SummaryBackground and objectives End-stage renal disease is linked to alterations in thyroid hormone levels and/or metabolism, resulting in a high prevalence of subclinical hypothyroidism and low triiodothyronine (T3) levels. These alterations are involved in endothelial damage, cardiac abnormalities, and inflammation, but the exact mechanisms are unclear. In this study, we investigated the relationship between serum free-T3 (fT3) and carotid artery atherosclerosis, arterial stiffness, and vascular calcification in prevalent patients on conventional hemodialysis.Design, setting, participants, & measurements 137 patients were included. Thyroid-hormone levels were determined by chemiluminescent immunoassay, carotid artery-intima media thickness (CA-IMT) by Doppler ultrasonography, carotid-femoral pulse wave velocity (c-f PWV), and augmentation index by Sphygmocor device, and coronary artery calcification (CAC) scores by multi-slice computerized tomography.Results Mean fT3 level was 3.70 Ϯ 1.23 pmol/L. Across decreasing fT3 tertiles, c-f PWV and CA-IMT values were incrementally higher, whereas CACs were not different. In adjusted ordinal logistic regression analysis, fT3 level (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97), age, and interdialytic weight gain were significantly associated with CA-IMT. fT3 level was associated with c-f PWV in nondiabetics but not in diabetics. In nondiabetics (n ϭ 113), c-f PWV was positively associated with age and systolic BP but negatively with fT3 levels (odds ratio ϭ 0.57, 95% confidence interval 0.39 to 0.83).Conclusions fT3 levels are inversely associated with carotid atherosclerosis but not with CAC in hemodialysis patients. Also, fT3 levels are inversely associated with surrogates of arterial stiffness in nondiabetics.

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The most convenient surgical procedure for benign thyroid diseases is still controversial. The aim of this study is to determine the recurrence rate and risk factors for recurrence after different thyroidectomy procedures in multinodular goiter patients. Patients were separated into two groups according to the detection of a recurrent nodule or not after thyroidectomy. Of the 748 patients, 216 (29%) had recurrence, while 532 had no recurrent nodule. The difference between surgical procedures described as subtotal (ST), near total (NT) and total thyroidectomy (TT) was statistically significant. Transient hypoparathyroidism was significantly higher in NT and TT, when compared to ST patients (P < 0.05). Young age, bilateral multinodular goiter and insufficient surgery are risk factors affecting recurrence for benign nodular thyroid disease. Currently, subtotal procedures should be discontinued and total or near total procedures should be preferred. Meanwhile, the probability of a higher risk of hypoparathyroidism should be kept in mind.