Thyroid function studies in children of nephrotic syndrome

Gurdeep Singh Dhanjal, Mani Garg


Background: Nephrotic syndrome is a condition which is characterized by proteinuria, hypoproteinemia, hypercholesterolemia and significant edema. In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of significant loss of thyroxine (T4), triiodothyronine (T3) in presence of proteinuria. The objectives of this study were to evaluate the level of serum free T3, free T4, and TSH in children with nephrotic syndrome and its correlation with healthy controls.

Methods: A comparative study was carried out on total of 60 children (divided into two equal groups of 30 cases and 30 controls) in the age group of 1-18 years of either sex admitted to Department of Paediatrics. Maharishi Markandeshwar institute of Medical Sciences and Research. Mullana, Ambala, Haryana over a from January 2017 to September 2018. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) were done in all 60 children and compared.

Results: Among cases 18 (60%) were males and 12 (40%) were females. 63.4% of the cases were in the age group 1-10 years and 36.6% were in age group 11-18 years. Studied patients showed lowered FT3 and FT4 and raised TSH in comparison with normal values.

Conclusions: Hypothyroidism should be actively sought for in children with nephrotic syndrome as it is a treatable complication.


Free thyroxine, Free triiodothyronine, Hypothyroidism, Nephrotic syndrome Thyroid stimulating hormone

Full Text:



Kaptein EM. Thyroid function in renal failure. Contributions to Nephro. 1986;50:64-72.

Campbell AG, McIntosh N. Endocrine gland disorders. In: Klenar CJ, Forfar, eds and Areil’s text book of paediatrics. 4th ed. London: New York and Tokyo,1992.

Hoffman AS, Arem R, Eknoyan G. Thyroid function in renal failure. In seminars in dialysis. Oxford, UK: Blackwell Publishing Ltd.1988;1(3):154-9.

Sawant SU, Chandran S, Almeida AF, Rajan MG. Correlation between oxidative stress and thyroid function in patients with nephrotic syndrome. Int J Nephrol. 2011;2011.

Barrett KE, Barman SM, Boitano S, Brooks HL. The thyroid gland. In: Ganong’s review of Medical Physiology. 23rd ed. New York: McGraw-Hill; 2010:301-14.

Murray RK, Bender DA, Botham KM, Kennelly PJ, Rodwell VW, Weil PA. Plasma proteins and Immunoglobulins. In: Harpers illustrated Biochemistry. 28th ed. New York: McGraw-Hill; 2009.

Ito S, Kano K, Ando T, Ichimura T. Thyroid function in children with nephrotic syndrome. Pediatr Nephrol. 1994;8(4):412-5.

Afroz S, Khan AH, Roy DK. Thyroid function in children with nephrotic syndrome. MMJ. 2011;20(3):407-11.

Shahni V, Nanda S, Gehlawat VK, Gathwala G. Hypothyroidism in nephrotic syndrome in children. IOSR-JDMS. 2014;13(8):7-11.

Kapoor K, Saha A, Dubey NK, Goyal P, Suresh C, Batra V, et al. Subclinical non-autoimmune hypothyroidism in children with steroid resistant nephrotic syndrome. Clin Experiment Nephrol. 2014;18(1):113-7.

Gattoo I, Aziz A Latief M, Najar BA. Thyroid Function in Pediatrics nephrotic syndrome: A hospital based observational study. Int J Advanc Res. 2015;3(5):500-5.

Hajizadeh N, Marashi SM, Nabavizadeh B, Elhami E, Mohammadi T, Nobandegani MN, et al. Examine of thyroid function in Pediatric nephrotic syndrome; Tehran-Iran. Int J Pediatr. 2015;3(2.1):59-65.

Ebadi A, Yadollahpour A, Shirali S, Daneghian S, Saki S. Evaluating thyroid function in Pediatric nephrotic syndrome: A study conducted in Ahvaz, Iran. Int J Pharm Res Allied Sci. 2016;5(2).

Choudhury J. A study on thyroid function test in children with nephrotic syndrome. Int J Contemp Pediatr. 2016;3(3):752-4.

Mohamed S, Zannoun M, El-Askary A, Abdel-aal M, Abdelrahman Y. Evaluation of thyroid functions, oxidative stress and antioxidants in Egyptian children with nephrotic syndrome. Kidney Res J. 2016;6(1):9-14.

Marimuthu V, Krishnamurthy S, Rajappa M. Non-autoimmune subclinical and overt hypothyroidism in idiopathic steroid-resistant nephrotic syndrome in children. Indian Pediatr. 2017;54(11):925-9.