Hypothyroidism mimicking chronic renal failure in reflux nephropathy

An adolescent with a history of pyelonephritis and renal scarring had antir eflux surgery at the age of 2.5 years. His serum creatinine was high at the age of 14 years (133 mu mol/1; glomerular filtration rate (GFR) 56 ml/min x 1.73 m(2)), and 1 reflux nephropathy with chronic renal failure was diagn osed. Because of a fall in height velocity, endocrinological investigations were performed six months later which showed hypothyroidism caused by auto immune thyroiditis. Substitution with thyroxine was started; renal function improved to normal six months later (GFR 108 ml/min x 1.73 m(2)). Metaboli c changes of hypothyroidism led to a reduction of GFR in this patient and m imicked chronic renal failure.