Thyroid function in children with nephrotic syndrome: A prospective hospital-based study

Background. Nephrotic syndrome is a common kidney disease among children which is characterized by proteinuria, hypercholesterolemia, hypoproteinemia, and edema. The urinary losses of proteins including albumin and thyroid-binding globulin might affect the thyroid hormone levels in those children. Objective. To assess the thyroid function in children with nephrotic syndrome during the nephrotic attack and after remission.Methods. This was a prospective study conducted at the Pediatrics department, Sohag University Hospital, Sohag, Egypt over a one-year period (from January to December 2017). Data were collected from 51 children with nephrotic syndrome aged between 1 and 12 years old. The study participants were subjected to investigations including thyroid-stimulating hormone (TSH), thyroxin (T4), triiodothyronine (T3), serum urea, creatinine, cholesterol, triglycerides, albumin, total proteins, urinary albumin-to-creatinine ratio and 24 hours urinary proteins during the nephrotic attack and after remission.Results. The mean age for the study participants was 6.1 ± 2.9 years. Thirty-one participants were males (60.8%). The study found that serum TSH levels were elevated while serum Total T3 and Total T4 were reduced during the nephrotic attack. As regards the thyroid hormone status, we found true hypothyroidism in 12 patients (23.52%) and subclinical hypothyroidism in 24 patients (47.06%) during the nephrotic attack. However, only one patient (1.96%) had true hypothyroidism and 14 patients (27.45%) had subclinical hypothyroidism after remission. Conclusion. A large proportion of children with nephrotic syndrome had thyroid dysfunction in the form of either true (overt) or subclinical hypothyroidism. Therefore, monitoring the thyroid function in those children is important.