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Kronik Böbrek Yetmezliği Hastalarında Renal ve Tiroid Fonksiyon Testlerinin Değerlendirilmesi

Year 2020, Volume: 2 Issue: 2, 52 - 57, 31.12.2020
https://doi.org/10.47112/neufmbd.795441

Abstract

Böbreğin, normalde tiroid hormonlarının metabolizmasında, parçalanmasında ve atılmasında önemli bir rol oynadığı bilinmektedir. Bu durumda böbrek fonksiyonunda meydana gelen bir bozulmanın, tiroid fizyolojisini de etkilemesi beklenmektedir. Çalışmamızda; hemodiyaliz tedavisi gören kronik böbrek yetmezliği olan hastalarda, tek bir hemodiyaliz seansının tiroid fonksiyonuna etkisini araştırmayı ve hemodiyaliz hastalarında tiroid fonksiyon testleri ve bazı biyokimyasal parametreleri sağlıklı gruplarla karşılaştırmayı amaçladık. 29 hastadan (ortalama yaş: 46.17 ± 14.93) diyaliz öncesi ve sonrasında aldığımız kan örnekleri ile kontrol grubu olan 28 sağlıklı katılımcıdan (ortalama yaş: 40.79 ± 14.42) aldığımız kan örnekleri otoanalizör ile analiz edildikten sonra istatistiksel olarak değerlendirildi. Diyaliz öncesi ve sonrası örnekler karşılaştırıldığında TT4, FT3 ve FT4 değerleri istatistiki olarak anlamlı bulundu (sırasıyla p < 0.01, p < 0.05 ve p < 0.05). Ayrıca; diyaliz sonrası ve kontrol grubunun örnekleri incelendiğinde, TT3 ve TSH düzeylerinde bir anlamlılık tespit edilmezken (p > 0.1), aynı grubun TT3 (p < 0.01), FT3 (p < 0.001) ve TSH (p < 0.05) değerleri arasında istatistiki olarak önemli düzeyde bir anlamlılık tespit edilmiştir. Buna ek olarak, diyaliz öncesi grupta kreatinin-FT4 (p < 0.01) ve diyaliz sonrası grupta kreatinin-üre (p < 0.001) değerlerinin de pozitif bir korelasyon gösterdiği tespit edilmiştir. Bu çalışmada kronik böbrek yetmezliği olan hastalarda tiroid bozukluklarının teşhisinde tiroid fonksiyon testlerinin önemini değerlendirerek tiroid fonksiyon testlerinin hemodiyaliz hastalarının tedavisinde önemli olabileceği kanaatine vardık.

