Impact of hypothyroidism on renal function and its mechanism revealed by 99Tc m-DTPA renal dynamic imaging
10.3760/cma.j.cn321828-20240425-00142
- VernacularTitle:99Tc m-DTPA肾动态显像探索甲状腺功能减退症对肾功能的影响及机制
- Author:
Jiahuan YANG
1
;
Peng ZHONG
1
;
Hong CHAI
1
;
Zequan CHEN
1
;
Libo CHEN
1
Author Information
1. 上海交通大学医学院附属第六人民医院核医学科，上海 200233
- Publication Type:Journal Article
- Keywords:
Hypothyroidism;
Glomerular filtration rate;
Radionuclide imaging;
Technetium Tc 99m pentetate
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(1):19-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To quantitatively evaluate the impact of hypothyroidism on renal function and address its underlying mechanisms using 99Tc m-diethylene triamine pentaacetic acid (DTPA) renal dynamic imaging. Methods:A total of 35 patients with differentiated thyroid cancer (12 males, 23 females, age (44.8±10.7) years), who were referred for radioiodine remnant ablation, were consecutively enrolled prospectively from October 2022 to October 2023 in Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Serum examinations of thyroid- and renal function-relevant parameters and 99Tc m-DTPA renal dynamic imaging were performed before and 4 weeks after stopping taking levothyroxine ( L-T 4). Paired t test, Wilcoxon signed rank test and Wilcoxon rank sum test were used to analyze data. Results:After L-T 4 withdrawal, glomerular filtration rate (GFR) derived from renal dynamic imaging, estimated GFR (eGFR), and cystatin C level significantly decreased ((95.80±18.09) vs (89.86±15.58) ml/min; t=4.83, P<0.001; (108.27±18.39) vs (87.97±16.24) ml·min -1·1.73 m -2;t=9.37, P<0.001; (0.72±0.12) vs (0.64±0.15) mg/L; t=3.73, P=0.001). GFR decreased more robustly in male patients than in females (6.16(3.62, 14.89) vs 3.83(0.57, 8.25) ml/min; Z=-1.98, P=0.048). Additionally, 99Tc m-DTPA renal dynamic imaging revealed that the peak times of both left and right kidneys were significantly prolonged (3.03(2.53, 3.78) vs 3.04(2.53, 4.13) min; Z=-3.85, P<0.001; 3.14(2.46, 4.20) vs 3.50(2.74, 4.50) min; Z=-3.44, P=0.001), but the left and right renal half-excretion times remained stable ( Z values: -0.88, -0.48, P values: 0.381, 0.634). Conclusion:Based on the 99Tc m-DTPA renal dynamic imaging results, it can be demonstrated that hypothyroidism can lead to a significant decrease in renal function, and the possible reason might be the reduction in the blood perfusion of kidneys.
