Pakfetrat Maryam, Dabbaghmanesh Mohammad Hossein, Karimi Zahed, Rasekhi Alireza, Malekmakan Leila, Hossein Nikoo Mohammad
Department of internal medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Hemodial Int. 2017 Jan;21(1):84-89. doi: 10.1111/hdi.12453. Epub 2016 Jun 30.
End stage renal disease (ESRD) reasons several changes in the function of thyroid gland as; lower levels of thyroid hormones, altered hormone metabolism, and increased iodine storage. The aim of this study was to evaluate the prevalence of nodular goiter and hypothyroidism in hemodialysis (HD) patients compared with normal population.
This cross-sectional study was conducted among HD patients and healthy people as the control group for thyroid function evaluation. Thyroid gland was evaluated by physical examination and ultrasonography. Blood level of FT3, FT4, TSH, TPO Ab, and urinary iodine excretion were checked in both groups. Data were analyzed using SPSS-17 and P-value less than 0.05 was considered as the significance level.
Eighty six HD patients (57.2 ± 17.2 mean age, 48 men) and 86 healthy people (56.6 ± 16.8 mean age, 48 men) were enrolled in this study. Goiter was confirmed by physical examination in 29.0% of the HD patients and 12.8% of the control group (P = 0.04). Nodular goiter that was shown by ultrasonography was found in 27.9% and 3.5% of the HD and control groups, respectively (P = 0.01). HD patients had a higher frequency of reduced FT3 (40.9% vs. 4.6%, P < 0.01) and increased TSH (18.6% vs. 8.1%, P < 0.03(. TPO Ab was positive in 15.1% of the HD and 11.6% of the control groups (P = 0.14).
The high incidence of nodular goiter and hypothyroidism in ESRD patients shows that screening for thyroid dysfunction and goiter, using appropriate laboratory tests, should be considered in evaluations of ESRD patients.
终末期肾病（ESRD）会导致甲状腺功能发生多种变化，如甲状腺激素水平降低、激素代谢改变以及碘储存增加。本研究的目的是评估血液透析（HD）患者与正常人群相比，结节性甲状腺肿和甲状腺功能减退的患病率。
本横断面研究在HD患者和作为对照组的健康人群中进行，以评估甲状腺功能。通过体格检查和超声检查评估甲状腺。两组均检测FT3、FT4、TSH、TPO Ab的血液水平以及尿碘排泄情况。使用SPSS - 17分析数据，P值小于0.05被视为显著性水平。
本研究纳入了86例HD患者（平均年龄57.2±17.2岁，48例男性）和86例健康人群（平均年龄56.6±16.8岁，48例男性）。体格检查确诊HD患者中29.0%患有甲状腺肿，对照组为12.8%（P = 0.04）。超声检查显示HD组和对照组中结节性甲状腺肿的发生率分别为27.9%和3.5%（P = 0.01）。HD患者FT3降低的频率更高（40.9%对4.6%，P < 0.01），TSH升高的频率更高（18.6%对8.1%，P < 0.03）。HD组中15.1%的患者TPO Ab呈阳性，对照组为11.6%（P = 0.14）。
ESRD患者中结节性甲状腺肿和甲状腺功能减退的高发生率表明，在评估ESRD患者时，应考虑使用适当的实验室检查筛查甲状腺功能障碍和甲状腺肿。