References

  • A.I. Katz, D.S. Emmanouel, M.D. Lindheimer, Thyroid hormone and the kidney, Nephron. 15 (1975) 223–249.
  • G. SÜLEYMANLAR, Kronik böbrek hastalığı ve yetmezliği: tanımı, evreleri ve epidemiyolojisi, Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi. 3 (2007) 1–7.
  • A.S. Levey, J. Coresh, E. Balk, A.T. Kausz, A. Levin, M.W. Steffes, R.J. Hogg, R.D. Perrone, J. Lau, G. Eknoyan, National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification, Annals of Internal Medicine. 139 (2003) 137–147.
  • W.J. Kalk, J.E. Morley, C.H. Gold, A. Meyers, Thyroid function tests in patients on regular hemodialysis, Nephron. 25 (1980) 173–178.
  • M.C. Pagliacci, G. Pelicci, F. Grignani, C. Giammartino, L. Fedeli, C. Carobi, U. Buoncristiani, I. Nicoletti, Thyroid function tests in patients undergoing maintenance dialysis: characterization of the ‘low-T4 syndrome’in subjects on regular hemodialysis and continuous ambulatory peritoneal dialysis, Nephron. 46 (1987) 225–230.
  • G. Lippi, M. Montagnana, G. Targher, G.L. Salvagno, G.C. Guidi, Relationship between thyroid status and renal function in a general population of unselected outpatients, Clinical Biochemistry. 41 (2008) 625–627.
  • G. Rajeev, W.D.S.C. Rayappa, R. Vijayalakshmi, M. Swathi, S. Kumar, Evaluation of thyroid hormone levels in chronic kidney disease patients, Saudi Journal of Kidney Diseases and Transplantation. 26 (2015) 90.
  • M.W. Szkudlinski, V. Fremont, C. Ronin, B.D. Weintraub, Thyroid-stimulating hormone and thyroid-stimulating hormone receptor structure-function relationships, Physiological Reviews. 82 (2002) 473–502.
  • G. Basu, A. Mohapatra, Interactions between thyroid disorders and kidney disease, Indian Journal of Endocrinology and Metabolism. 16 (2012) 204.
  • J. Punekar, A.A. Singh, M.K. Malav, Study of thyroid function in patients with chronic kidney disease, Int J Health Sci Res. 7 (2017) 68–72.
  • S. Kirubakaran, A Prospective Study on the Evaluation of Thyroid Function Status in Patients with Chronic Kidney Disease, (n.d.).
  • V. V Deokar, S.S. Patil, K. Babu, J. Patel, Evaluation of thyroid function status in patıents with chronic kidney disease, Journal of Critical Reviews. 7 (2020) 535–538.
  • P. Iglesias, J.J. Díez, Thyroid dysfunction and kidney disease, European Journal of Endocrinology. 160 (2009) 503–515.
  • J. Horacek, S.D. Sulkova, M. Kubisova, R. Safránek, E. Malírova, M. Kalousová, I. Svilias, J. Malý, L. Sobotka, P. Zák, Thyroid hormone abnormalities in hemodialyzed patients: low triiodothyronine as well as high reverse triiodothyronine are associated with increased mortality, Physiological Research. 61 (2012) 495.
  • S.E.S. Farag, Functional and Morphological Thyroid Disorders in Hemodialysis Patients, J Thyroid Disord Ther. 2 (2013) 2–5.
  • S. Jusufovic, E. Hodzic, Functional thyroid disorders are more common in patients on chronic hemodialysis compared with the general population, Materia Socio-Medica. 23 (2011) 206.
  • E.O. Kim, I.S. Lee, Y.A. Choi, S.J. Lee, Y.K. Chang, H.E. Yoon, Y.S. Jang, J.M. Lee, H.S. Kim, C.W. Yang, Unresolved subclinical hypothyroidism is independently associated with progression of chronic kidney disease, International Journal of Medical Sciences. 11 (2014) 52.
  • S. Sakurai, Y. Hara, S. Miura, M. Urabe, K. Inoue, T. Tanikawa, M. Yanagisawa, M. Iitaka, J.U.N. Ishii, Thyroid functions before and after maintenance hemodialysis in patients with chronic renal failure, Endocrinologia Japonica. 35 (1988) 865–876.
  • K. Yonemura, T. Nakajima, T. Suzuki, S. Ando, R. Genma, H. Nakamura, A. Hishida, Low free thyroxine concentratios and deficient nocturnal surge of thyroid‐stimulating hormone in haemodialysed patients compared with undialysed patients, Nephrology Dialysis Transplantation. 15 (2000) 668–672.
  • J. Malyszko, J. Malyszko, S. Wolczynski, M. Mysliwiec, Adiponectin, leptin and thyroid hormones in patients with chronic renal failure and on renal replacement therapy: are they related?, Nephrology Dialysis Transplantation. 21 (2006) 145–152.
  • M. Tarakçıoğlu, E. Algün, R. Şekeroğlu, S. Alıcı, S. Topal, İ. Meral, Hemodiyaliz Hastalarında Tiroid Hormon Düzeyleri ve Bir Hemodiyaliz Seansının Bu Değerlere Etkisi, Van Tıp Dergisi. 4 (n.d.) 201–204.

Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients

Year 2020, Volume: 2 Issue: 2, 52 - 57, 31.12.2020
https://doi.org/10.47112/neufmbd.795441

