Renal damage in hyperthyroidism

　　The renal damage caused by hyperthyroidism is caused by hyperthyroidism (abbreviated as hyperthyroidism). Hyperthyroidism is an endocrine disease caused by the increase of thyroid hormone in the blood circulation due to various reasons and its action on the whole body tissues and organs. The pathophysiological effects of excessive thyroid hormone secretion are multifaceted, and the mechanism of action has not been fully elucidated. The main effects on the kidneys include:

　　1. Increase in glomerular filtration rate and tubular reabsorption rate and excretion capacity
　　Thyroid hormones excite the sympathetic nervous system of the myocardium, and the effect of catecholamines is enhanced. Thyroid hormones have a direct effect on the myocardium, promoting protein synthesis, increasing the activity of Na+-K+-ATPase in the myocardium, increasing the activity of Ca2-ATPase in the sarcoplasmic reticulum, increasing the activity of myosin ATPase, thereby increasing myocardial contraction and increasing the cardiac output. At rest, heart rate accelerates, peripheral vascular resistance decreases, and arterial blood pressure increases, manifesting a typical hyperdynamic circulation. At this time, the effect on the kidneys is the increase in renal plasma flow, glomerular filtration rate, and tubular reabsorption rate and excretion capacity.

　　2. Impaired urine concentration function
　　Due to increased renal medullary blood flow in hyperthyroidism, the concentration of solutes in the medulla decreases, leading to decreased osmotic pressure and impaired urine concentration function. During hyperthyroidism, serum osmolality is higher than normal, and there is also hypercalcemia and hypercalciuria. The prominent manifestations are polydipsia, polyuria, and significant thirst. Due to increased body heat production, increased intake of food and water, and dysfunction of the gastrointestinal tract, water excretion may also be affected. During hyperthyroidism, serum sodium and potassium are normal, and aldosterone secretion is also normal.

　　3. Calcium and phosphorus metabolism disorder
　　Thyroid hormones can stimulate osteoclasts and osteoblasts, leading to bone demineralization, increased excretion of calcium and phosphorus in urine, and blood calcium concentration is generally normal or slightly high. In addition, the cause of increased blood calcium may also be related to factors such as accelerated bone metastasis, lack of calcitonin, and increased activity of vitamin D. During hyperthyroidism, it promotes the production of highly active vitamin D3 metabolites, which can stimulate gastrointestinal absorption of calcium, reduce reabsorption of calcium and phosphates in renal tubules, and promote increased excretion of phosphorus in urine. Due to the acceleration of bone resorption and formation, mainly with increased resorption, and the obvious disturbance of calcium and phosphorus metabolism, hyperthyroid patients may develop osteoporosis.

　　4. Renal tubular acidosis
　　During hyperthyroidism, it may be complicated with distal renal tubular acidosis, which may be related to the effect of calcium salt deposition on renal tubular function. In addition, due to the autoimmune disorder during hyperthyroidism, both thyroid and renal tubular lesions may occur simultaneously.

　　Renal damage in hyperthyroidism (hyperthyroidism) is a series of changes in the kidneys caused by increased levels of thyroid hormones in the blood circulation. The main clinical complications related to renal damage in hyperthyroidism include renal tubular acidosis, and there are individual reports of nephrotic syndrome.

　　The renal damage in hyperthyroidism primarily presents with the clinical manifestations of hyperthyroidism itself, such as heat intolerance, sweating, polyphagia, weight loss, palpitations, etc. Clinical manifestations of kidney damage: patients may experience polydipsia, polyuria, and mild proteinuria, which may be related to increased renal blood flow. When renal insufficiency occurs, there may be corresponding clinical manifestations. A few patients may have renal tubular acidosis.

　　To prevent renal damage in hyperthyroidism, it is necessary to prevent the occurrence of hyperthyroidism. In recent years, the incidence of hyperthyroidism has increased, and preventing the occurrence and progression of hyperthyroidism can effectively control the occurrence of renal damage. The main preventive methods are as follows:
　　1. Coastal areas should pay attention to iodine content in food, and it is recommended to avoid high-iodine diets to prevent hyperthyroidism.
　　2. In inland areas, especially in iodine-deficient areas, iodine supplementation should be limited, and the intake of thyroid tablets should also be limited in terms of time.
　　3. Regularly check thyroid B-ultrasound or thyroid function to detect hyperthyroid patients early.
　

　　The diagnosis of renal damage in hyperthyroidism not only relies on clinical manifestations but also requires auxiliary examination methods, which are indispensable. Common examinations include the following:
　　1. Serum thyroid hormone test.
　　1. Serum thyroid hormone test.
　　2. Thyroid ultrasound examination.

　　In addition to conventional treatment for kidney damage caused by hyperthyroidism (hyperthyroidism), dietary adjustments are also needed. Common dietary requirements are as follows:

　　1. Increase calories, supplement protein
　　Patients with hyperthyroidism should pay attention to dietary supplementation. Hyperthyroidism causes excessive secretion of thyroid hormones, promoting the metabolism of three major nutrients such as sugar, fat, and protein, and accelerating oxidation. However, it should be avoided to eat greasy fatty foods, as patients with kidney disease should use light diet, which has a protective effect on delaying kidney damage.

　　2. Supplement vitamins
　　Patients with hyperthyroidism are very prone to deficiencies of vitamins and minerals. In addition to hyperthyroidism itself and the use of antithyroid drugs in the treatment of hyperthyroidism, it also causes leukopenia, so it is also necessary to increase vitamins and minerals. Therefore, patients with hyperthyroidism should eat more foods rich in vitamins and minerals, such as fresh vegetables and fruits, nuts.

　　3. Control fiber
　　Patients with hyperthyroidism often have diarrhea. If too much fiber-rich food is provided, it may worsen diarrhea, so appropriate control of fiber-rich foods should be maintained.

　　4. Limit high-potassium foods
　　When oliguria, anuria, or increased blood potassium levels occur, vegetables and fruits rich in potassium, such as soybean sprouts, chive, and green garlic, should be limited.

　　5. Avoid eating iodine-rich foods
　　In commonly consumed food, seaweed, purple seaweed, sea cabbage, sea fish, shrimp, crabs, and shellfish are rich in iodine.

　　The treatment for kidney damage caused by hyperthyroidism should mainly target the treatment of hyperthyroidism. If there are obvious symptoms or kidney damage caused by hypercalcemia, efforts should be made to reduce blood calcium levels and actively treat the symptoms.
　　The main purpose of the treatment for hyperthyroidism (hyperthyroidism) is to reduce the concentration of thyroid hormones in the blood and re-establish a normal metabolic state of the body. Currently, the basic methods for controlling hyperthyroidism include the use of antithyroid drugs and adjuvant drug therapy, radioactive iodine (131I) therapy, and surgical treatment. The three treatment plans have their respective advantages and disadvantages, and careful consideration must be given to various factors such as the patient's age, gender, condition, and complications before choosing.