Acute-on-Chronic Kidney Injury in Thyroid Hormone Withdrawal: A Case with Possible Implications for Radioactive Iodine Planning

Case Reports in Endocrinology
Elizabeth A McAninch, Violet S Lagari

Abstract

The association between renal dysfunction and hypothyroidism is of increasing clinical importance as thyroid hormone replacement may attenuate decline in renal function and improve cardiovascular outcomes in patients with chronic kidney disease (CKD). Although multiple mechanisms for the induction of renal insufficiency in hypothyroidism have been described, the renal impact of short-term, acute hypothyroidism is unknown, which has possible implications for thyroid cancer patients preparing to receive radioactive iodine (RAI). A 56-year-old gentleman with history of unilateral renal agenesis and CKD stage III presented with intermediate-risk papillary thyroid cancer. In preparation for RAI, he underwent thyroid hormone withdrawal (THW) associated with acute kidney injury (AKI), as marked by a decrease in his estimated GFR from 53 to 32 mL/min/1.73 m(2). Upon resumption of thyroid hormone, renal function returned to baseline within months. Although AKI in this case was not otherwise associated with adverse outcome and reversed upon resumption of thyroid hormone, it is possible that this phenomenon could result in potential harm, particularly in the patient with baseline renal insufficiency. In CKD patients, preparation for RAI t...Continue Reading

References

Jul 1, 1979·Annals of Internal Medicine·P B HalversonA R Sulaiman
Jan 19, 1999·Archives of Internal Medicine·S H Kreisman, J V Hennessey
Mar 12, 2005·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Victor J Bernet
Dec 20, 2008·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Rachel P Espiritu, Marius N Stan
Oct 29, 2009·Thyroid : Official Journal of the American Thyroid Association·UNKNOWN American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid CancerR Michael Tuttle
Oct 25, 2011·Journal of the American Society of Nephrology : JASN·Laura H Mariani, Jeffrey S Berns
Jan 4, 2013·Thyroid : Official Journal of the American Thyroid Association·Dong Ho ShinShin-Wook Kang
Feb 28, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Connie M RheeKamyar Kalantar-Zadeh

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Citations

Dec 22, 2020·International Journal of Nephrology·Fateme Shamekhi Amiri

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