Santivanez et al reported risk factors for subclinical hypothyroidism in a patient with chronic kidney disease (CKD). The authors are from Hospital General Universitario de Castellon, Universidad Cardenal Herrera-CEU, and Universidad Jaime I Castellon in Valencia, Spain.
Patient selection: CKD stage 3 to 5
The median age was 71 with range 58 to 84 years, so in an older population.
Hypothyroidism: elevated TSH with low free T4
Predictors of hypothyroidism on multivariate analysis:
(1) older age (RR 1.016), probably >= 75 years based on Table 1
(2) lower GFR (RR 0.963), which correlates with greater renal disease severity (higher stage), probably < 20 mL per min per 1.73 square meters
Stage of CKD
Percent with Hypothyroidism
3
13%
4
16%
5
26%
Other predictors for univariate analysis:
(1) proteinuria > 1 gram per day
(2) hypertension
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