation in patients with thyroid dysfunction. J. Endocrinol. Invest. 39, 495–507 (2016)CrossRefGoogle Scholar
  22. 22.
    L. Chaker, S. Sedaghat, E.J. Hoorn, W.P. Elzen, J. Gussekloo, A. Hofman, M.A. Ikram, O.H. Franco, A. Dehghan, R.P. Peeters, The association of thyroid function and the risk of kidney function decline: a population-based cohort study. Eur. J. Endocrinol. 175, 653–660 (2016)CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Pedro Weslley Souza Rosario
    • 1
    Email author
  • Maria Regina Calsolari
    • 1
  1. 1.Santa Casa de Belo HorizonteMinasBrazil

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