Therapeutic Research

Abstract

The patient was a 91−year−old man who had been treated for atrial fibrillation, hypertension etc., at the outpatient clinic of our hospital. BUN and creatinine levels were around 20 mg／dL and 1.0 mg／dL, respectively. Edema was noted in January 2009 and renal function worsened, and the patient was referred to our department with a BUN level of 150.1 mg／dL and a serum creatinine level of 8.78 mg／dL in early April 2009. Urinalysis was negative for protein and occult blood and mild renal atrophy was noted on CT, suggesting progression of chronic renal failure resulting from nephrosclerosis. Dialysis was started and an examination for the cause of the disease progression showed a TSH of 152.6μU／mL,FT3 of 1.08 pg／mL, and FT4 of ＜0.05 ng／dL. In addition, based on anti−Tg−Ab（−）, anti−TPO−Ab of 0.7 U／mL, and ultrasonic findings, the patient was diagnosed with hypothyroidism secondary to chronic thyroiditis. Levothyroxine therapy was started and renal function improved, and the patient withdrew from dialysis in late April. Subsequent renal function has been maintained. The patient is being managed at our outpatient clinic with a BUN level of 40.0 mg／dL and a creatinine level of 1.7 mg／dL.