Gomez-Pan A, Alvarez-Ude F, Yeo P P, Hall R, Evered D C, Kerr D N
Clin Endocrinol (Oxf). 1979 Nov;11(5):567-74. doi: 10.1111/j.1365-2265.1979.tb03110.x.
Hypothalamo-hypophysial-thyroid function has been studied in twenty-five patients with chronic renal failure. Eight were receiving conservative treatment, nine peritoneal dialysis and eight haemodialysis. All were clinically euthyroid. Total thyroxine (T4) and triiodothyronine (T3) levels were reduced but free T4 levels were normal, while free T3 was reduced in patients with the most severe renal failure. It is suggested that the binding of thyroid hormones by the transport proteins is reduced and that peripheral conversion of T4 to T3 is impaired in renal failure. The thyrotrophin response to thyrotrophin-releasing hormone (TRH) is reduced in renal failure but this reduction is probably independent of alterations in thyroid hormone metabolism. Growth hormone was released by TRH in seven of the patients studied, possibly as a result of protein malnutrition.
对25例慢性肾衰竭患者的下丘脑-垂体-甲状腺功能进行了研究。8例接受保守治疗，9例接受腹膜透析，8例接受血液透析。所有患者临床甲状腺功能均正常。总甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平降低，但游离T4水平正常，而在最严重肾衰竭患者中游离T3降低。提示肾衰竭时甲状腺激素与转运蛋白的结合减少，且T4向T3的外周转化受损。肾衰竭时促甲状腺激素对促甲状腺激素释放激素（TRH）的反应降低，但这种降低可能与甲状腺激素代谢改变无关。在所研究的患者中，7例患者的生长激素由TRH释放，这可能是蛋白质营养不良的结果。
