Analysis of Thyroid Function in ANCA-Associated Vasculitis Patients with Renal Injury

Overview

Journal J Pers Med

Date 2024 Jan 22

PMID 38248799

Authors

Wenhui Yu

Yuelan Wang

Liang Ma

Shenju Gou

Ping Fu

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies indicated common thyroid dysfunction in various kidney diseases. This study aimed to investigate the thyroid function in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with renal injury.

Methods: Briefly, 174 patients diagnosed as having AAV with renal injury and without previous thyroid disease history were included in the retrospective and prospective study. The clinical parameters were collected and compared between different groups.

Results: Of the patients included, 24 exhibited normal thyroid function, while 150 had thyroid dysfunction, including 55 (36.67%) with hypothyroidism. Those AAV patients with thyroid dysfunction showed different clinical parameters from those with normal thyroid function. The patients were followed up for a median of 68.6 (64.3; 72.8) months. Those with thyroid dysfunction were more prone to progressing to dialysis dependence compared to the group with normal thyroid function. Logistic regression analysis showed advanced age and decreased albumin as independent risk factors for thyroid dysfunction in patients with AAV. Survival analysis and multivariate Cox regression analysis showed that thyroid dysfunction was a risk factor for AAV patients with renal injury to progress to the endpoint of dialysis dependence.

Conclusion: Thyroid dysfunction, predominantly hypothyroidism, was commonly complicated in AAV patients with renal injury. AAV patients with thyroid dysfunction were presented with different clinical parameters and more prone to progressing to dialysis dependence compared to those with normal thyroid function.

Citing Articles

Clinical associations with thyroid disease in ANCA-associated vasculitis.

Zhang Z, Huang W, Ren F, Luo L, Zhou J, Huang D Clin Rheumatol. 2024; 43(12):3821-3827.

PMID: 39441466 DOI: 10.1007/s10067-024-07146-5.

References

Baier E, Tampe D, Hakroush S, Tampe B . Low levels of hemoglobin associate with critical illness and predict disease course in patients with ANCA-associated renal vasculitis. Sci Rep. 2022; 12(1):18736. PMC: 9636265. DOI: 10.1038/s41598-022-23313-7. View

Schairer B, Jungreithmayr V, Schuster M, Reiter T, Herkner H, Gessl A . Effect of Thyroid Hormones on Kidney Function in Patients after Kidney Transplantation. Sci Rep. 2020; 10(1):2156. PMC: 7005730. DOI: 10.1038/s41598-020-59178-x. View

Kjaergaard A, Teumer A, Marouli E, Deloukas P, Kus A, Sterenborg R . Thyroid function, pernicious anemia and erythropoiesis: a two-sample Mendelian randomization study. Hum Mol Genet. 2022; 31(15):2548-2559. DOI: 10.1093/hmg/ddac052. View

Liu P, Liu R, Chen X, Chen Y, Wang D, Zhang F . Can levothyroxine treatment reduce urinary albumin excretion rate in patients with early type 2 diabetic nephropathy and subclinical hypothyroidism? A randomized double-blind and placebo-controlled study. Curr Med Res Opin. 2015; 31(12):2233-40. DOI: 10.1185/03007995.2015.1094044. View

Wang Y, Zhao M, Yu J, Xin G, Liu Y, Zhang Y . The clinical and pathological characteristics of Chinese elderly patients with anti-neutrophil cytoplasmic autoantibodies associated small vessel vasculitis. Exp Gerontol. 2004; 39(9):1401-5. DOI: 10.1016/j.exger.2004.05.004. View

Ni J, Li J, Wang Y, Guan L, Lin H, Zhang L . Systemic Lupus Erythematosus Patients With Related Organic Damage Are at High Risk of Hypothyroidism. Front Endocrinol (Lausanne). 2022; 13:920283. PMC: 9335194. DOI: 10.3389/fendo.2022.920283. View

Prendecki M, Martin L, Tanna A, Antonelou M, Pusey C . Increased Prevalence of Thyroid Disease in Patients with Antineutrophil Cytoplasmic Antibodies-associated Vasculitis. J Rheumatol. 2018; 45(5):686-689. DOI: 10.3899/jrheum.170661. View

Kreisman S, Hennessey J . Consistent reversible elevations of serum creatinine levels in severe hypothyroidism. Arch Intern Med. 1999; 159(1):79-82. DOI: 10.1001/archinte.159.1.79. View

Jennette J, Falk R, Bacon P, Basu N, Cid M, Ferrario F . 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2012; 65(1):1-11. DOI: 10.1002/art.37715. View

10.

Trivioli G, Marquez A, Martorana D, Tesi M, Kronbichler A, Lyons P . Genetics of ANCA-associated vasculitis: role in pathogenesis, classification and management. Nat Rev Rheumatol. 2022; 18(10):559-574. DOI: 10.1038/s41584-022-00819-y. View

11.

Baier E, Kluge I, Hakroush S, Tampe B . Low hemoglobin levels are associated with Bowman's capsule rupture and peritubular capillaritis in ANCA-associated renal vasculitis: a link of vascular injury to anemia?. J Nephrol. 2023; 36(8):2305-2316. PMC: 10638148. DOI: 10.1007/s40620-023-01748-z. View

12.

Dilek M, Akpolat T, Cengiz K . Hypothyroidism as a cause of resistance to erythropoietin. Nephron. 2002; 92(1):248. DOI: 10.1159/000064459. View

13.

Zhou J, Tripathi M, Ho J, Widjaja A, Shekeran S, Camat M . Thyroid Hormone Decreases Hepatic Steatosis, Inflammation, and Fibrosis in a Dietary Mouse Model of Nonalcoholic Steatohepatitis. Thyroid. 2022; 32(6):725-738. DOI: 10.1089/thy.2021.0621. View

14.

Geetha D, Jefferson J . ANCA-Associated Vasculitis: Core Curriculum 2020. Am J Kidney Dis. 2019; 75(1):124-137. DOI: 10.1053/j.ajkd.2019.04.031. View

15.

Lionaki S, Hogan S, Falk R, Joy M, Chin H, Jennette C . Association between thyroid disease and its treatment with ANCA small-vessel vasculitis: a case-control study. Nephrol Dial Transplant. 2007; 22(12):3508-15. DOI: 10.1093/ndt/gfm493. View

16.

Salvador F . ANCA associated vasculitis. Eur J Intern Med. 2020; 74:18-28. DOI: 10.1016/j.ejim.2020.01.011. View

17.

Li L, Hu Y, Ai S, Cheng L, Liu J, Morris E . The relationship between thyroid dysfunction and nephrotic syndrome: a clinicopathological study. Sci Rep. 2019; 9(1):6421. PMC: 6478922. DOI: 10.1038/s41598-019-42905-4. View

18.

Pyne D, Isenberg D . Autoimmune thyroid disease in systemic lupus erythematosus. Ann Rheum Dis. 2002; 61(1):70-2. PMC: 1753864. DOI: 10.1136/ard.61.1.70. View

19.

Omar S, Hadj Taeib S, Kanoun F, Hammami M, Kamoun S, Romdhane N . [Erythrocyte abnormalities in thyroid dysfunction]. Tunis Med. 2010; 88(11):783-8. View

20.

Nakazawa D, Masuda S, Tomaru U, Ishizu A . Pathogenesis and therapeutic interventions for ANCA-associated vasculitis. Nat Rev Rheumatol. 2018; 15(2):91-101. DOI: 10.1038/s41584-018-0145-y. View