Importance of specific reference values for evaluation of the deteriorating thyroid function in patients with end-stage renal disease on hemodialysis.
J Endocrinol Invest
; 38(1): 47-56, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-24996935
ABSTRACT
BACKGROUND/AIM:
We evaluated the thyroid function in end-stage renal disease (ESRD) on maintenance hemodialysis. MATERIAL/METHODS:
Thyroid function and clinical hypothyroid score were evaluated in 145 ESRD patients.RESULTS:
Comparison of thyroid function between 127 ESRD patients, excluding 18 patients with suppressed or elevated serum TSH level, and age/sex-matched healthy controls (76 in midlife group aged under 65 and 51 in late-life group aged 65 or over) using a multivariate logistic regression analysis suggested significant difference (P < 0.0001), mainly in serum fT4 level (P = 0.0099) and age (P = 0.0492), but not in serum fT3 (not significant; ns), TSH (ns) level or fT3/fT4 ratio (ns). Serum fT3 level and fT3/fT4 ratio were significantly lower (P < 0.001) in late-life group only in ESRD. Reference values calculated for midlife ESRD patients, such as 0.6-1.3 ng/dl for fT4 compared with 0.8-1.7 ng/dl for healthy control, were helpful for the diagnosis of mild but definite hyperthyroidism in whom serum fT4 level was 1.5 ng/dl. The prevalence of primary thyroid dysfunction, compared with the values for ESRD, was 0.7 % for hyperthyroidism, 1.4 % for overt hypothyroidism and 10.3 % for subclinical hypothyroidism. Hypothyroid score was high among those with ESRD independent of thyroid dysfunction.CONCLUSIONS:
Serum fT4 level was markedly lower without a change in fT3/fT4 ratio in ESRD. This may suggest typical carbohydrate-sufficient non-thyroidal illness. The specific reference values for ESRD were useful to evaluate borderline thyroid dysfunction and to evaluate the prevalence of the patients with primary thyroid dysfunction in ESRD.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Testes de Função Tireóidea
/
Glândula Tireoide
/
Diálise Renal
/
Falência Renal Crônica
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Japão