ArticleEuropean thyroid journal2015
Do Not Forget Nephrotic Syndrome as a Cause of Increased Requirement of Levothyroxine Replacement Therapy.
Article in European thyroid journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Concomitant Use of Levothyroxine and Proton Pump Inhibitors in Patients with Primary Hypothyroidism: a Systematic Review.Journal of general internal medicine · 2021Pooled it
- Kidney diseases and the thyroid: interactions and consequences.Nature reviews. Endocrinology · 2026Review
- Simultaneous Presentation of Minimal Change Disease and Tubulointerstitial Nephritis Associated with Primary Sjögren's Syndrome and Hashimoto's Thyroiditis.Internal medicine (Tokyo, Japan) · 2025Review
- Levothyroxine: Conventional and Novel Drug Delivery Formulations.Endocrine reviews · 2023Review
- Nonautoimmune overt hypothyroidism in the early stages of nephrotic syndrome: a case report from Somalia.Annals of medicine and surgery (2012) · 2023Article
- Urinary excretion of thyroid hormone in CKD patients: a proof-of-concept of nephrogenic hypothyroidism.Renal failure · 2023Article
- Seeking optimization of LT4 treatment in patients with differentiated thyroid cancer.Hormones (Athens, Greece) · 2022Review
- Factors influencing the levothyroxine dose in the hormone replacement therapy of primary hypothyroidism in adults.Reviews in endocrine & metabolic disorders · 2022Review
- It's Not Lupus This Time! A Case of Worsening Hypothyroidism in a Patient With Nephrotic Syndrome.Cureus · 2022Article
- Case Report: Myxedema Coma Caused by Immunoglobulin A Vasculitis in a Patient With Severe Hypothyroidism.Frontiers in immunology · 2022Article
- Association between albuminuria and thyroid function in patients with chronic kidney disease.Endocrine · 2021Article
- Subclinical hypothyroidism in children: updates for pediatricians.Annals of pediatric endocrinology & metabolism · 2021Article
- Severity of Proteinuria Is Directly Associated With Risk of Hypothyroidism in Adults.The Journal of clinical endocrinology and metabolism · 2021Article
- Nephrotic Syndrome as a Cause of Transient Clinical Hypothyroidism.Case reports in endocrinology · 2021Article
- Liquid and softgel capsules of l-thyroxine results lower serum thyrotropin levels more than tablet formulations in hypothyroid patients.Journal of clinical & translational endocrinology · 2019Article
- Changes in the thyroid hormone profiles in children with nephrotic syndrome.Korean journal of pediatrics · 2019Article
- Increased Requirement of Replacement Doses of Levothyroxine Caused by Liver Cirrhosis.Frontiers in endocrinology · 2018Article
- Review
- Autoimmune Thyroiditis and Glomerulopathies.Frontiers in endocrinology · 2017Review
- Nephrotic Syndrome Increases the Need for Levothyroxine Replacement in Patients with Hypothyroidism.Journal of clinical and diagnostic research : JCDR · 2016Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nephrotic syndrome increases L-thyroxine requirements because of urinary loss of free and protein-bound thyroid hormones. We report 2 hypothyroid patients referred to us because of high serum TSH, even though the L-thyroxine daily dose was maintained at appropriate levels or was increased. The cause of nephrotic syndrome was multiple myeloma in one patient and diabetic glomerulosclerosis in the other patient. As part of the periodic controls for diabetes, urinalysis was requested only in the second patient so that proteinuria could be detected. However, as in the first patient, facial puffiness and body weight increase were initially attributed to hypothyroidism, which was poorly compensated by L-thyroxine therapy. In the first patient, the pitting nature of the pedal edema was missed at the initial examination. An endocrinologist consulted over the phone by the practitioner hypothesized some causes of intestinal malabsorption of L-thyroxine. This diagnosis would have been accepted had the patient continued taking a known sequestrant of L-thyroxine, i.e. calcium carbonate. The diagnostic workup of patients with increasing requirements of L-thyroxine replacement therapy should not be concentrated on the digestive system alone. Careful history taking and physical examination need to be thorough. Endocrinologists should not forget nephrotic syndrome that, in turn, can be secondary to serious diseases.
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