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Thyroid hormone concentrations in dialysate during hemodialysis in children

W Waters, M Bulla, U Buschsieweke

    Nuklearmedizin. Nuclear Medicine
    |December 1, 1981
    PubMed

    Insights

    Thyroxine (T4) levels slightly increase during hemodialysis in children. Hormone loss into dialysate is minimal and does not explain lower serum thyroid hormone concentrations in these patients.

    Area of Science:

    • Pediatric Nephrology
    • Endocrinology
    • Clinical Chemistry

    Background:

    • Hemodialysis is a life-sustaining treatment for children with kidney failure.
    • Thyroid hormone levels can be altered in patients undergoing chronic dialysis.
    • Understanding hormone kinetics during hemodialysis is crucial for patient management.

    Purpose of the Study:

    • To quantify the loss of thyroxine (T4) and triiodothyronine (T3) into the dialysate during hemodialysis in pediatric patients.
    • To determine if hormone loss during hemodialysis accounts for observed changes in serum thyroid hormone concentrations.

    Main Methods:

    • Modified radioimmunoassay was used to measure T4 concentrations in dialysate from 15 children undergoing hemodialysis.
    • T4 and T3 concentrations were monitored throughout the dialysis procedure.
    • Calculated hormone loss into the dialysate.

    Main Results:

    • A slight increase in T4 concentration was observed in the dialysate during hemodialysis.
    • T4 concentration at the end of dialysis was approximately 50% higher than at the start.
    • The estimated daily loss of T4 was 19.2 micrograms, and T3 loss was less than 75 ng, comparable to normal urinary excretion.

    Conclusions:

    • The loss of thyroid hormones (T4 and T3) into the dialysate during hemodialysis is minimal.
    • This hormone loss does not explain the reduced serum thyroid hormone concentrations observed in children undergoing hemodialysis.
    • Further investigation is needed to elucidate the mechanisms behind altered thyroid hormone levels in pediatric hemodialysis patients.

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