Endocrine Abstracts (2012) 29 P1622

Thyroid hormone abnormalities in haemodialyzed patients: low triiodothyronine as well as high reverse triiodothyronine are associated with increased mortality

J. Horacek1, S. Dusilova Sulkova1,2, M. Kubisova1, R. Safranek1, E. Malirova1, M. Kalousova3, I. Svilias1, J. Maly1, L. Sobotka1 & P. Zak1


1Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic; 2Institute of Clinical and Experimental Medicine, Prague, Czech Republic; 31st Faculty of Medicine and University Hospital Prague, Charles University in Prague, Prague, Czech Republic.


Objective: Numerous abnormalities of thyroid hormones in end-stage renal disease (ESRD) have been described. Our aim was to analyze the impact of these abnormalities on survival.

Design: In 167 haemodialyzed ESRD patients, TSH and thyroid hormone levels (including reverse T3, i.e. T4, fT4, T3, fT3, rT3) were determined. The patients were then prospectively followed up for up to 5 years and the possible impact of any observed abnormalities on their mortality was studied.

Results: Only 16.8% patients had all six tests within the reference range. The pattern of nonthyroidal illness syndrome was found in 56.3%. Low T3 was particularly common (44.3%), and clearly associated with increased 6- and 12-month mortality and decreased overall survival (log-rank test, P=0.007). Independent of T3 levels (Spearman correlation, NS), increased rT3 was more frequently observed (9.9%) than expected from the literature, and was also related to increased mortality and decreased survival (log-rank test, P=0.021).

Conclusions: Increased rT3 may be more common in ESRD patients than previously expected, and together with decreased T3 it may serve as an indicator of poor prognosis in subsequent months.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.