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2014, Number S2

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Gac Med Mex 2014; 150 (S2)

Frequency of altered levels of thyroid hormones in patients undergoing peritoneal dialysis

Pámanes GJ, Gamboa OFA, Torres CLF

Language: Spanish
References: 25
Page: 222-227
PDF size: 215.95 Kb.


ABSTRACT

Background: There are concomitant conditions that, by themselves, alter the metabolism of thyroid hormones in chronic kidney disease (CKD), in addition to structural and functional alterations of the thyroid gland. It has been shown that there are various abnormalities in CKD that interfere with peripheral hormonal metabolism. Objectives: To determine the frequency of alteration of thyroid hormones in patients undergoing peritoneal dialysis and to identify if thyroid disease prevails. Methods: Cross-sectional and descriptive study with peritoneal dialysis patients in a secondary hospital. We took into account the patient age, cause of renal disease, peritoneal dialysis modality and time it was received. Also, serum free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), and stimulating hormone thyroid (TSH). Results: We studied 76 patients, 43 being men with a mean age of 58.3 years, and the average time of peritoneal dialysis was 27.2 months, and resulting continuous ambulatory peritoneal dialysis (n = 61) was the main mode. Of the subjects, 96.1% had at least one alteration in thyroid hormone, 27 had subclinical hypothyroidism, and five had primary hypothyroidism. Conclusions: A basic thyroid profile must be used in profile screening of patients undergoing peritoneal dialysis.


REFERENCES

  1. Garrido E, Heyser SE, Aguilar A, et al. Alteraciones de la función tiroidea en niños con insuficiencia renal crónica. Nefrología. 2009;29(5):449-55.

  2. Rao MB, Bay WH, George JM, Hebert LA. Primary hypothyroidism in chronic renal failure. Clin Nephrol. 1986;25(1):11-4.

  3. Wha E, Young J, Tae Y, et al. Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients. Am J Nephrol. 2008;28(6):908-13.

  4. Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005;67(3):1047-52.

  5. Semple CG, Beastall GH, Henderson IS, Thomson JA, Kennedy AC. Thyroid function and continuous ambulatory peritoneal dialysis. Nephron. 1982;32(3):249-52.

  6. Enia G, Panuccio V, Cutrupi S, et al. Subclinical hypothyroidism is linked to micro-inflammation and predicts death in continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant. 2007;22(2):538-44.

  7. Melillo CM, Suescun MO. Niveles de tirotrofina y hormonas tiroideas en el paciente renal crónico en hemodiálisis. Rev Argent Endocrinol Metab. 2010;47:5-17.

  8. Targher G, Chonchol M, Zoppini G, et al. Prevalence of thyroid autoimmunity and subclinical hypothyroidism in persons with chronic kidney disease not requiring chronic dialysis. Clin Chem Lab Med. 2009;47(11);1367-71.

  9. Lin C, Chen TW, Ng YY, Chou YH, Yang WC. Thyroid disfunction and nodular goiter in hemodialysis and peritoneal dialysis patients. Perit Dial Int. 1998;18(5):516-21.

  10. Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F. Low triiodothyronine: a new facet of inflammation in end-stage renal disease. J Am Soc Nephrol. 2005;16(9):2789-95.

  11. Gómez G, Ruiz R. Hipotiroidismo. Med Int Mex. 2010;26(5):462-71.

  12. Wartofsky L, Dickey RA. The evidence for a narrower thyrotopin reference range is compelling. J Clin Endocrinol Metab. 2005;90(9): 5483-8.

  13. Papalia T, Greco R, Lofaro D, Mollica A, Bonofiglio R. Thyroid status and kidney transplantation outcomes. Transplant Proc. 2011;43(4): 1042-4.

  14. Davis FB, Spector DA, Davis PJ, Hirsch BR, Walshe JJ, Yoshida K. Comparison of pituitary thyroid function in patients with endstage renal disease and in age- and sex- matched controls. Kidney Int. 1982;21(2): 362-4.

  15. Pasqualini T, Zantleifer D, Balzaretti M, et al. Evidence of hypothalamic- pituitary thyroid abnormalities in children with end-stage renal disease. J Pediatr. 1991;118(6):873-8.

  16. Düsünsel R, Poyrazoglu HM, Gündüz Z, Kurtoglu S, Kiris A, Günes T. Evidence of central hypothyroidism in children on continuous ambulatory peritoneal dialysis. Adv Perit Dial. 1999;15:262-8.

  17. Van Hoek I, Daminet S. Interactions between thyroid and kidney function in pathological conditions of these organ systems: a review. Gen Comp Endocrinol. 2009;160(3):205-15.

  18. DeGroot LJ. «Non-thyroidal illness syndrome» is functional central hypothyroidism, and if severe, hormone replacement is appropriate in light of present knowledge. J Endocrinol Invest. 2003;26(12):1163-70.

  19. Cuevas-Ramos D, Pérez-Enríquez B. [Subclinical thyroid dysfunction. Diagnostic and therapeutic considerations]. Rev Invest Clin. 2006;58(6):608-16.

  20. Yanes M, Rodríguez L, Cruz J, Turcios S, Yanes MA. Hipotiroidismo subclínico, ni tan asintomático, ni tan inofensivo. Revista Cuba de Endocrinología. 2009;20(2):51-7.

  21. Jácome A. Hipotiroidismo subclínico: ¿cuándo tratar? Revista Medicina. 2007;29(79):240-53.

  22. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-99.

  23. Rammana M, Martínez JD, Martínez MA, et al. Hypothyroidism and Renal Function in Patients with Systolic Heart Failure. Tex Heart Inst J. 2010; 37(1):66-9.

  24. Silva GC, Carneiro JB, Tardelli CC, Risso M, Ventura M. Kidney failure in the elderly due to hypothyroidism: a case report. Sao Paulo Med J. 2008;126(5):291-3.

  25. Castellano M, Truconi A, Chaler E, Maceiras M, Rivarola MA, Belgorosky A. Thyroid function and serum thyroid binding proteins in prepubertal and pubertal children with chronic renal insufficiency receiving conservative treatment, undergoing hemodialysis, or receiving care after renal transplantation. J Pediatr. 1996;128(6):784-90.




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