Abstract

MELILLO, C.M.  and  SUESCUN, M.O.. Thyrotropin and thyroid hormone levels in chronic renal patients under hemodyalisis. Rev. argent. endocrinol. metab. [online]. 2010, vol.47, n.3, pp.5-17. ISSN 1851-3034.

Severe illness induces various hormonal changes in the hypothalamic-pituitary-thyroid axis. Chronic renal failure is a serious condition showing a high mortality index. The aim of this work was to evaluate thyroid hormone level in chronic renal patients under hemodialysis in order to estimate its potential use as morbidity / mortality indicator. We studied chronic renal patients from Nephrology and Hemodialysis Units of our Hospital and compared them with a control group (CT) without renal or thyroid pathology. We evaluated patients before (pre-dialysis) and after dialysis (post-dialysis) during one year. We then classified patients according to the duration of their hemodialysis treatment. We assessed Thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4) and free thyroxine (T4L) levels and other biochemical indicators: urea, creatinine, albumin, and total protein. Pre-dialysis samples showed higher TSH levels (p<0.05), a significant decrease in T3, and a lower decrease in T4 and T4L than CT. During the dialysis procedure, we observed a fluctuation in thyroid hormone levels (p<0.05), higher in post-dialysis samples, and no changes in TSH levels. The one- year follow- up showed a low decrease in T3 levels in pre- and post-dialysis samples. An increase in TSH levels and a decrease in T3 levels (p<0.05) was observed in patients after long hemodialysis treatment. Renal patients showed a direct correlation between TSH and urea and inverse correlation between TSH and albumin. However, an inverse correlation between T3 and urea and a direct correlation between T3 and albumin was observed. This study shows that thyroid-hormonal changes are induced by pathology and dialysis treatment. We suggest T3 measurement as a useful morbidity indicator for chronic renal patients.

Keywords : Thyroid hormone; Thyrotropin; Chronic renal failure; Hemodialysis.

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