Endocrine Abstracts

Aim

Euthyroid Sick Syndrome (ESS) is a thyroid disease appeared in critical and noncritical illnesses. ESS can be seen in patients with end stage renal disease (ESRD). In this study, we aimed to evaluate the frequency of ESS before and after renal transplantation in patients with ESRD, and its association with oxidative stress by evaluating thiol-disulphide levels.

Material and Method

In this study, free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone (TSH) levels were recorded before and after renal transplantation in patients with ESRD. ESS was diagnosed in patients with unresponsive TSH to low fT3 and/ or fT4 levels, Thiol and disulphide parameters of patients before and after transplantation were also recorded.

Results

One- hundred twenty one patients were included in the study. Of these, 69 (57%) were males and 52 (43%) were females. The mean age was 45±12.61 years. ESS was detected in 39 (32%) of 121 patients. Of 39 patients, 24 (61%) had ESS before transplantation and 15 (39%) after transplantation. Frequency of ESS was 19.8% in patients followed with ESRD. Sixteen of 24 (66.7%) patients with ESS before transplantation reached to normal thyroid functions after transplantation. After transplantation, patients with ESS had significantly higher urea and creatinine (respectively, P = 0.025 and P = 0.009), and lower fT4, fT3, total protein, and albumin (P = <0.001; for all parameters) compared to patients without ESS. Patients with ESS before transplantation had also significantly higher creatinine levels compared to patients without ESS (P = 0.034). Free T4 and fT3 levels were significantly low (P <0.001 for both). Thiol- disulphide levels of 20 patients with ESS at any time compared with 68 patients without ESS. We found that native thiol and total thiol were low significantly in patients with ESS (respectively, P = 0.025 and P = 0.044).

Conclusion

Our study is the initial study evaluating the oxidative stress and antioxidation status in etiology of ESS in patients with renal transplantation. Presence of markedly low level of antioxidation in these patients supports the possible role of oxidative stress in etiology of ESS.