甲状腺功能紊乱与慢性肾脏病  

Update of relationship between thyroid disorders and chronic kidney disease

作　　者：周岩[1] 程震[1] 

机构地区：[1]南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所,南京210016

出　　处：《肾脏病与透析肾移植杂志》2016年第2期176-180,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：甲状腺激素可影响肾脏生长发育及改变肾功能。甲状腺功能紊乱可导致肾脏血流动力学的改变。甲状腺功能减低可降低肾小球滤过率(GFR)导致血清肌酐升高,而甲状腺功能亢进则可增加GFR。慢性肾脏病(CKD)患者常合并原发和亚临床甲状腺功能减低及低T3综合症。甲状腺激素降低能预测终末期肾病患者心血管和全因死亡率。本文重点就甲状腺病理生理学变化、对CKD患者肾功能的影响及CKD患者甲状腺功能紊乱作一综述。Thyroid hormones may directly affect the kidney and alter kidney function. The renal manifestations of thyroid disorders are based on hemodynamic alterations or / and to direct effects of thyroid hormones. Hypothyroidism may be accompanied by an increase of serum creatinine and reduction of glomerular filtration rate（ GFR）,whereas hyperthyroidism may increase GFR. Treatment of thyroid disorders may lead to normalization of GFR. Primary and subclinical hypothyroidism and low triiodothyronine（ T3） syndrome are common features in patients with chronic kidney disease（ CKD）. In addition low levels of thyroid hormones may predict a higher risk of cardiovascular and overall mortality in patients with end-stage renal disease. The causal nature of this correlation remains uncertain. In this review,special emphasis is given to the thyroid pathophysiology,its impact on kidney function and CKD and the interpretation of laboratorial findings of thyroid dysfunction in CKD.

关 键 词：甲状腺疾病 慢性肾脏病 甲状腺 

分 类 号：R581[医药卫生—内分泌]