Función tiroidea en pacientes pediátricos con enfermedad renal crónica

Abstract

Thyroid Function in Pediatric Patients with Chronic Renal Failure Objective: To characterize the thyroid function in mild (L), moderate (M), hemodialysis (HD), peritoneal dialysis (PD), chronic renal failure (CRF) and post kidney transplant (TX). Method: 46 children between 9.3 ± 3.7 years-old with CRF (10 mild (L), 10 moderate (M), 10 peritoneodialysis (PD), 6 hemodialysis (HD), 10 transplants (TX)) were evaluated. Basal total T4 and free T3, TRH test (TSH at 0-30-60 min), creatinine, BUN, creatinine clearance and anthropometric parameters were measured. The statistics analysis included Anova Test to compare group results and correlation coefficients for studied variables. Results: Basal thyroid hormone levels were normal in all groups and no differences between groups (except higher TSH in L (p < 0.01)) were found. TRH test response was prolonged on L, M, PD and HD and deficient in TX, except 3 TX patients who had normal TRH response, all using Tacrolimus, Micofenolate and Prednisone on alternate day treatment versus the remaining TX who where on Cyclosporine or Azathioprine, Micofenolate and continuous corticoid regimen. Prolonged TRH response correlates with creatinine (p < 0.001) and creatinine clearance (p < 0,01). Conclusions: Basal thyroid hormones were normal in all groups. TRH test response was predominantly prolonged in L, M, PD and HD, suggesting adaptative phenomena at tertiary level, and correlates with renal function. TX patients had deficient TRH response, suggesting hypofisial dysfunction.