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What is Abnormalities of Thyroid Function in Chronic Dialysis Patients about?

Hypothyroidism is a highly prevalent yet underrecognized endocrine complication in chronic kidney disease (CKD) patients, including those receiving dialysis. In dialysis-dependent and nondialysis-dependent (NDD) CKD patients, other thyroid function test derangements, such as low triiodothyronine (T3), low thyroxine (T4), and high reverse triiodothyronine (rT3) levels, are also frequently observed. Although the mechanistic link between thyroid and kidney disease has not been fully elucidated, existing data suggest that the relationship is bidirectional. Previously thought to be a physiologic adaptation in patients with end-stage kidney disease (ESKD) who are prone to hypercatabolism, malnutrition, and dialytic protein and amino acid losses, growing evidence shows that hypothyroidism is associated with a higher risk of cardiovascular disease, adverse patient-centered outcomes, and mortality in the dialysis-dependent and NDD-CKD populations. This chapter summarizes (1) the epidemiology of hypothyroidism and other thyroid function test alterations commonly observed in dialysis patients, (2) the mechanistic pathways linking thyroid and kidney disease, and (3) recent data on the prognost

Author

Connie M. Rhee

Publisher

Elsevier

Published

2023

Language

EN