Clinical signifi cance of various variants of euthyroid pathology syndrome in patients with end-stage chronic kidney disease on programmed hemodialysis

Abstract

The number of patients with end-stage renal disease (ESRD) is growing every year. Due to the high comorbidity of such patients, the search for factors that influence the course of the disease and outcome is of particular importance. Indications for studying the functional state of the thyroid gland, as well as recommendations for the treatment of thyroid dysfunction in patients with ESRD have not been developed.THE AIM: to study indicators of thyroid status and identify clinically significant variants of the euthyroid pathology syndrome in patients with ESRD on program hemodialysis (PHD).PATIENTS AND METHODS. The study included 123 patients with ESRD undergoing PHD. A cross-sectional study was conducted to examine thyroid function parameters in patients with ESCKD undergoing PHD. All patients were assessed for the levels of thyroidstimulating hormone (TSH), free triiodothyronine (free T3) and free thyroxine (free T4), the comorbidity index, which was calculated using the Charlson scale, the effectiveness of program hemodialysis using Kt/V, and the urea reduction coefficient (URR).RESULTS. Increased TSH levels were associated with higher body mass index in the studied patients. “Low T3” syndrome is associated with older age and high comorbidity. The high level of T4 in the examined patients is also associated with old age, high comorbidity and a KT/V index below the target values.CONCLUSION. The TSH level in patients with endstage renal insufficiency on programmed hemodialysis does not reflect the true functional state of the thyroid gland.