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Effects of chronic peritoneal dialysis on thyroid function tests.

C Robey¹, K Shreedhar, V Batuman

¹Endocrinology Section, East Orange Veterans Administration Medical Center, NJ 07019.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation

|February 1, 1989

Summary

Peritoneal dialysis causes significant protein and thyroid hormone losses, potentially leading to hypothyroidism. Long-term thyroid function monitoring is crucial for patients undergoing continuous ambulatory peritoneal dialysis (CAPD).

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Area of Science:

Nephrology
Endocrinology
Biochemistry

Background:

Peritoneal dialysis (PD) is linked to substantial protein loss.
The impact of PD on thyroid hormone levels and the risk of hypothyroidism require investigation.

Purpose of the Study:

To quantify thyroid hormone (T4 and T3) excretion in peritoneal dialysate.
To assess the risk of clinical hypothyroidism in patients undergoing PD.

Main Methods:

Studied nine end-stage renal disease (ESRD) patients on continuous ambulatory peritoneal dialysis (CAPD) or chronic intermittent peritoneal dialysis (IPD).
Measured total protein, thyroid binding globulin (TBG), total T4, total T3, and thyroid stimulating hormone (TSH) in peritoneal fluid and serum.

Main Results:

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High protein (21.5 g/24h) and TBG (6.4 mg/24h) losses were observed in peritoneal fluid.
Peritoneal T4 and T3 losses were modest and correlated with protein and TBG losses.
Three of nine patients showed mildly elevated TSH, suggesting early thyroid failure.

Conclusions:

Significant protein and TBG losses during PD do not immediately cause overt hypothyroidism.
PD patients may be predisposed to thyroid failure due to protein losses.
Long-term thyroid function monitoring is recommended for PD patients.