Thyroid Function in Idiopathic Nephrotic Syndrome

Introduction:Nephrotic syndrome is a common glomerular disease in children. It’s main feature is loss of albumin and high molecular weight proteins such as thyroxin-binding globulin and thyroid hormones. Threrefore subclinical hypothyroidism is proposed with increasing in TSH and normal free thyroxin and free triidothyronine, but some nephrotic patients reveal low/normal free fractions and overt hypothyroidism. As hypothyroidism affect steroid-response and prognosis, thyroxin replacement therapy is wise until stable thyroid status is achieved.Method:This is a cross-sectional study included nephrotic patients admitted and the out-patients in clinic of Qods hospital from 1395 to 1396. There were 49 children in active and 24 in remission phase. We assessed thyroid function (TSH, free T3, free T4, total T3, total T4, and anti-TPO) for the patients and for 74 healthy children matched in gender and age.Result:Thirty six(73.5%)of patients in active phase had abnormal total thyroxin with positive correlation with Upr/Ucr ratio (p<0.001). TSH level was elevated in active phase, with positive correlation with Upr/Ucr ratio(p<0.001). Thirty four percent of patients needed thyroxin replacement therapy for a short time.Conclusion:Due to prevalence of hypothyroidism in our nephrotic patients, we recommend routine thyroid screening and early replacement therapy. A multi-central is also proposed for further confirmation.