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Special Issue: Current evidence and perspectives for hypertension management in Asia

A high level of thyroid-stimulating hormone is a risk factor for the development of chronic kidney disease in men: a 10-year cohort study

Hypertension Research volume 47, pages 663–671 (2024)Cite this article

Abstract

Hypothyroidism has been reported to be associated with chronic kidney disease (CKD). However, the impact of thyroid-stimulating hormone (TSH) on new onset of CKD and its gender dependence remain undetermined. We investigated the association of serum TSH level and the development of CKD defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or positive for urine protein in 28,990 Japanese subjects who received annual health examinations. After excluding subjects with no data for serum TSH, urinalysis and eGFR and those with CKD at baseline, a total of 10,392 subjects (men/women: 6802/3590, mean age: 48 years) were recruited. During a 10-year follow-up, 1185 men (6.7%) and 578 women (2.9%) newly developed CKD. Multivariable Cox proportional hazard models after adjustment of age, body mass index, smoking habit, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease and eGFR (≥ 90 mL/min/1.73 m2) showed that the hazard ratio (HR) for the development of CKD in the high TSH (> 4.2 mU/L) group was significantly higher than that in the low TSH (≤ 4.2 mU/L) group in men (HR [95% confidence interval]: 1.41 [1.09–1.83]) but not in women (1.08 [0.77–1.51]). There was a significant interaction between sex and the category of TSH level for the development of CKD (p = 0.02). The adjusted HR with a restricted cubic spline increased with a higher level of TSH in men but not in women. In conclusion, a high level of TSH is associated with an increased risk for the development of CKD in men but not in women.

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Acknowledgements

The authors are grateful to Keita Numata and Takashi Hisasue for data management and Tomoyuki Tanaka for provision for information of measurement system for TSH.

Funding

M.T and M.F were supported by JSPS KAKENHI (22K08313, 23K07993).

Author information

Author notes

  1. These authors contributed equally: Keisuke Endo, Marenao Tanaka.

Authors and Affiliations

  1. Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

    Keisuke Endo, Marenao Tanaka, Tatsuya Sato, Hirofumi Ohnishi & Masato Furuhashi

  2. Tanaka Medical Clinic, Yoichi, Japan

    Marenao Tanaka

  3. Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan

    Tatsuya Sato

  4. Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan

    Kazuma Mori

  5. Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan

    Itaru Hosaka & Takuma Mikami

  6. Department of Ophthalmology, School of Medicine, Sapporo Medical University, Sapporo, Japan

    Araya Umetsu

  7. Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan

    Yukinori Akiyama

  8. Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan

    Hirofumi Ohnishi

  9. Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan

    Nagisa Hanawa

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Contributions

KE, MT and MF designed the study, performed data collection and statistical analyses, and wrote the paper. TS, KM, IH, TM, AU and NH performed data collection. YA and HO performed the statistical analyses. All authors approved the final version of the manuscript.

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Correspondence to Masato Furuhashi.

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Endo, K., Tanaka, M., Sato, T. et al. A high level of thyroid-stimulating hormone is a risk factor for the development of chronic kidney disease in men: a 10-year cohort study. Hypertens Res 47, 663–671 (2024). https://doi.org/10.1038/s41440-023-01453-1

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