ESPE Abstracts

Introduction: There is a known interaction between kidney and thyroid functions for years. In steroid resistant nephrotic syndrome (SRNS), protracted proteinuria is a characteristic feature of SRNS that leads to loss of thyroxine binding globulin and albumin resulting in low level of thyroid hormones. Furthermore, the long duration of proteinuria in patients with SRNS might damage the renal tubules leading to reduced absorption of low molecular weight proteins that could exhaust the thyroid reserve leading to overt hypothyroidism. Thus, SRNS patients have variable thyroid function range. There is scarcity of data on the prevalence of thyroid dysfunction in these children. Therefore the present study will be conducted to investigate the frequency of subclinical and possible overt hypothyroidism in SRNS.

Objectives: This study aimed at assessing thyroid function (TSH, total T4, FT4, total T3, FT3) in those patients with SRNS and correlate the levels of thyroid hormones with the clinical and laboratory findings of the patients and the duration of illness. Besides, it aimed at determining the frequency of subclinical and overt hypothyroidism in SRNS patients.

Methods: A comparative cross sectional hospital-based study was used to evaluate the thyroid status of children with SRNS who are attending the nephrology clinic of Alexandria University Children's Hospitals. Fifty children with SRNS and equal number of age and sex matched healthy controls were enrolled in this study. Demographic data and thorough clinical examination were fully done for two groups. Renal profile and thyroid function tests were done for them too.

Results: Mean age for the SRNS and control groups was 7.93 ± 3.43 and7.58 ± 2.77 respectively. There was statistically significant correlation between the two groups according to anthropometric measurements and systolic and diastolic blood pressure. The mean TSH level was significantly higher in children with SRNS than the control group. The prevalence of non auto-immune subclinical hypothyroidism was 54 % among SRNS group with no detected thyroid dysfunction in the control group. No cases with overt hypothyroidism were detected among the two groups.

Conclusion: A significant number of SRNS children showed subclinical non-autoimmune hypothyroidism in comparison to healthy controls. It was noticed especially with those who suffered from protracted course of proteinuria. Thus, testing thyroid functions must be done on regular basis in SRNS patients for early diagnosis of subclinical or even overt hypothyroidism and early treatment accordingly.