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  1. Article: Renal impairment resulting from hypothyroidism.

    Connor, Andrew / Taylor, Joanne E

    NDT plus

    2008  Volume 1, Issue 6, Page(s) 440–441

    Language English
    Publishing date 2008-10-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2410383-4
    ISSN 1753-0784
    ISSN 1753-0784
    DOI 10.1093/ndtplus/sfn158
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Renal impairment resulting from hypothyroidism-or impaired estimated glomerular filtration rate in a patient with hypothyroidsm.

    Brueckner, Dieter / Brueckner, Maike M

    NDT plus

    2014  Volume 2, Issue 3, Page(s) 262–263

    Language English
    Publishing date 2014-11-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2410383-4
    ISSN 1753-0784
    ISSN 1753-0784
    DOI 10.1093/ndtplus/sfp021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Renal Toxicity of Cancer Immunother apy.

    Büchler, T

    Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti

    2020  Volume 33, Issue 1, Page(s) 29–31

    Abstract: Background: Acute renal impairment is a relatively rare complication of anti-tumour immunotherapy ... type 1 diabetes mellitus, hypophysitis, adrenal insufficiency, and hypothyroidism should be excluded ... The incidence of renal toxicity due to immuno-oncological therapy is relatively low, approximately 2 ...

    Title translation Renální toxicita imunoonkologické léčby.
    Abstract Background: Acute renal impairment is a relatively rare complication of anti-tumour immunotherapy. The incidence of renal toxicity due to immuno-oncological therapy is relatively low, approximately 2% in patients treated with PD-1/PD-L1 inhibitors and 4.5% with combination treatments with PD-1/PD-L1 therapy and a CTLA-4 inhibitor. The most common underlying pathology is acute tubulointerstitial nephritis. Autoimmune nephropathy presenting as a electrolyte imbalance may also occur during immuno-oncological therapy. Discontinuation of immunotherapy and corticosteroid therapy are indicated in patients with moderate to severe renal toxicity.
    Case: A 61-year-old patient with metastatic renal cell carcinoma was admitted to hospital after 7 months of treatment with nivolumab for general deterioration, severe weakness, nausea, and anorexia. Laboratory examinations showed worsening of the glomerular filtration rate, severe hyperkalaemia, and metabolic acidosis. Thyroid hormone and cortisol levels were within normal ranges. Renal tubular acidosis resulting from immuno-oncological therapy was diagnosed, and treatment with methylprednisolone was initiated. Electrolyte abnormalities and symptoms improved rapidly, after which the dose of prednisone was gradually reduced; however, after a reduction to 5 mg daily, hyperkalaemia recurred and the patient was kept on a maintenance dose of 10 mg prednisone administered orally on a daily basis thereafter. Immunotherapy was not reintroduced.
    Conclusion: Renal toxicity following immuno-oncological therapy usually presents initially as an increase in the serum creatinine level without any clinical signs or symptoms. Electrolyte disturbances, oliguria, anuria, and swelling may develop gradually. Endocrine and metabolic disorders such as new-onset type 1 diabetes mellitus, hypophysitis, adrenal insufficiency, and hypothyroidism should be excluded as possible causes of electrolyte abnormalities. Corticosteroids at the usual immunosuppressive dose are the treatment of choice. The prognosis is generally favourable because renal toxicity responds well to corticosteroid treatment regardless of the underlying pathology.
    MeSH term(s) Antineoplastic Agents, Immunological/adverse effects ; Humans ; Immunotherapy/adverse effects ; Kidney Diseases/chemically induced ; Kidney Diseases/drug therapy ; Kidney Diseases/epidemiology ; Middle Aged ; Prognosis
    Chemical Substances Antineoplastic Agents, Immunological
    Language English
    Publishing date 2020-02-15
    Publishing country Czech Republic
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1217739-8
    ISSN 1802-5307 ; 0862-495X
    ISSN (online) 1802-5307
    ISSN 0862-495X
    DOI 10.14735/amko202029
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Anti-programmed death-1 inhibitor nivolumab-induced immune-related adverse events: hepatitis, renal insufficiency, myositis, vitiligo, and hypothyroidism: a case-based review.

    Zekić, Tatjana / Benić, Mirjana Stanić

    Rheumatology international

    2022  Volume 43, Issue 3, Page(s) 559–565

    Abstract: ... a part of hypothyroidism and elevated renal parameters due to hypohydration. The rapid regression ... mg daily for 22 days, after which hypothyroidism and increased creatine kinase were found ... without muscle pain and functional impairment. Dexamethasone was continued, and a rapid decline in all parameters ...