Abstract

It is known that the kidney normally plays an important role in the metabolism, degradation and excretion of several thyroid hormones. Accordingly, deterioration in renal function is expected to lead to disturbing thyroid physiology. In the study, we aimed to investigate the effect of a single hemodialysis session on thyroid function in patients with chronic renal failure that have hemodialysis treatment, and also to compare thyroid function tests and some biochemical parameters in hemodialysis patients with healthy groups. We collected blood samples which were drawn pre- and after-dialysis sessions from 29 patients (mean age: 46.17 ± 14.93) and 28 healthy participants (mean age: 40.79 ± 14.42) as control group, and analysed using an autoanalyzer followed by statistical analysis. TT4, FT3 and FT4 values were found statistically significant (p < 0.01, p < 0.05 and p < 0.05, respectively) in comparison of pre- and post-dialysis samples. Also, the findings of the study revealed that there was a significant difference only among the parameters of TT3 (p < 0.01), FT3 (p < 0.001) and TSH (p < 0.05) for the healthy participants and dialysis group in spite of any statistically significance was not detected in the values of TT3 and TSH parameters of the same group (p > 0.1). In addition, statistical results proved that creatinine - FT4 values (p < 0.01) in the pre-dialysis group and creatinine - urea values in the post-dialysis group (p < 0.001) were correlated positively. We evaluated the significance of the thyroid function tests during the diagnosis of thyroid disorders in patients with chronic kidney failure in the present study and found that thyroid function tests could be crucial for the treatment of hemodialysis patients.

References

  • A.I. Katz, D.S. Emmanouel, M.D. Lindheimer, Thyroid hormone and the kidney, Nephron. 15 (1975) 223–249.
  • G. SÜLEYMANLAR, Kronik böbrek hastalığı ve yetmezliği: tanımı, evreleri ve epidemiyolojisi, Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi. 3 (2007) 1–7.
  • A.S. Levey, J. Coresh, E. Balk, A.T. Kausz, A. Levin, M.W. Steffes, R.J. Hogg, R.D. Perrone, J. Lau, G. Eknoyan, National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification, Annals of Internal Medicine. 139 (2003) 137–147.
  • W.J. Kalk, J.E. Morley, C.H. Gold, A. Meyers, Thyroid function tests in patients on regular hemodialysis, Nephron. 25 (1980) 173–178.
  • M.C. Pagliacci, G. Pelicci, F. Grignani, C. Giammartino, L. Fedeli, C. Carobi, U. Buoncristiani, I. Nicoletti, Thyroid function tests in patients undergoing maintenance dialysis: characterization of the ‘low-T4 syndrome’in subjects on regular hemodialysis and continuous ambulatory peritoneal dialysis, Nephron. 46 (1987) 225–230.
  • G. Lippi, M. Montagnana, G. Targher, G.L. Salvagno, G.C. Guidi, Relationship between thyroid status and renal function in a general population of unselected outpatients, Clinical Biochemistry. 41 (2008) 625–627.
  • G. Rajeev, W.D.S.C. Rayappa, R. Vijayalakshmi, M. Swathi, S. Kumar, Evaluation of thyroid hormone levels in chronic kidney disease patients, Saudi Journal of Kidney Diseases and Transplantation. 26 (2015) 90.
  • M.W. Szkudlinski, V. Fremont, C. Ronin, B.D. Weintraub, Thyroid-stimulating hormone and thyroid-stimulating hormone receptor structure-function relationships, Physiological Reviews. 82 (2002) 473–502.
  • G. Basu, A. Mohapatra, Interactions between thyroid disorders and kidney disease, Indian Journal of Endocrinology and Metabolism. 16 (2012) 204.
  • J. Punekar, A.A. Singh, M.K. Malav, Study of thyroid function in patients with chronic kidney disease, Int J Health Sci Res. 7 (2017) 68–72.
  • S. Kirubakaran, A Prospective Study on the Evaluation of Thyroid Function Status in Patients with Chronic Kidney Disease, (n.d.).
  • V. V Deokar, S.S. Patil, K. Babu, J. Patel, Evaluation of thyroid function status in patıents with chronic kidney disease, Journal of Critical Reviews. 7 (2020) 535–538.
  • P. Iglesias, J.J. Díez, Thyroid dysfunction and kidney disease, European Journal of Endocrinology. 160 (2009) 503–515.
  • J. Horacek, S.D. Sulkova, M. Kubisova, R. Safránek, E. Malírova, M. Kalousová, I. Svilias, J. Malý, L. Sobotka, P. Zák, Thyroid hormone abnormalities in hemodialyzed patients: low triiodothyronine as well as high reverse triiodothyronine are associated with increased mortality, Physiological Research. 61 (2012) 495.
  • S.E.S. Farag, Functional and Morphological Thyroid Disorders in Hemodialysis Patients, J Thyroid Disord Ther. 2 (2013) 2–5.
  • S. Jusufovic, E. Hodzic, Functional thyroid disorders are more common in patients on chronic hemodialysis compared with the general population, Materia Socio-Medica. 23 (2011) 206.
  • E.O. Kim, I.S. Lee, Y.A. Choi, S.J. Lee, Y.K. Chang, H.E. Yoon, Y.S. Jang, J.M. Lee, H.S. Kim, C.W. Yang, Unresolved subclinical hypothyroidism is independently associated with progression of chronic kidney disease, International Journal of Medical Sciences. 11 (2014) 52.
  • S. Sakurai, Y. Hara, S. Miura, M. Urabe, K. Inoue, T. Tanikawa, M. Yanagisawa, M. Iitaka, J.U.N. Ishii, Thyroid functions before and after maintenance hemodialysis in patients with chronic renal failure, Endocrinologia Japonica. 35 (1988) 865–876.
  • K. Yonemura, T. Nakajima, T. Suzuki, S. Ando, R. Genma, H. Nakamura, A. Hishida, Low free thyroxine concentratios and deficient nocturnal surge of thyroid‐stimulating hormone in haemodialysed patients compared with undialysed patients, Nephrology Dialysis Transplantation. 15 (2000) 668–672.
  • J. Malyszko, J. Malyszko, S. Wolczynski, M. Mysliwiec, Adiponectin, leptin and thyroid hormones in patients with chronic renal failure and on renal replacement therapy: are they related?, Nephrology Dialysis Transplantation. 21 (2006) 145–152.
  • M. Tarakçıoğlu, E. Algün, R. Şekeroğlu, S. Alıcı, S. Topal, İ. Meral, Hemodiyaliz Hastalarında Tiroid Hormon Düzeyleri ve Bir Hemodiyaliz Seansının Bu Değerlere Etkisi, Van Tıp Dergisi. 4 (n.d.) 201–204.
There are 21 citations in total.

