The Influence of Chronic Renal Failure on Serum and Urinary Thyroid Hormone Levels

Abstract

The effects of various degrees of chronic renal failure on serum and urinary thyroid hormones were studied in 10 patients with a mean creatinine clearance (Cr.Cl.) of 23 ml/min (group A), in 11 patients with a Cr.Cl. of 5.7 ml/min (group B), and in 60 healthy euthyroid subjects with normal renal function. We found a significant decrease (P < 0.01) of serum total thyroxine (T4) (5.3 ±1.9 (sd) μg/100 ml in group A and 4.1 ± 1.5 in group B), serum total triiodothyronine (T3) (65.4 ± 17.4 ng/100 ml ~57.4 ± 13.9), serum free T4 (5.60 ± 1.74 arb.U ∼ 4.45 ± 1.61), and serum free T3 (69.51 ± 21.22 arb.U ∼ 62.09 ± 12.39). T3 uptake test and basal thyroid stimulating hormone (TSH) values were normal in both groups of renal patients. No statistical significance was found in T4 excretion in urine. Urinary T3 excretion was significantly reduced (P < 0.01) in group A (27 ± 44 ng/24 h), and undetectable in terminal renal failure. Urinary protein excretion was non-selective and low (median 0.2 g/24 h and 0.7 g/24 h, respectively). Conclusively we have found reduced levels of serum total and free T3, and in contradiction to most investigators substantially reduced levels of serum total and free T4. Urinary excretion of T4 and T3 reflects the low levels of free serum hormones and the tubular impairment.

Thyroid Gland Volume and Serum Concentrations of Thyroid Hormones in Chronic Renal Failure

“…A high incidence of goiter has been reported in CRF patients in Utah [1], in Illinois, USA [2], South Africa [11], Israel [12], and Basle, Switzerland [13], but was infre quently encountered in Maryland, USA [4], Alberta and Quebec in Canada [3,8], London, England [7], and in Denmark [6]. The geographical variation suggests that the genesis of the goiter is not related to uremia per se but to environmental goitrogenic factors.…”

Triiodothyronine Stimulates Growth of Peripheral Blood Mononuclear Cells in Serum-Free Cultures in Uremic Patients

“…The concentration of free T3 was calculated as the product of FFI 3 and the serum total T3 concentration as estimated in duplicate by a stan dard radioimmunoassay. The intra-assay coefficient of variation of the radioimmunoassay was 4% [16]. …”

Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters.

“…Serum T 4 and T 3 were measured by radioimmunoassay (8). Serum TSH was measured by immunoradiometric assay (Boots, Cell Tech, United Kingdom; lower detection limit 0.05 mU .…”