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Thyroid function in long term haemofiltration.

H Schneider, E Streicher

    Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
    |January 1, 1978
    PubMed
    Summary
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    Hemofiltration treatment can lower thyroid hormone levels (T3 and T4) over time. However, patients generally remain euthyroid, showing no signs of hypothyroidism during long-term therapy.

    Area of Science:

    • Nephrology
    • Endocrinology
    • Internal Medicine

    Background:

    • Hemofiltration is a renal replacement therapy.
    • Thyroid function can be affected by chronic illness and treatments.

    Purpose of the Study:

    • To assess thyroid function in patients undergoing long-term hemofiltration.
    • To investigate the impact of hemofiltration on thyroid hormone levels and thyroid status.

    Main Methods:

    • Screening of thyroid function in ten patients on hemofiltration.
    • Comparison of serum T3, T4, TSH, and TBG levels before and during hemofiltration.
    • Evaluation of TSH response to TRH stimulation.

    Main Results:

    • A continuous decrease in serum T3 and T4 levels was observed during long-term hemofiltration.

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  • Serum TSH levels also declined, with some individual variations.
  • Thyroid hormone levels increased during a single treatment, but the T4/TBG ratio remained normal, indicating peripheral euthyroidism.
  • TSH levels decreased significantly after 5 hours of hemofiltration, possibly due to losses.
  • Normal TSH response to TRH stimulation was noted.

    • Conclusions:

    • Chronic hemofiltration leads to a proportional decline in thyroid hormones and their binding proteins.
    • Patients on long-term hemofiltration maintain a euthyroid state, evidenced by normal T4/TBG ratios and absence of clinical hypothyroidism.
    • Hemofiltration may cause TSH losses, but the hypothalamic-pituitary-thyroid axis remains responsive.