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Pituitary-thyroid function in chronic renal failure assessed by a highly sensitive thyrotropin assay
M J Hardy1, S S Ragbeer, L Nascimento
1Department of Laboratory Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
The Journal of Clinical Endocrinology and Metabolism
|January 1, 1988
Summary
Patients with chronic renal failure on hemodialysis show impaired pituitary-thyroid function. Thyroid hormone levels are low, suggesting altered feedback mechanisms beneficial in severe illness.
Area of Science:
- Endocrinology
- Nephrology
Background:
- Chronic renal failure (CRF) impacts multiple endocrine systems.
- Hemodialysis is a common treatment for CRF, but its systemic effects require further investigation.
Purpose of the Study:
- To assess pituitary-thyroid function in patients with CRF undergoing maintenance hemodialysis.
- To compare thyroid hormone levels and TSH response between dialysis patients and healthy controls.
Main Methods:
- Serum levels of total T3, free T3, total T4, free T4, and TSH were measured.
- 40 CRF patients on hemodialysis and 35 normal subjects were included in the study.
Main Results:
- Dialysis patients exhibited significantly lower serum thyroid hormone levels compared to controls (P < 0.001).
- A high proportion of dialysis patients had thyroid hormone levels in the hypothyroid range.
- Serum TSH levels were higher in dialysis patients (P < 0.01) but mostly within normal limits, with no significant correlation to thyroid hormones.
Conclusions:
- Results suggest impaired thyroidal response to TSH and blunted pituitary response to low thyroid hormones in CRF patients.
- The findings imply a reset feedback mechanism, potentially adapting to severe nonthyroidal illness.