Hypothyroidism and Renal Function in Patients with Systolic Heart Failure

摘要

The extent to which hypothyroidism affects renal function in patients with heart failure remains incompletely explored, despite the known adverse prognostic implications of renal dysfunction in these patients. In a pilot retrospective study, we evaluated 75 patients (age, ≥18 yr) with left ventricular ejection fractions 5.5 μIU/mL). Renal function, measured in terms of glomerular filtration rate, was analyzed once in each patient, and the populations were statistically compared, with P 2 ; P =0.032). There was no significant difference between patients with controlled hypothyroidism (66.89 ± 24.18 mL/min/1.73 m 2 ) and those with normal thyroid function ( P =0.131). In patients with uncontrolled hypothyroidism, mean glomerular filtration rate (60.2 ± 17.4 mL/min/1.73 m 2 ) was significantly worse than in patients with normal thyroid function ( P =0.015). We found that heart-failure patients with insufficiently treated hypothyroidism have worse renal function than do patients whose thyroid function is normal or whose hypothyroidism is effectively treated. Larger studies will be needed in order to evaluate this conclusion further. We recommend that hypothyroidism in heart-failure patients be strictly controlled, lest it affect prognosis adversely. Key words: Comorbidity, glomerular filtration rate, heart failure/complications/epidemiology/mortality, hypothyroidism/complications/physiopathology, kidney/physiopathology, kidney function tests, prognosis, risk factors, thyroid function tests, thyroid diseases/complications, thyroid hormones/physi-ology