Subclinical hypothyroïdism Clinical Trial
Official title:
Effects of Levothyroxine Treatment on Hemodynamic and Isotopic Renal Functions in Subclinical Hypothyroidism
Renal and cardiovascular effects of subclinical hypothyroidism, defined by a high TSH and
normal T4 are less known and the indications for treatment of subclinical hypothyroidism are
subject to controversies.
The investigators propose to assess whether the hormone replacement for subclinical
hypothyroidism in patients with chronic kidney disease is beneficial for hemodynamic and
renal functions and which mechanisms are involved.
Isotopic measurements of glomerular filtration and renal blood flow and an hemodynamic
evaluation by transthoracic echocardiography and flow-mediated vasodilation will be carried
out before and 6 months after substitution.
Animal experimental hypothyroidism is associated with renal and hemodynamic abnormalities.
In human, exact measurements of GFR showed a decline in GFR after thyroidectomy and an
increase in GFR and renal blood flow after hormone replacement. Renal and cardiovascular
effects of subclinical hypothyroidism, defined by a high TSH and normal T4 are less known
and the indications for treatment of subclinical hypothyroidism are subject to
controversies. A retrospective study suggests that treatment of subclinical hypothyroidism
may slow the degradation rate of renal function estimated by MDRD. However, the potential
hemodynamic benefit of treatment has not yet been studied.
The investigators propose to assess whether the hormone replacement for subclinical
hypothyroidism in patients with chronic kidney disease is beneficial for hemodynamic and
renal functions and which mechanisms are involved.
Isotopic measurements of glomerular filtration and renal blood flow and an hemodynamic
evaluation by transthoracic echocardiography and flow-mediated vasodilation will be carried
out before and 6 months after substitution. This open prospective study will include 16
patients in order to detect an increase of 1.2 standard deviation for the measured
glomerular filtration.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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