Thyroxine treatment induces upregulation of renin‐angiotensin‐aldosterone system due to decreasing effective plasma volume in patients with primary myxoedema

Background. In experimental animals and humans, hypothyroidism is associated with fluid retention and generalized oedema, increased antidiuretic hormone (ADH), decreased atrial natriuretic hormone (ANH), and decreased renin‐angiotensin‐aldosterone system (RAAS), which subsequently can be corrected b...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2001-09, Vol.16 (9), p.1799-1806
Main Authors: Park, Cheol Whee, Shin, Young Shin, Ahn, Seog Ju, Kim, Suk Young, Choi, Eui Jin, Chang, Yoon Sik, Bang, Byung Kee
Format: Article
Language:English
Subjects:
Adult
antidiuretic hormone
atrial natriuretic hormone
Biological and medical sciences
Endocrinopathies
Female
Follow-Up Studies
glomerular filtration rate
Humans
Kidney - drug effects
Kidney - physiopathology
Medical sciences
Myxedema - drug therapy
Myxedema - physiopathology
myxoedema
Neurotransmitter Agents - blood
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Plasma Volume
Renin-Angiotensin System - drug effects
renin‐angiotensin‐aldosterone
Thyroid Hormones - blood
Thyroid. Thyroid axis (diseases)
thyroxine
Thyroxine - therapeutic use
Up-Regulation
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Summary:Background. In experimental animals and humans, hypothyroidism is associated with fluid retention and generalized oedema, increased antidiuretic hormone (ADH), decreased atrial natriuretic hormone (ANH), and decreased renin‐angiotensin‐aldosterone system (RAAS), which subsequently can be corrected by thyroid hormone replacement. The purpose of this study was to determine the effect of thyroxine therapy on RAAS and neurohormones affecting water and electrolyte metabolism and the reason for these changes in patients with primary myxoedema. Methods. We measured changes in the plasma renin activity (PRA), serum aldosterone (Aldo), ADH, ANH levels, serum and 24 h urinary electrolytes and osmolalities, and cardiac function in 22 female patients with primary myxoedema before and after correction of hypothyroidism. We also evaluated age‐, sex‐, and BMI‐matched 15 healthy control subjects (Cont). Results. It took an average of 4.3 months (range, 3–9 months) to normalize thyroid function. The mean reductions of body weight and estimated plasma volume were 1.8±1.0 kg (P=0.002) and 8.5% (P
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/16.9.1799