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[Decrease in triiodothyronine and its reverse form under the effect of extrarenal dialysis. Role of carbohydrate

M F Verger, C Verger, D Mercier-Hatt

    Presse Medicale (Paris, France : 1983)
    |June 23, 1984
    PubMed
    Summary

    Patients undergoing hemodialysis show decreased thyroid hormone levels (T3 and rT3), unlike those on peritoneal dialysis. This suggests dialysis-related thyroid dysfunction stems from dietary imbalances, not just kidney failure or malnutrition.

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    Area of Science:

    • Nephrology
    • Endocrinology
    • Metabolic Research

    Background:

    • Renal failure and malnutrition are known to affect thyroid hormone levels.
    • Previous studies indicate alterations in thyroid function in patients with systemic diseases.
    • The specific impact of different dialysis modalities on thyroid hormones requires further elucidation.

    Purpose of the Study:

    • To compare thyroid hormone levels in patients on continuous ambulatory peritoneal dialysis (CAPD) versus hemodialysis (HD).
    • To investigate the potential causes of thyroid abnormalities in dialysis patients.
    • To determine if renal failure, malnutrition, or dietary composition is the primary driver of observed thyroid changes.

    Main Methods:

    • Thyroid hormone levels (T3 and reverse T3) were measured in 12 stable CAPD patients and 18 stable HD patients.

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  • Patient groups were compared to each other and to healthy controls (implied).
  • Clinical status and nutritional parameters were considered.

    • Main Results:

    • Patients on CAPD exhibited normal thyroid hormone levels, comparable to controls.
    • Patients on HD showed a significant decrease in triiodothyronine (T3) and reverse triiodothyronine (rT3) levels.
    • These findings contrast with the typical hormonal profiles seen in malnutrition and systemic diseases.

    Conclusions:

    • Thyroid abnormalities in dialysis patients are not solely due to renal failure or malnutrition.
    • The observed differences between CAPD and HD patients suggest a link to the specific dietary composition.
    • A disturbance in the calorie/carbohydrate ratio of ingested food is implicated as the cause of thyroid dysfunction in hemodialysis patients.