    Abstract Nivolumab (NIVO) is a monoclonal antibody used to treat renal cell cancer. It is an anti-programmed death-1 (anti-PD-1) inhibitor, enhancing the tumor-targeted immune response of T lymphocytes, resulting in immune-mediated adverse events (AEs). We present five immunological AEs in a single patient treated with NIVO. A 68-year-old male patient with metastatic renal cell carcinoma and right-sided nephrectomy received NIVO after pazopanib and sunitinib treatment. Two and a half months after starting NIVO, hepatocellular enzymes and creatinine were elevated. Concomitantly, the patient noticed hypopigmentation of the hand skin and a change in voice and speech. Due to hepatitis, he has been treated with dexamethasone 16 mg daily for 22 days, after which hypothyroidism and increased creatine kinase were found without muscle pain and functional impairment. Dexamethasone was continued, and a rapid decline in all parameters except thyroid-stimulating hormone (TSH) and vitiligo was observed. Myositis was initially considered a part of hypothyroidism and elevated renal parameters due to hypohydration. The rapid regression on glucocorticoid treatment and a longer time for creatinine normalization than expected with hydration were noticed. Nivolumab likely induced those side effects as assessed by Naranjo Adverse Drug Reaction Probability Scale. The literature review shows that the consequences of PD-1 inhibition are not uniform. Side effects of checkpoint inhibitors should be monitored carefully in the early and later treatment schedules evaluating subclinical manifestations like myositis and worsening of kidney parameters. Early administered higher doses of glucocorticoids can stop drug toxicity and reverse-induced tissue damage.
    MeSH term(s) Male ; Humans ; Aged ; Nivolumab/adverse effects ; Carcinoma, Renal Cell/chemically induced ; Carcinoma, Renal Cell/drug therapy ; Carcinoma, Renal Cell/pathology ; Vitiligo/chemically induced ; Vitiligo/drug therapy ; Creatinine ; Kidney Neoplasms/chemically induced ; Kidney Neoplasms/drug therapy ; Kidney Neoplasms/pathology ; Hypothyroidism ; Myositis/drug therapy ; Drug-Related Side Effects and Adverse Reactions ; Hepatitis ; Renal Insufficiency ; Dexamethasone/adverse effects
    Chemical Substances Nivolumab (31YO63LBSN) ; Creatinine (AYI8EX34EU) ; Dexamethasone (7S5I7G3JQL)
    Language English
    Publishing date 2022-11-30
    Publishing country Germany
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 8286-7
    ISSN 1437-160X ; 0172-8172
    ISSN (online) 1437-160X
    ISSN 0172-8172
    DOI 10.1007/s00296-022-05247-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction.

    Bando, Y / Ushiogi, Y / Okafuji, K / Toya, D / Tanaka, N / Miura, S

    Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association

    2002  Volume 110, Issue 8, Page(s) 408–415

    Abstract: The aim of this study was to investigate the frequency and mechanisms of hypothyroidism observed ... In particular, in patients who showed overt hypothyroidism, further studies including large-needle biopsies ... respectively). The frequency of overt hypothyroidism in the diabetic group (22%; 7/32) was significantly higher ...

    Abstract The aim of this study was to investigate the frequency and mechanisms of hypothyroidism observed in diabetic patients with advanced diabetic nephropathy, including outcomes of management for this condition. A controlled study was designed using 32 diabetic and 31 non-diabetic patients not receiving hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) who excreted mean urinary protein greater than 0.5 g/day examined on three consecutive days during admission to our hospital. Thyroid hormones in both serum and urine, anti-thyroid antibodies, renal function and iodine concentrations in serum were measured during admission in all patients included. In particular, in patients who showed overt hypothyroidism, further studies including large-needle biopsies of the thyroid and iodine-perchlorate discharge tests were performed. All patients in the two groups revealed negative antithyroid antibody titers, and the mean serum total iodine levels did not significantly differ between the two groups. Mean serum FT4 levels significantly decreased, and the TSH level was significantly elevated in the diabetic group compared to those in the non-diabetic group (p < 0.005, p < 0.02, respectively). The frequency of overt hypothyroidism in the diabetic group (22%; 7/32) was significantly higher (p < 0.05) than that in the non-diabetic group (3.2%; 1/31). The daily urinary thyroid hormone excretion in both groups did not show any significant correlation with serum thyroid hormone levels. Seven patients who revealed overt hypothyroidism in the diabetic group showed elevated serum total iodine levels during hypothyroidal status, ranging between 177 and 561 microg/l. Also, the iodine-perchlorate discharge tests carried out in six of these patients all showed a positive discharge. After management based on iodine restriction, normalization of serum thyroid hormone levels in accordance with definite decreases in the serum total iodine level was achieved, accompanied by a significant weight reduction. In conclusion, we found a significantly high prevalence of non-autoimmune primary hypothyroidism in patients with advanced diabetic nephropathy compared to those with non-diabetic chronic renal dysfunction, which may partly relate to earlier development of oedematous status. Clinical and laboratory findings suggest that impaired renal handling of iodine resulting in an elevation of serum iodine levels, rather than autoimmune mechanism or urinary hormone loss, may play a principal role in the development of these conditions, probably through a prolongation of the Wolff-Chaikoff effect. The mechanisms by which this phenomenon develops more frequently in diabetic than in non-diabetic renal dysfunction remain to be elucidated.
    MeSH term(s) Aged ; Antibodies/analysis ; Diabetes Mellitus, Type 2/complications ; Diabetic Nephropathies/complications ; Diabetic Nephropathies/epidemiology ; Diabetic Nephropathies/therapy ; Female ; Goiter/complications ; Goiter/pathology ; Humans ; Hypothyroidism/epidemiology ; Hypothyroidism/etiology ; Hypothyroidism/therapy ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/etiology ; Luminescent Measurements ; Male ; Middle Aged ; Proteinuria/metabolism ; Radionuclide Imaging ; Radiopharmaceuticals ; Sodium Pertechnetate Tc 99m ; Thyroglobulin/analysis ; Thyroid Function Tests ; Thyroid Gland/diagnostic imaging ; Thyroid Gland/immunology ; Thyroid Gland/pathology ; Thyroid Hormones/blood ; Treatment Outcome
    Chemical Substances Antibodies ; Radiopharmaceuticals ; Thyroid Hormones ; Thyroglobulin (9010-34-8) ; Sodium Pertechnetate Tc 99m (A0730CX801)
    Language English
    Publishing date 2002-11
    Publishing country Germany
    Document type Clinical Trial ; Journal Article
    ZDB-ID 1225416-2
    ISSN 1439-3646 ; 0947-7349
    ISSN (online) 1439-3646
    ISSN 0947-7349
    DOI 10.1055/s-2002-36427
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Non-Autoimmune Primary Hypothyroidism in Diabetic and Non-Diabetic Chronic Renal Dysfunction

