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Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients

 Ea Wha Kang  ;  Ju Young Nam  ;  Tae-Hyun Yoo  ;  Sug Kyun Shin  ;  Shin-Wook Kang  ;  Dae-Suk Han  ;  Seung Hyeok Han 
 AMERICAN JOURNAL OF NEPHROLOGY, Vol.28(6) : 908-913, 2008 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Echocardiography ; Female ; Humans ; Hypothyroidism/blood* ; Hypothyroidism/complications ; Hypothyroidism/diagnosis* ; Kidney Failure, Chronic/blood ; Kidney Failure, Chronic/complications* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory/methods* ; Regression Analysis ; Systole ; Thyrotropin/metabolism
Subclinical hypothyroidism ; Continuous ambulatory peritoneal dialysis ; Left ventricular dysfunction
BACKGROUND: Despite the high prevalence of subclinical hypothyroidism in patients with chronic kidney disease, little is known about the clinical features and implications of this disorder in end-stage renal disease patients. This study aimed to investigate the clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: This is a cross-sectional study with 51 stable patients who were maintained on CAPD for more than 3 months. A thyroid function test with blood sampling and echocardiography were conducted. Subclinical hypothyroidism was defined as a thyrotropin (TSH) level over 5 mIU/l and normal free T(4). RESULTS: Of the 51 patients, subclinical hypothyroidism was detected in 14 (27.5%). Among those with subclinical hypothyroidism, only 4 (28.6%) patients had autoimmune thyroiditis. Patients with subclinical hypothyroidism had lower left ventricular ejection fractions (LVEF; 61.5 vs. 70.0%, p = 0.002) and lower fractional shortening at endocardial levels (endoFS; 33.9 vs. 40.0%, p = 0.009) compared to those with normal TSH levels. In addition, logTSH was inversely associated with LVEF (r = -0.361, p = 0.009) and endoFS (r = -0.320, p = 0.022). In a multivariate linear regression, adjusted for age, diabetes, previous coronary artery disease and logCRP (C-reactive protein), logTSH was an independent correlate with LVEF (beta = -0.388, p < 0.001). CONCLUSION: This study suggests that subclinical hypothyroidism is common and might be implicated in cardiac dysfunction in CAPD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kang, Ea Wha(강이화)
Nam, Ju Young(남주영)
Shin, Sug Kyun(신석균)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Han, Dae Suk(한대석)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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