Thyroid Hormone Metabolism in Renal Diseases1

Functional and Morphological Thyroid Disorders in Hemodialysis Patients

“…Thyroid hormones (TH) are essential for the development and growth of kidney, water and electrolyte homeostasis and maintenance of renal blood flow. While, kidney is included in thyroid hormones metabolism and elimination [1,2].…”

Diagnosis of Hypothyroidism in Patients with End-Stage Renal Disease

“…Low serum TT4 (41 %) and FT4I (21 %) values are common in euthyroid patients with uremia [1]. These alterations in the uremic patient may be related to the state of malnutrition [2].…”

“…In addition, in patients with diabetes mellitus, there is an increased frequency of elevated antimicrosomal antibody titers (17%) [20] as well as of hypothyroidism (3%) [21,22], It is of interest to note that all of the 6 hypothyroid patients studied were female; 3 had elevated antimicrosomal antibody liters, 3 had diabetes mellitus and 2 had thyromegaly. Uremic patients also have been reported to have an increased prevalence of both goiter (up to 58%) [1] and hypothyroidism (6-10%) [2][3][4], Thus, it would appear that female patients with uremia and diabetes mellitus are at higher risk to develop hypothyroidism.…”

“…Our results indicate that the diagnosis of hypothyroidism in uremic patients cannot be made by clinical or routine laboratory values and rests on the presence of an overtly elevated serum TSH concentration. Thus, routine measurement of serum TSH levels may be warranted in all patients with ESRD who have reduced total T4 or free T4 index values to insure accurate diagnosis and allow institution of specific therapy.The prevalence of thyroid dysfunction as evidenced by the presence of goiter [1,2] or primary hypothyroid ism [2][3][4] is increased in patients with end-stage renal disease (ESRD). Since hypothyroidism may contribute to the morbidity of patients with ESRD, it is essential to diagnose and manage this entity in these patients.…”

“…In addition, a signifi cant number of patients with ESRD have reduced serum levels of total thyroxine (TT4), free T4 index (FT41) and triiodothyronine (Tj) with normal or only slightly ele vated thyrotrophin (TSH) levels, in the absence of hypo thyroidism [1,7], Thus, the diagnosis of hypothyroidism in patients with ESRD may pose a clinical problem.…”