P1554AEFFECT OF HAEMODILUTION ON THYROID FUNCTION BEFORE AND AFTER HAEMODIALYSIS IN PATIENT WITH END-STAGE RENAL DISEASE

Abstract Background and Aims To study the factors involved in the low thyroid hormones in end - stage renal disease (ESRD), we compared thyroid function before and after hemodialysis (HD). Method The serum free thyroxine (fT4), free triiodothyronine (fT3), and thyroid - simulating hormone (TSH), thyroxine binding globulin (TBG) and thyroglobulin (Tg) levels were measured before and after HD in 12 patients with chronic glomerulonephritis (CGN, age; 48.7 ± 11.8 [mean ± SD]) and 11 patients with diabetic nephropathy (DN, age; 57.6 ± 6.5), comparing with controls (n = 13, age; 40.9 ± 11.3). Results The serum fT4, fT3 and TBG levels were low before HD but increased almost in parallel with the increase in hematocrit and albumin levels after HD in both ESRD groups. The serum TSH level was high before HD but decreased after HD and Tg level remained almost unchanged. In DN, serum fT4 levels was almost the same, but fT3 levels was lower with slightly higher TSH level, compared with CGN. Conclusion Significantly lower fT4, fT3 and TBG levels in ESRD before HD seemed to be due to hemodilution and almost corrected after HD. The TSH level was promptly normalized with elevated fT4, and Tg levels remained unchanged probably due to the balance between corrected hemodilution and rapid response to decreased TSH stimulation. It may better to evaluate thyroid function after HD in ESRD. Accelerated senile changes were suggested in DN.