Thyroid function tests in patients undergoing maintenance dialysis: Characterization of the 'low-T4 syndrome' in subjects on regular hemodialysis and continuous ambulatory peritoneal dialysis

M. C. Pagliacci, G. Pelicci, F. Grignani, C. Giammartino, L. Fedeli, C. Carobi, U. Buoncristiani, I. Nicoletti

Research output: Contribution to journalArticle

Abstract

Thyroid function tests were evaluated in 38 patients on regular hemodialysis (HD), in 36 on continuous ambulatory peritoneal dialysis (CAPD) and in 39 healthy controls. A significant reduction in total thyroxine (TT4), total triiodothyronine (TT3), reverse (rT3), and free T4 (fT4) mean levels and normal TSH, free T3, TBC and albumin concentrations was found in both HD and CAPD patients. A 'low-T4 syndrome' (serum T4 <5 μg/dl) was found in 9 CAPD (25%) and 20 HD (53%) patients, but none of them had fT4 levels below the normal laboratory range. The only striking difference between low-T4 HD and low-T4 CAPD patients was the significantly lower TBG and albumin serum levels in CAPD group. Low-T4 HD displayed normal TBG levels but enhanced fT4/TT4 and fT4/TT4 x TBG ratios. We concluded that: (1) the abnormalities in thyroid function tests in patients on long-term dialysis (HD and CAPD) do not express the existence of a true hypothyroidism; (2) a different pathogenesis of the low-T4 syndrome in the CAPD and HD groups may be hypothesized: in the former it could be attributed to a reduction in serum-binding capacity for thyroid hormones, in the latter the relative increase in fT4 percentage despite normal TBG levels suggests either the presence of T4-TBG-binding inhibitor(s), or structural abnormalities of thyroid-hormone-binding proteins.

Original languageEnglish
Pages (from-to)225-230
Number of pages6
JournalNephron
Volume46
Issue number3
Publication statusPublished - 1987

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Thyroid function tests in patients undergoing maintenance dialysis: Characterization of the 'low-T<sub>4</sub> syndrome' in subjects on regular hemodialysis and continuous ambulatory peritoneal dialysis'. Together they form a unique fingerprint.

  • Cite this