Exacerbation of renal failure due to hypothyroidism in a patient with ischemic nephropathy

A case of acute-on-chronic renal failure in a 70-year-old woman with ischem ic nephropathy and primary hypothyroidism is presented. Her renal function became progressively worse as the level of serum creatinine increased from 283 to 628 mu mol/l (3.2-7.1 mg/dl) within 8 months. Her thyroid function h ad been normal before the exacerbation of renal failure, but it was markedl y reduced with a marked elevation of serum thyroid-stimulating hormone. Thy roid hormone replacement therapy resulted in rapid improvement of the renal function to 159 mu mol/l (1.8 mg/dl) of serum creatinine. The development of primary hypothyroidism seemed to worsen the already impaired renal funct ion in this case. We suggest the assessment of thyroid function in patients with unexplained deterioration of renal failure. Copyright (C) 2000 S. Kar ger AG, Basel.