Estimation of kidney function in Graves’ disease using creatinine and cystatin C

Introduction: There is no consensus regarding methods to estimate kidney function in hyperthyroidism. The aim was therefore to assess changes in filtration markers in patients with Graves’ disease undergoing treatment with antithyroid drugs. Methods: Thirty patients with de novo Graves’ disease were...

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Main Authors: Sorena Abbaszadeh, Martin H Lundqvist, Östen Ljunggren, Anders Olof Larsson, Maria K Svensson, Selwan Khamisi
Format: Article
Language:English
Published: Bioscientifica 2025-04-01
Series:Endocrine Connections
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Online Access:https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0698.xml
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author Sorena Abbaszadeh
Martin H Lundqvist
Östen Ljunggren
Anders Olof Larsson
Maria K Svensson
Selwan Khamisi
author_facet Sorena Abbaszadeh
Martin H Lundqvist
Östen Ljunggren
Anders Olof Larsson
Maria K Svensson
Selwan Khamisi
author_sort Sorena Abbaszadeh
collection DOAJ
description Introduction: There is no consensus regarding methods to estimate kidney function in hyperthyroidism. The aim was therefore to assess changes in filtration markers in patients with Graves’ disease undergoing treatment with antithyroid drugs. Methods: Thirty patients with de novo Graves’ disease were included. Blood sampling, including thyroid-stimulating hormone, fT3, fT4 and creatinine, was performed at baseline, 6 weeks, 3, 6, 12 and 24 months. Cystatin C was measured from frozen samples. To calculate creatinine- and cystatin C-based eGFR, the Lund–Malmö equation (LMR) and the CAPA formula were used. Results: fT3 and fT4 normalized during treatment. Creatinine increased initially but stabilized after 6 months. eGFRLMR decreased until 12 months. Cystatin C decreased, while eGFRCAPA and eGFRCAPA/eGFRLMR increased until 6 months. The mean of eGFRLMR and eGFRCAPA remained stable. The % changes in creatinine and cystatin C were associated with % changes in fT3 and fT4. In regression models including fT3 or fT4 with body weight (all % change), fT3 and fT4 were the strongest predictors of percentual changes in both creatinine and cystatin C. Conclusion: The increase in creatinine and decrease in cystatin C during the treatment of Graves’ disease was significantly associated with changes in thyroid hormones, and for creatinine, also body weight. The mean of eGFRLMR and eGFRCAPA remained stable, suggesting that creatinine and cystatin C were affected by different non-GFR-related factors. The potential use of eGFRLMR and eGFRCAPA to assess kidney function in patients with thyroid disorders should be further evaluated in studies measuring kidney function with state-of-the-art methods.
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spelling doaj-art-a945d0e9298d4553b30f8830f2bf6f032025-08-20T02:20:25ZengBioscientificaEndocrine Connections2049-36142025-04-0114510.1530/EC-24-06981Estimation of kidney function in Graves’ disease using creatinine and cystatin CSorena Abbaszadeh0Martin H Lundqvist1Östen Ljunggren2Anders Olof Larsson3Maria K Svensson4Selwan Khamisi5Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, SwedenDepartment of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, SwedenDepartment of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, SwedenDepartment of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, SwedenDepartment of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, SwedenDepartment of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, SwedenIntroduction: There is no consensus regarding methods to estimate kidney function in hyperthyroidism. The aim was therefore to assess changes in filtration markers in patients with Graves’ disease undergoing treatment with antithyroid drugs. Methods: Thirty patients with de novo Graves’ disease were included. Blood sampling, including thyroid-stimulating hormone, fT3, fT4 and creatinine, was performed at baseline, 6 weeks, 3, 6, 12 and 24 months. Cystatin C was measured from frozen samples. To calculate creatinine- and cystatin C-based eGFR, the Lund–Malmö equation (LMR) and the CAPA formula were used. Results: fT3 and fT4 normalized during treatment. Creatinine increased initially but stabilized after 6 months. eGFRLMR decreased until 12 months. Cystatin C decreased, while eGFRCAPA and eGFRCAPA/eGFRLMR increased until 6 months. The mean of eGFRLMR and eGFRCAPA remained stable. The % changes in creatinine and cystatin C were associated with % changes in fT3 and fT4. In regression models including fT3 or fT4 with body weight (all % change), fT3 and fT4 were the strongest predictors of percentual changes in both creatinine and cystatin C. Conclusion: The increase in creatinine and decrease in cystatin C during the treatment of Graves’ disease was significantly associated with changes in thyroid hormones, and for creatinine, also body weight. The mean of eGFRLMR and eGFRCAPA remained stable, suggesting that creatinine and cystatin C were affected by different non-GFR-related factors. The potential use of eGFRLMR and eGFRCAPA to assess kidney function in patients with thyroid disorders should be further evaluated in studies measuring kidney function with state-of-the-art methods.https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0698.xmlgraves’ diseasehyperthyroidismestimated glomerular filtration rate (egfr)kidney functioncreatininecystatin c
spellingShingle Sorena Abbaszadeh
Martin H Lundqvist
Östen Ljunggren
Anders Olof Larsson
Maria K Svensson
Selwan Khamisi
Estimation of kidney function in Graves’ disease using creatinine and cystatin C
Endocrine Connections
graves’ disease
hyperthyroidism
estimated glomerular filtration rate (egfr)
kidney function
creatinine
cystatin c
title Estimation of kidney function in Graves’ disease using creatinine and cystatin C
title_full Estimation of kidney function in Graves’ disease using creatinine and cystatin C
title_fullStr Estimation of kidney function in Graves’ disease using creatinine and cystatin C
title_full_unstemmed Estimation of kidney function in Graves’ disease using creatinine and cystatin C
title_short Estimation of kidney function in Graves’ disease using creatinine and cystatin C
title_sort estimation of kidney function in graves disease using creatinine and cystatin c
topic graves’ disease
hyperthyroidism
estimated glomerular filtration rate (egfr)
kidney function
creatinine
cystatin c
url https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0698.xml
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