Features of the thyroid status in patients receiving programmed hemodialysis

Abstract

INTRODUCTION. In patients with CKD stage 5 receiving hemodialysis as the main method of renal replacement therapy (RRT), the endocrine system organs, including the thyroid gland, are affected over time. The study of changes in the thyroid status is an urgent task. AIM OF STUDY. Study of functional and gender characteristics of the thyroid status, depending on the duration of patients stay on hemodialysis. PATIENTS AND METHODS. The thyroid status was measured in 108 patients (44 women and 64 men, average age 51.7±15.4 years) undergoing hemodialysis. Patients were divided into quartiles according to the duration of stay on the RRT: group 1 4 – 25 months (28 people), group 2 41 – 59 months (26 people), group 3 68 – 97 months (26 people) and the fourth more than 100 months (28 people). We performed correlation analysis and comparison between groups on the level of free T 4, TSH, the ratio of fT4 to TSH. RESULTS. The average value of fT4 was 11.95±2.07 pmol / ml and TSH 1.5± 0.94 mcME/ml. Significant differences in thyroid status were obtained between the first and second groups in terms of TSH level and ratio fT 4 to TSH (P<0.01) – the level of TSH in the second group is higher (0.74 to 2.1 mсME/ml) and the ratio of fT4 to TSH is lower (13.09 to 4.91). In total, thyroid dysfunction was detected in 20.3% of the examined patients. CONCLUSION. Thus, deviations in the thyroid status occur after 2 years of being on RRT by hemodialysis. In patients who have been on RRT for more than 5 years, the thyroid status stabilizes. The reasons for this phenomenon are completely incomprehensible.