    Bando, Y. / Ushiogi, Y. / Okafuji, K. / Toya, D. / Tanaka, N. / Miura, S.

    Experimental and Clinical Endocrinology & Diabetes

    2002  Volume 110, Issue 08, Page(s) 408–415

    Abstract: The aim of this study was to investigate the frequency and mechanisms of hypothyroidism observed ... In particular, in patients who showed overt hypothyroidism, further studies including large-needle biopsies ... respectively). The frequency of overt hypothyroidism in the diabetic group (22%; 7/32) was significantly higher ...

    Abstract The aim of this study was to investigate the frequency and mechanisms of hypothyroidism observed in diabetic patients with advanced diabetic nephropathy, including outcomes of management for this condition. A controlled study was designed using 32 diabetic and 31 non-diabetic patients not receiving hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) who excreted mean urinary protein greater than 0.5 g/day examined on three consecutive days during admission to our hospital. Thyroid hormones in both serum and urine, anti-thyroid antibodies, renal function and iodine concentrations in serum were measured during admission in all patients included. In particular, in patients who showed overt hypothyroidism, further studies including large-needle biopsies of the thyroid and iodine-perchlorate discharge tests were performed. All patients in the two groups revealed negative antithyroid antibody titers, and the mean serum total iodine levels did not significantly differ between the two groups. Mean serum FT4 levels significantly decreased, and the TSH level was significantly elevated in the diabetic group compared to those in the non-diabetic group (p < 0.005, p < 0.02, respectively). The frequency of overt hypothyroidism in the diabetic group (22%; 7/32) was significantly higher (p < 0.05) than that in the non-diabetic group (3.2%; 1/31). The daily urinary thyroid hormone excretion in both groups did not show any significant correlation with serum thyroid hormone levels. Seven patients who revealed overt hypothyroidism in the diabetic group showed elevated serum total iodine levels during hypothyroidal status, ranging between 177 and 561 μg/l. Also, the iodine-perchlorate discharge tests carried out in six of these patients all showed a positive discharge. After management based on iodine restriction, normalization of serum thyroid hormone levels in accordance with definite decreases in the serum total iodine level was achieved, accompanied by a significant weight reduction. In conclusion, we found a significantly high prevalence of non-autoimmune primary hypothyroidism in patients with advanced diabetic nephropathy compared to those with non-diabetic chronic renal dysfunction, which may partly relate to earlier development of oedematous status. Clinical and laboratory findings suggest that impaired renal handling of iodine resulting in an elevation of serum iodine levels, rather than autoimmune mechanism or urinary hormone loss, may play a principal role in the development of these conditions, probably through a prolongation of the Wolff-Chaikoff effect. The mechanisms by which this phenomenon develops more frequently in diabetic than in non-diabetic renal dysfunction remain to be elucidated.
    Keywords Hypothyroidism ; Advanced diabetic nephropathy ; Wolff-Chaikoff effect
    Language English
    Publishing date 2002-01-01
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1225416-2
    ISSN 1439-3646 ; 0947-7349
    ISSN (online) 1439-3646
    ISSN 0947-7349
    DOI 10.1055/s-2002-36427
    Database Thieme publisher's database

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