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Hashimoto’s thyroiditis and renal transplant rejection

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Abstract

Purpose

Hashimoto’s thyroiditis (HT) is a common autoimmune thyroid disorder that can disrupt thyroid function and homeostasis. As HT results from a dysregulated immune system, we hypothesized that these patients might be more susceptible to transplant failure; however, literature on this association is limited. The purpose of this study is to examine the association of HT with the risk of renal transplant failure.

Methods

We utilized the United States Renal Database System dataset collected from 2005 to 2014 and compared the time from first renal transplant to transplant failure in end-stage renal disease (ESRD) patients with a HT diagnosis to ESRD patients without a HT diagnosis that underwent renal transplant.

Results

A total of 144 ESRD patients had International Classification of Disease-9 claim codes for HT prior to renal transplant, amongst a total cohort of 90,301 renal transplant patients aged 18–100 and meeting criteria. Patients with HT were significantly more likely to be female, white, and to have a diagnosis of cytomegalovirus compared to patients without. ESRD patients with a HT diagnosis that underwent renal transplant had a significantly increased risk of renal transplant failure compared to those ESRD renal transplant patients without an HT diagnosis. There was a significantly increased adjusted hazard ratio for graft failure in patients with a HT diagnosis compared to those without.

Conclusion

Thyroid health and HT may play a significant role in the development of the increased risk of renal transplant failure observed in this study. Additional studies are needed to investigate the underlying mechanisms for this association.

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Data availability

The data underlying this article are available at https://usrds.org/for-researchers/standard-analysis-files/ and can be accessed by submitting documents for a standard data request.

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Acknowledgements

This work was supported in part by a fellowship to BS from the Medical Scholars Program of the Medical College of Georgia, a grant from Dialysis Clinic, Inc. (JLW, MFK, AM) and the Translational Research Program of the Department of Medicine. Time and resources from the Charlie Norwood VA Medical Center also supported this project (SB, WB). The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government. The data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as official policy or interpretation of the United States Government.

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Authors and Affiliations

  1. Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA

    B. Sigman, D. F. Linder, J. L. Waller, W. B. Bollag, S. L. Baer, S. Tran, M. Kheda, A. Mohammed, C. M. Isales & B. Siddiqui

  2. Charlie Norwood VA Medical Center, Augusta, GA, USA

    W. B. Bollag & S. L. Baer

  3. Southwest Georgia Nephrology, Albany, GA, USA

    M. Kheda

  4. College of Nursing at Augusta University, Augusta, GA, USA

    L. Young

Authors
  1. B. Sigman
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  2. D. F. Linder
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  3. J. L. Waller
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  4. W. B. Bollag
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  5. S. L. Baer
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  9. A. Mohammed
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Corresponding author

Correspondence to W. B. Bollag.

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Conflict of interest

The authors have no conflicts of interest to report.

Research involving human participants

This analysis utilized a retrospective cohort study design to examine the association of HT with the risk for renal transplant failure. All data were collected from the USRDS database of federal Centers for Medicare and Medicaid (CMS) claims, which is de-identified to protect the privacy of patients. As such, this study was deemed “non-human subjects research” by the Augusta University Institutional Review Board.

Informed consent

This manuscript has been reviewed by the National Institute of Diabetes and Digestive and Kidney Disease and found to fulfill all USRDS privacy requirements. In accordance with USRDS guidelines, no patient consent was required for usage of this database.

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Sigman, B., Linder, D.F., Waller, J.L. et al. Hashimoto’s thyroiditis and renal transplant rejection. J Endocrinol Invest 46, 2125–2132 (2023). https://doi.org/10.1007/s40618-023-02065-9

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  • DOI: https://doi.org/10.1007/s40618-023-02065-9

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