Prevalence of Clinical and Subclinical Thyroid Disease in a Peritoneal Dialysis Population

Author:

Ng Yee Yung1,Wu Shiao Chi2,Lin Hong Da3,Hu Fen Hsiang4,Hou Chun Cheng5,Chou Yea Yun1,Chiu Shih Min1,Sun Ya Hui1,Cho Sandy Shan-Ying1,Yang Wu Chang1

Affiliation:

1. Division of Nephrology, Division of Nephrology, Min-Sheng Hospital, Taoyuan, Taiwan

2. Taipei Veterans General Hospital Institute of Health and Welfare Policy, Division of Nephrology, Min-Sheng Hospital, Taoyuan, Taiwan

3. Division of Endocrinology and Metabolism, Division of Nephrology, Min-Sheng Hospital, Taoyuan, Taiwan

4. Taipei Veterans General Hospital, National Yang Ming University, School of Medicine, Taipei Division of Nephrology, Division of Nephrology, Min-Sheng Hospital, Taoyuan, Taiwan

5. Wei-Gong Memorial Hospital, Miaoli County, Taiwan, Division of Nephrology, Min-Sheng Hospital, Taoyuan, Taiwan

Abstract

Aims We investigated dialysis duration, dose of erythropoietin (EPO), and clinical manifestations in peritoneal dialysis (PD) patients with subclinical hypothyroidism. Methods This cross-sectional study, performed in 3 centers, assessed 122 adult patients on PD for more than 6 months with regard to demographic data, dialysis duration, thyroid function, biochemical data, EPO dose, and clinical manifestations. Thyroid dysfunction was determined by serum thyroid-stimulating hormone, free thyroxine, total thyroxine, total triiodothyronine, antithyroid peroxidase antibodies, and auto-antibodies against thyroglobulin. Results Of the 122 study patients, 98 (80.3%) were assessed as having euthyroidism; 19 (15.6%), subclinical hypothyroidism; and 5 (4.1%), subclinical hyperthyroidism. The proportion of women (74.2% vs. 57.1%, p = 0.038), the mean duration of PD (58.1 months vs. 37.9 months, p = 0.032), and the weighted mean monthly EPO dose (1.22 μg/kg vs. 1.64 μg/kg, p = 0.009) were significantly higher in the subclinical hypothyroidism group than in the euthyroidism group, but the prevalences of coronary artery disease and cerebrovascular disease were not. From the multivariate model, PD duration was more significant than sex as a risk factor for subclinical hypothyroidism ( p = 0.0132). Conclusions Subclinical hypothyroidism is frequent in PD patients, especially female patients and patients with a longer PD duration. Compared with euthyroid patients, patients with subclinical hyperthyroidism need a higher dose of EPO to maintain a stable hemoglobin level.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

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