The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone

Song, Sang Heon; Kwak, Ihm Soo; Lee, Jun Young; Kang, Yang Ho; Seong, Eun Young; Park, Jin Sup

doi:10.1093/ndt/gfn682

Cited by 89 publications

(75 citation statements)

References 14 publications

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“…This study showed that low T3 syndrome was highly prevalent in CKD and was a remarkable finding in early CKD. Furthermore, serum T3 levels were associated with severity of CKD in normal TSH level (13).…”

Section: Resultsmentioning

confidence: 93%

Thyroid Functional Status in Chronic Kidney Disease

Hossain

Shah

Begum

et al. 2018

Bangladesh J. Nuclear Med.

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Section: Resultsmentioning

confidence: 93%

Thyroid Functional Status in Chronic Kidney Disease

Hossain

Shah

Begum

et al. 2018

Bangladesh J. Nuclear Med.

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“…The difference between clinical and subclinical hypothyroidism is that in the subclinical type serum level of TSH is increased without the presence of the overt clinical manifestation of hypothyroidism. Similarly, the rate of "low T3 syndrome'' also referred as "the euthyroid sick syndrome" in patients with CKD increases consistently with declining GFR and it varies from 20% to 80% (100)(101)(102)(103). Euthyroid sick syndrome is the most common thyroid disorder in CKD patients.…”

Section: Ckd and Thyroid Diseasesmentioning

confidence: 99%

The Thyroid and the Kidney: A Complex Interplay in Health and Disease

et al. 2014

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Thyroid hormones may directly affect the kidney and altered kidney function may also contribute to thyroid disorders. The renal manifestations of thyroid disorders are based on hemodynamic alterations or/and to direct effects of thyroid hormones. The renin-angiotensin system plays a crucial role in the cross-talk between the thyroid and the kidney. Hypothyroidism may be accompanied by an increase of serum creatinine and reduction of glomerular filtration rate (GFR), whereas hyperthyroidism may increase GFR. Treatment of thyroid disorders may lead to normalization of GFR. Primary and subclinical hypothyroidism and low triiodothyronine (T3) syndrome are common features in patients with chronic kidney disease (CKD). In addition low levels of thyroid hormones may predict a higher risk of cardiovascular and overall mortality in patients with end-stage renal disease. The causal nature of this correlation remains uncertain. In this review, special emphasis is given to the thyroid pathophysiology, its impact on kidney function and CKD and the interpretation of laboratorial findings of thyroid dysfunction in CKD.

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“…Recent reports suggest that as many as 70% of patients with ESRD present with low T3 levels (2)(3)(4)(5) and as many as 20%-25% have subclinical hypothyroidism (6,7). The underlying pathophysiology of these derangements is likely multifactorial, involving iodine retention, altered serum protein binding capacity, systemic inflammation, and peripheral deiodinase activity (8,9).…”

Section: Introductionmentioning

confidence: 99%

Baseline Levels and Trimestral Variation of Triiodothyronine and Thyroxine and Their Association with Mortality in Maintenance Hemodialysis Patients

Meuwese

Dekker

Lindholm

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Conflicting evidence exists with regard to the association of thyroid hormones and mortality in dialysis patients. This study assesses the association between basal and trimestral variation of thyroid stimulating hormone, triiodothyronine, and thyroxine and mortality.Design, setting, participants, & measurements In 210 prevalent hemodialysis patients, serum triiodothyronine, thyroxine, thyroid stimulating hormone, and interleukin-6 were measured 3 months apart. Cardiovascular and non-cardiovascular deaths were registered during follow-up. Based on fluctuations along tertiles of distribution, four trimestral patterns were defined for each thyroid hormone: persistently low, decrease, increase, and persistently high. The association of baseline levels and trimestral variation with mortality was investigated with Kaplan-Meier curves and Cox proportional hazard models.Results During follow-up, 103 deaths occurred. Thyroid stimulating hormone levels did not associate with mortality. Patients with relatively low basal triiodothyronine concentrations had higher hazards of dying than patients with high levels. Longitudinally, patients with persistently low levels of triiodothyronine during the 3-month period had higher mortality hazards than those having persistently high levels. These associations were mainly attributable to cardiovascular-related mortality. The association between thyroxine and mortality was not altered after adjustment for triiodothyronine.Conclusions Hemodialysis patients with reduced triiodothyronine or thyroxine levels bear an increased mortality risk, especially due to cardiovascular causes. This was true when considering both baseline measurements and trimestral variation patterns. Our longitudinal design adds observational evidence supporting the hypothesis that the link may underlie a causal effect.

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The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone

Abstract: This study showed that low T3 syndrome was highly prevalent in CKD and was a remarkable finding in early CKD. Furthermore, serum T3 levels were associated with severity of CKD even in the normal TSH level.

Cited by 89 publications

References 14 publications

Thyroid Functional Status in Chronic Kidney Disease

Thyroid Functional Status in Chronic Kidney Disease

The Thyroid and the Kidney: A Complex Interplay in Health and Disease

Baseline Levels and Trimestral Variation of Triiodothyronine and Thyroxine and Their Association with Mortality in Maintenance Hemodialysis Patients

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