The association between peripheral sensitivity of thyroid hormones and contrast-induced acute kidney injury: a retrospective study on euthyroid patients underwent coronary angiography

Abstract Purpose: Peripheral sensitivity of thyroid hormones (PSTH) plays a vital role in many renal diseases, but the relationship between PSTH and contrast-induced acute kidney injury (CI-AKI) is still not clear. Our study aimed to identify the association between PSTH and CI-AKI in euthyroid patients with stable coronary heart disease (SCAD) underwent coronary angiography (CAG). Methods: This is a retrospective cross-sectional study which enrolled 2482 euthyroid patients with SCAD underwent CAG. CI-AKI was defined by serum creatinine (Scr) elevation. The indicator of PSTH was serum free triiodothyronine / free thyroxine (FT3/FT4) ratio. Multivariable logistic regression analysis was performed with confounders being adjusted, while receiver operator characteristic (ROC) analysis was performed with area under ROC curve (AUC) being calculated. Besides, subgroup analysis was also conducted. Results: Overall, 297 (12.0%) patients were diagnosed with CI-AKI. Patients with CI-AKI had lower FT3/FT4 (2.34±0.46 vs. 2.54±0.48, P<0.001). Higher FT3/FT4 was proven to be negatively associated with the incidence of CI-AKI (adjusted OR [95%CI] = 0.573 [0.421 to 0.779], P < 0.001). A similar negative association was also observed for FT3 (adjusted OR [95%CI] = 0.524 [0.367 to 0.748], P < 0.001), but not for FT4. Furthermore, we found FT3/FT4 performed well in predicting the incidence of CI-AKI (AUC: 0.613). These findings between FT3/FT4 and CI-AKI were consistent across subgroups. Conclusion: PSTH was negatively associated with the incidence of CI-AKI in euthyroid patients with SCAD who underwent CAG.