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Thyroid Disorders and Chronic Kidney Disease

机译：甲状腺疾病和慢性肾脏病

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摘要

Thyroid hormones play a very important role regulating metabolism, development, protein synthesis, and influencing other hormone functions. The two main hormones produced by the thyroid are triiodothyronine (T3) and thyroxine (T4). These hormones can also have significant impact on kidney disease so it is important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD). CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Low T3 levels are the most common laboratory finding followed by subclinical hypothyroidism in CKD patients. Hyperthyroidism is usually not associated with CKD but has been known to accelerate it. One of the most important links between thyroid disorders and CKD is uremia. Patients who are appropriately treated for thyroid disease have a less chance of developing renal dysfunction. Clinicians need to be very careful in treating patients with low T3 levels who also have an elevation in TSH, as this can lead to a negative nitrogen balance. Thus, clinicians should be well educated on the role of thyroid hormones in relation to CKD so that proper treatment can be delivered to the patient.
机译：甲状腺激素在调节新陈代谢，发育，蛋白质合成以及影响其他激素功能中起着非常重要的作用。甲状腺产生的两种主要激素是三碘甲状腺素（T3）和甲状腺素（T4）。这些激素也会对肾脏疾病产生重大影响，因此，重要的是要考虑与慢性肾脏病（CKD）相关的甲状腺功能障碍的生理联系。已知CKD会影响垂体-甲状腺轴和甲状腺激素的外周代谢。 T3水平低是CKD患者最常见的实验室检查结果，其次是亚临床甲状腺功能减退症。甲状腺功能亢进症通常与CKD不相关，但已知会使其加速。甲状腺疾病和CKD之间最重要的联系之一是尿毒症。经适当治疗的甲状腺疾病患者出现肾功能障碍的机会较小。临床医生在治疗T3水平低，TSH升高的患者时要非常小心，因为这可能导致负氮平衡。因此，应对临床医生进行甲状腺激素相对于CKD的作用的良好教育，以便可以为患者提供适当的治疗。

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