甲状腺机能减退致急性肾损伤的临床病理特点及预后分析

Analysis on acute renal injury caused by hypothyroidism and its clinical pathological characteristics and prognosis

目的探讨甲状腺机能减退致急性肾损伤的临床病理特点及预后。方法选取2006年12月至2012年12月在我院住院并确诊为甲状腺机能减退致急性肾损伤且有完整随诊资料的患者7例作为研究对象,观察患者治疗前后临床各项指标的变化及肾脏病理特点。结果本组7例患者,治疗后甲状腺功能均恢复正常,肾功能明显改善,其中6例恢复正常,脂质代谢纠正,治疗前后比较差异具有统计学意义(P<0.05)。结论甲状腺机能减退症可致急性肾损伤,肾损伤与甲状腺功能及血脂水平相关,临床特点为尿检轻度异常,轻中度SCr增高,肾脏病理以急性小管间质病变为主,肾小球病变轻。及时有效地甲状腺激素替代治疗,可恢复正常肾功能。

Objective To analyze acute renal injury induced by hypothyroidism and its clinical pathological characteristics and prognosis. Methods Seven patients admitted to our hospital and confirmatively diagnosed with hypothyroidism-induced acute kidney injury with complete follow-up information during December 2006 and December 2012 were enrolled as studied subjects,so as that the changes in various indicators,as well as renal pathology and clinical prognosis,would be explored. Results Thyroid function returned to normal and kidney function improved significantly after treatment（ P〈0. 05）. Conclusion Hypothyroidism may cause acute kidney injury,which is associated with thyroid function and blood lipid levels,and is clinically characterized by mildly abnormal urine,mild to moderate increase in SCR. Its renal pathology is dominated by acute tubulointerstitial lesions and mild glomerular lesions. Timely and effective thyroid hormone replacement therapy helps to make kidney function return to normal. The disease should be taken seriously,so as not to delay time for treatment.