Details

Primary Language English
Subjects Engineering
Journal Section Articles
Authors

Mustafa Yöntem 0000-0001-9350-8708

Birgül Erbil This is me 0000-0002-7836-9508

Behiç Selman Erdoğdu 0000-0001-7098-5982

Publication Date December 31, 2020
Acceptance Date October 19, 2020
Published in Issue Year 2020 Volume: 2 Issue: 2

Cite

APA Yöntem, M., Erbil, B., & Erdoğdu, B. S. (2020). Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients. Necmettin Erbakan Üniversitesi Fen Ve Mühendislik Bilimleri Dergisi, 2(2), 52-57. https://doi.org/10.47112/neufmbd.795441
AMA Yöntem M, Erbil B, Erdoğdu BS. Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients. NEJSE. December 2020;2(2):52-57. doi:10.47112/neufmbd.795441
Chicago Yöntem, Mustafa, Birgül Erbil, and Behiç Selman Erdoğdu. “Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients”. Necmettin Erbakan Üniversitesi Fen Ve Mühendislik Bilimleri Dergisi 2, no. 2 (December 2020): 52-57. https://doi.org/10.47112/neufmbd.795441.
EndNote Yöntem M, Erbil B, Erdoğdu BS (December 1, 2020) Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients. Necmettin Erbakan Üniversitesi Fen ve Mühendislik Bilimleri Dergisi 2 2 52–57.
IEEE M. Yöntem, B. Erbil, and B. S. Erdoğdu, “Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients”, NEJSE, vol. 2, no. 2, pp. 52–57, 2020, doi: 10.47112/neufmbd.795441.
ISNAD Yöntem, Mustafa et al. “Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients”. Necmettin Erbakan Üniversitesi Fen ve Mühendislik Bilimleri Dergisi 2/2 (December 2020), 52-57. https://doi.org/10.47112/neufmbd.795441.
JAMA Yöntem M, Erbil B, Erdoğdu BS. Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients. NEJSE. 2020;2:52–57.
MLA Yöntem, Mustafa et al. “Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients”. Necmettin Erbakan Üniversitesi Fen Ve Mühendislik Bilimleri Dergisi, vol. 2, no. 2, 2020, pp. 52-57, doi:10.47112/neufmbd.795441.
Vancouver Yöntem M, Erbil B, Erdoğdu BS. Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients. NEJSE. 2020;2(2):52-7.


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