Toru Sanai1,2,3, Ken Okamura4, Tomoya Kishi5, Motoaki Miyazono5, Yuji Ikeda5, Takanari Kitazono4. 1. The Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-city, Saga, 849-8501, Japan. sunny@fukumitsu-hospital.jp. 2. The Department of Nephrology, Abe Clinic, 2-3-8 Taharashin-machi, Kokuraminami-ku, Kitakyushu-city, Fukuoka, 800-0226, Japan. sunny@fukumitsu-hospital.jp. 3. The Division of Nephrology, Department of Internal Medicine, Fukumitsu Hospital, 4-10-1 Kashiihama, Higashi-ku, Fukuoka-city, Fukuoka, 813-0016, Japan. sunny@fukumitsu-hospital.jp. 4. The Department of Medicine and Clinical Science (The Second Department of Internal Medicine), Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-city, Fukuoka, 812-8582, Japan. 5. The Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-city, Saga, 849-8501, Japan.
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.
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 ESRDpatients. RESULTS: Comparison of thyroid function between 127 ESRDpatients, 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 ESRDpatients, 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.
Authors: N Mansournia; S Riyahi; S Tofangchiha; M A Mansournia; M Riahi; Z Heidari; E Hazrati Journal: J Endocrinol Invest Date: 2016-10-13 Impact factor: 4.256
Authors: N Sforza; J Rosenfarb; R Rujelman; M Rosmarin; E Blanc; C Frigerio; P Fossati; D Caruso; C Faingold; T Meroño; G Brenta Journal: J Endocrinol Invest Date: 2017-05-22 Impact factor: 4.256