[Effect of erythropoietin on thyroid function in patients on hemodialysis]

Chronical renal insufficiency is followed by many endocrinological abnormalities which pathogenesis isn't still enough clarified. The hormone level of thyroid gland is often abnormal. It is well known that use of erythropoietin leeds to an improvement of the various endocrine disorders. The aim of this paper was to evaluate the erythropoetin impact on the thyroid function in patients on haemodialysis.

This study included patients that were on chronical haemodialysis treatment 4 hours 3 times a week. Acetate or bicarbonate were used as buffers. 32 out of totally 74 patients, received erythropoietin (40-50 IU/kg/HD), and 42 patients did not. FT3, FT4, TSH were taken right before haemodialysis as were albumins, total proteins and hematocrit. FT3 and FT4 were determined by fluorimmunnoassay method, and TSH by immunoradiometric assay (IRMA) method.

Our survey included 74 clinically crithroid patients, 37 males and 37 females, average age 49.3 +/- 12.3 and duration of the haemodialysis 4.34 +/- 2.846. Thyroid Stimulation Hormone (TSH) was high in 10.8% of patients (8/74), FT3 was low in 38% of patients (28/74), and FT4 in 25% of our patients (18/24). The hormone level of the thyroid gland was similar in both groups, so there was no statistically important difference between them. FT3 in group with erythropoietin was 5.21 +/- 0.93, FT4--12.18 +/- 4.84, TSM -2.02 +/- 1.46 mlU/K, while in group without erythropoetin (non-erythropoietin group) references were FT3-4.81 +/- 0.87, FT4-12.49 +/- 1.98 TSH 2.31 +/- 2.08. No significant correlation was found between Hct, albumin, protein and T3, T4 and TSH in group that received erythropoietin, although there was correction of anemia.

Our results imply that patients on haemodialysis usually have asymptomatic abnormalities of thyroid gland. The use of erythropoietin did not improve their hormonal status, although correction of anemia was gained.