Hypothyroidism: a reversible cause of ‘acute kidney injury’- a series of 5 cases

Abstract

The effects of thyroid hormones on the kidneys are well known. Thyroid dysfunction causes remarkable changes in glomerular and tubular functions and electrolyte and water homeostasis. There have been reports of elevated serum creatinine associated with hypothyroidism, the pathogenesis of which is thought to be multi-factorial. We present five cases, all of who were referred to the nephrology department for evaluation of unexplained „acute kidney injury‟. Hypothyroidism was suspected based on history and clinical examination. In all cases, investigation revealed significantly elevated TSH, low T3, T4 levels, elevated CPK levels, normal urine analysis and normal sonological study of kidney. All the cases showed complete normalization of renal parameters after 4-8 weeks of treatment with levothyroxine. This case series depicts the need for high index of suspicion for diagnosis of hypothyroidism in the setting of unexplained „acute kidney injury‟.