Evaluation of Thyroid function Status in Hemodialysis Patients
Kerbala Journal of Medicine,
2009, Volume 2, Issue 5, Pages 716-724
Abstractbackground The interactions between kidney and thyroid functions are known
for years. Thyroid hormones (TH) are necessary for growth and development
of the kidney and for the maintenance of water and electrolytes homeostasis.
On the other hand, kidney is involved in the metabolism and elimination of TH.
Chronic renal failure (CRF) affects thyroid function in many ways, including low
circulating thyroid hormone levels, altered peripheral hormone metabolism,
insufficient binding to carrier proteins, possible reduction in tissue hormone content
and altered iodide storage in the thyroid gland. Thus, patients with renal failure may
have various abnormalities of thyroid function; nevertheless, they are typically
Objectives: the aim of the present study is to evaluate thyroid function status in
patients with hemodialysis in Karbala province, and to determine the benefit of
thyroid function test as a routine test requested in hemodialysed patients.
Methods: Forty-two hemodialysed patients who attend hemodialysis unit in
Al_Hussien teaching hospital in Karbala province with mean age of (44.4±15.9),
another 32 apparently healthy subjects with mean age (41.4±12.5) took part in the
current study as a control group. An early morning fasting sample of venous blood
from each, total trioiodothyronine (TT3), total thyroxine (TT4) and thyroid
stimulating hormone TSH were estimated by Enzyme Linked ImmuoSorbent Assay(
Result: The (TT3) level in haemodialysed patients was significantly lower than the
level TT3 in control group (P< 0.001).T-student test reveals no significant difference
in the total thyroxine (TT4) level between haemodialysed patients and control group.
Also There was no significant difference in the mean level of TSH between
hemodialysis and control group. About 41% of haemodialysed patients have TT3
level in the lower tertile of the reference range another 26% have TT3 level below the
reference value. There was no correlation between TT3 level in hemodialysis group
and duration of hemodialysis (in months).
Conclusion: Abnormalities in thyroid function test in hemodialysis patient are more
common than that in general population, and low T3 syndrome is considered the main
disorder that affect the thyroid function test in hemodialysis patients. So this disorder
should be investigated in those patients routinely as, its presence in hemodialysis
patients indicates a bad prognosis for them
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