Thyroid Function Studies in the Nephrotic Syndrome

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Total serum and urinary thyroxine (T4), triiodothyronine (T3), and thyroxine-binding globulin (TBG) as well as serum free T4, thyroid-stimulating hormone (TSH), and T3 resin uptake (T3RU) were measured in seven patients with the nephrotic syndrome. The nephrotic syndrome was defined by proteinuria exceeding 3 g/24 h. All patients were clinically euthyroid. Most values for total serum T4, free T4, T3, T3RU, TBG, and TSH were within normal limits. However, the mean serum T3 and TBG values were significantly lower in patients compared with the control group. The values (mean ± 2 SD) for urinary T4 were 24.3 ± 20.3 in the patient group and 1.5 ± 0.7 µg/24 h in the control group. Urinary T3 values for patients and the control group were 2100 ± 856 and 848 ± 253 ng/24 h respectively. Urinary TBG was 2.1 ± 1.8 mg/24 h in the patients and undetectable in the control group. There was no correlation between daily urinary T3 and T4 and urinary TBG. There was a weak correlation between daily urinary protein excretion and urinary T4 (r = 0.5).

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