Evaluating Thyroid Function Tests in Patients with Kidney Disease

  • Stephanie Smooke PrawEmail author
  • Jennifer Sue An Way
  • Rebecca Weiss


Disorders of thyroid function, especially hypothyroidism, are more prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), compared to the general population. While tests for thyroid function are among the most common hormonal tests ordered, the interpretation of thyroid function tests can be obscured by multiple entities in patients with renal disease, including non-thyroidal illness syndrome (NTI), malnutrition, inflammation, iodine retention, metabolic acidosis, medications, mineral deficiencies, and dialysis. Several studies have shown that both hypothyroidism and hyperthyroidism are associated with increased cardiovascular morbidity and mortality in CKD and ESRD. It is important, then, to understand which thyroid function test results represent authentic thyroid dysfunction, rather than changes secondary to renal disease.

In this chapter, we will review commonly ordered tests of thyroid function, alterations associated with renal disease, testing for thyroid autoimmunity, and the impact of medications on thyroid hormone measurements and thyroid hormone absorption, relevant for the many kidney disease patients that take levothyroxine therapy.


Thyroid function tests Chronic kidney disease Thyroid dysfunction Thyroid autoimmunity Medication and thyroid hormone measurement 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Stephanie Smooke Praw
    • 1
    Email author
  • Jennifer Sue An Way
    • 1
  • Rebecca Weiss
    • 2
  1. 1.Division of Endocrinology, Diabetes, and Metabolism, Department of MedicineDavid Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.Department of Endocrinology, Kaiser Permanente—Woodland HillsWoodland HillsUSA

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