Interactions between thyroid disorders and kidney disease.
Interactions between thyroid disorders and kidney disease.
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DOI：
10.4103/2230-8210.93737
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发表时间：
2012-03
影响因子：
--
通讯作者：
Mohapatra A
中科院分区：
文献类型：
--
作者：
Basu G;Mohapatra A
在其他器官的疾病状态中，甲状腺和肾脏的功能之间有几种相互作用。甲状腺激素影响肾脏发育和生理。甲状腺激素具有肾前和肾内效应，通过它们增加肾血流量和肾小球滤过率（GFR）。甲状腺功能减退与GFR降低有关，甲状腺功能亢进导致GFR升高以及肾素-血管紧张素-醛固酮活化增加。慢性肾脏疾病（CKD）以低T3综合征为特征，现在被认为是非典型非甲状腺疾病的一部分。CKD患者原发性甲状腺功能减退和亚临床甲状腺功能减退的发生率也增加。慢性肾病中甲状腺功能低下的生理益处以及慢性肾病进展伴甲状腺功能亢进的风险强调了慢性肾病中甲状腺激素异常的保守治疗方法。甲状腺功能障碍也与肾小球肾炎有关，通常由共同的自身免疫性病因。有几种药物可能同时影响甲状腺和肾脏功能。很少有关于甲状腺和肾脏恶性肿瘤之间相互作用的描述。对所有这些相互作用的详细了解对于肾病学家和内分泌学家对患者的最佳管理都是重要的。
There are several interactions between thyroid and kidney functions in each other organ's disease states. Thyroid hormones affect renal development and physiology. Thyroid hormones have pre-renal and intrinsic renal effects by which they increase the renal blood flow and the glomerular filtration rate (GFR). Hypothyroidism is associated with reduced GFR and hyperthyroidism results in increased GFR as well as increased renin – angiotensin – aldosterone activation. Chronic kidney disease (CKD) is characterized by a low T3 syndrome which is now considered a part of an atypical nonthyroidal illness. CKD patients also have increased incidence of primary hypothyroidism and subclinical hypothyroidism. The physiological benefits of a hypothyroid state in CKD, and the risk of CKD progression with hyperthyroidism emphasize on a conservative approach in the treatment of thyroid hormone abnormalities in CKD. Thyroid dysfunction is also associated with glomerulonephritis often by a common autoimmune etiology. Several drugs could affect both thyroid and kidney functions. There are few described interactions between thyroid and renal malignancies. A detailed knowledge of all these interactions is important for both the nephrologists and endocrinologists for optimal management of the patient.