Abstract:
Objective To explore the association between FT3/FT4 ratio and renal function in chronic kidney disease (CKD) patients with crescent formation and its prognostic value.
Methods Clinical data of 119 CKD patients with crescent formation confirmed by kidney biopsy in the Department of Nephrology, Zhongshan Hospital, Fudan University from March 2012 to May 2014 were retrospectively analyzed. The differences in clinical characteristics and laboratory tests were compared between the two groups. Cox regression analysis was used to analyze the risk factors of the composite endpoint of a 50% decrease in estimated glomerular filtration rate (eGFR) plus the initiation of renal replacement therapy or death.
Results There were significant differences in gender, age, proportion with hypertension, urine albumin-creatinine ratio, 24-hour urine protein, eGFR, serum albumin, thyroid function, renal pathology, and medicine treatments between the two groups (P < 0.05). The multivariate Cox regression showed that hypertension and elevated cTnT were independent risk factors for the composite endpoint (P < 0.05). Compared to patients in the high-level FT3/FT4 ratio group, composite endpoint risk of patients in the low-level group was higher (P < 0.01). After adjusting for the effect of pathological type, degree of renal tubular lesion or eGFR level, the risk of composite endpoint was still higher in patients with low FT3/FT4 ratio (P < 0.05).
Conclusion The FT3/FT4 ratio is probably a new prognostic factor for CKD patients with crescent formation, which may play an important role in the formulation and adjustment of treatment plans.