Thyroid function in type 2 cardiorenal syndrome

Introducere: The risk of chronic kidney disease occur-re in heart failure (HF) is not well established, but type 2 cardiorenal syndrome (T2CRS) is very often encoun-tered in HF patients and it is associated with a poor prognosis. Thyroid hormone, also, has been identified as a risk factor for the for heart disease progression and development.
Objective: To investigate whether thyroid function is associated with T2CRS
Methods: This observational cohort study included 26 patients with reduced ejection fraction HF. Routine bi-ochemistry, including Cystatine C, TSH, NT-proBNP and proteinuria were measured. Glomerular filtration rate (GFR) was estimated by the CKD-EPI CYSTATIN C based formula adjusted for Body Surface Area. We divided patients into two groups with/without T2CRS according to eGFR..
Results: Among 26 adult participants, 15 had T2 CRS: eGFR <60 ml/min with a meanTSH level of 7.4±3.28 UN/ml (p<0.05); Cystatine C of 1.74±0.13 mg/L; mean ejection fraction (EF) of 43.4±2.84% level; NT-proBNP 4714±1544 pg/mL; uric acid level 446.2±81.27mmol/L; total cholesterol – 7.95±3.37mmol/L; triglycerides 2.19mmol/L and 0.12g/l proteins in urine. 11 subjects without T2CRS: eGFR≥60 ml/min; a meanTSH level of 2.2±0.65 UN/ml (p<0.01); Cystatine C of 1.15±0.07 mg/L; mean EF of 42±2.77% ; NT-proBNP 1744±496 pg/mL; uric acid level 235.5±113.5mmol/L total cho-lesterol – 5.01±0.51mmol/L; triglycerides 2.20mmol/L and 0.07g/l proteins in urine. Compared with partici-pants with T2 CRS, those without T2 CRS had an in-creased rate of subclinical primary hypothyroidism, higher levels of uric acid, total cholesterol and trigli-cerydes.
Conclusions: Our results suggest subclinical hypothy-roidism is associated not also with heart failure, but also with CKD and may be considered as a novel risk factor of reduced renal function and T2 CRS develop-ment. Further studies are needed to better understand the causal implications of hypothyroidism in CKD pa-tients and T2 CRS.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)