nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2018-22-4-40-49nefr-516Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESДИСФУНКЦИЯ ЩИТОВИДНОЙ ЖЕЛЕЗЫ ПРИ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК: СОСТОЯНИЕ ПРОБЛЕМЫ И ПУТИ РЕШЕНИЯTHYROID DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: THE STATE OF THE PROBLEM AND THE WAYS OF SOLVINGВолковаА. Р.VolkovaA. R.

197022, Россия, Санкт-Петербург, ул. Л. Толстого, д. 6–8, корп. 11

Кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики с клиникой

Проф. Волкова Анна Ральфовна, д-р мед. наук Тел.: +7 921-334-29-63

197022, Russia, St-Petersburg, L. Tolstoy st., 6–8, build. 11

Department of the Faculty therapy

Prof. Anna R. Volkova MD, PhD, DMedSci Phone +79213342963

volkovaa@mail.ruДыгунО. Д.DygunO. D.

197022, Россия, Санкт-Петербург, ул. Л. Толстого, д. 6-8, корп. 11

Кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики с клиникой

ассистент. Тел.: +7 965-797-11-79

197022, Russia, St-Petersburg, L. Tolstoy st., 6–8, build. 11

Department of the Faculty therapy

Olga D. Dygun MD Phone +79657971179

dod.90@mail.ruЛукичевБ. Г.LukichevB. G.

197022, Россия, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54

кафедра пропедевтики внутренних болезней

Проф. Лукичев Борис Георгиевич, д-р мед. наук Тел.: +7 921-572-31-50

197022, Russia, St-Petersburg, L. Tolstoy st., 17, build. 54

MD, PhD, DMedSci Phone +7 921-572-31-50

Prof. Boris G. Lukichev MD, PhD, DMedSci Phone +7 921-572-31-50

ДораС. В.DoraS. V.

197022, Россия, Санкт-Петербург, ул. Л. Толстого, д. 6-8, корп. 11

Кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики с клиникой

Дора Светлана Владимировна, канд. мед. наук  Тел.: +7 921-319-49-73

197022, Russia, St-Petersburg, L. Tolstoy st., 6–8, build. 11

Department of the Faculty therapy

Ass. Svetlana V. Dora MD, PhD Phone +79213194973

doras2001@mail.ruГалкинаО. В.GalkinaO. V.

197022, Россия, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54.

лаборатория биохимического гомеостаза

Галкина Ольга Владимировна, канд. мед. наук Тел.: +7 921-385-52-86

197022, Russia, St-Petersburg, L. Tolstoy st., 17, build. 54

Laboratory of biochemical homeostasis of the Nephrology Scientific

Head Olga V. Galkina, MD, PhD. Phone +7 921-385-52-86

ovgalkina@mail.ruПервый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияFirst Pavlov St. Petersburg State Medical UniversityRussian FederationНаучно-исследовательский институт нефрологии Первого Санкт-Петербургского государственного медицинского университета им. акад. И.П. ПавловаРоссияResearch Institute First Pavlov St. Petersburg State Medical UniversityRussian Federation2018210720182244049Copyright © Волкова А.Р., Дыгун О.Д., Лукичев Б.Г., Дора С.В., Галкина О.В., 20182018Волкова А.Р., Дыгун О.Д., Лукичев Б.Г., Дора С.В., Галкина О.В.Volkova A.R., Dygun O.D., Lukichev B.G., Dora S.V., Galkina O.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/516

Нарушение функционального состояния щитовидной железы часто выявляется у больных различных профилей. Особенностью пациентов с патологией почек является более высокая  встречаемость различных нарушений функции щитовидной железы, особенно гипотиреоза.  Известно, что у пациентов с хронической болезнью почек (ХБП) нарушено выведение йода  из организма, так как в норме 90% йода выводится с мочой. Накопление высоких  концентраций неорганического йода приводит к формированию эффекта Вольфа–Чайкова:  подавлению органификации йода в щитовидной железе и нарушению синтеза гормонов  щитовидной железы. Нарушается также периферический метаболизм тиреоидных гормонов,  а именно, подавляется активность дейодиназы I типа и угнетается периферическая  конверсия Т4 в Т3 (так называемый синдром низкого Т3). Поэтому у больных с ХБП часто  выявляют гипотиреоз, и происхождение гипотиреоза не всегда связано с исходом  аутоиммунного тиреоидита. В статье представлен обзор большого количества  популяционных исследований по изучению дисфункции щитовидной железы у больных с  ХБП, а также данные экспериментальных работ, уточняющие патогенетические механизмы  дисфункции щитовидной железы у больных с ХБП. Лечебная тактика до сих пор не  регламентирована. Однако в ряде исследований заместительная терапия тиреоидными гормонами у больных с ХБП имела некоторые преимущества.

Disturbance of the thyroid function is often detected in patients with different profiles. A special feature of patients with chronic kidney  disease is the higher incidence of various thyroid function  disturbances, especially hypothyroidism. It is known that in patients  with chronic kidney disease (CKD) iodine excretion from the body is  violated, since normally 90% of iodine is excreted in urine.  Accumulation of high concentrations of inorganic iodine leads to the  formation of the Wolf-Chaikoff effect: suppression of iodine  organization in the thyroid gland and disruption of the thyroid  hormones synthesis. Peripheral metabolism of thyroid hormones is  also disturbed, namely, deiodinase type I activity is suppressed and  peripheral conversion of T4 into T3 is inhibited (so-called low T3  syndrome). Therefore, patients with CKD are often diagnosed with  hypothyroidism, and the origin of hypothyroidism is not always  associated with the outcome of autoimmune thyroiditis. The article  presents an overview of a large number of population studies of  thyroid gland dysfunction in patients with CKD, as well as  experimental data specifying the pathogenetic mechanisms of  thyroid dysfunction in patients with CKD. Therapeutic tactics are still  not regulated. However, in a number of studies, replacement therapy with thyroid hormones in patients with CKD had some advantages.

щитовидная железахроническая болезнь почекгипотиреозтиреотропный гормон гипофизаскорость клубочковой фильтрацииthyroid glandchronic kidney diseasehypothyroidismpituitary thyroid-stimulating hormoneglomerular filtration rateReferencesDuntas LH, Biondi B. New insights into subclinical hypothyroidism and cardiovascular risk. Semin Thromb Hemost 2011; 37:27–34. doi:10.1055/s-0030-1270068Duntas LH, Biondi B. New insights into subclinical hypothyroidism and cardiovascular risk. Semin Thromb Hemost 2011; 37:27–34. doi:10.1055/s-0030-1270068Смирнов АВ, Шилов ЕМ, Добронравов ВА и др. Национальные рекомендации. Хроническая болезнь почек: основные принципы скрининга, диагностики, профилактики и подходы к лечению. Клиническая нефрология 2012:4–26. [Smirnov AV, Shilov EM, Dobronravov VA i dr. National recommendations. Chronic kidney disease: the basic principles of screening, diagnosis, prevention and treatment approaches. Clinicheskaia nefrologiia 2012:4–26]Смирнов АВ, Шилов ЕМ, Добронравов ВА и др. Национальные рекомендации. Хроническая болезнь почек: основные принципы скрининга, диагностики, профилактики и подходы к лечению. Клиническая нефрология 2012:4–26. [Smirnov AV, Shilov EM, Dobronravov VA i dr. National recommendations. Chronic kidney disease: the basic principles of screening, diagnosis, prevention and treatment approaches. Clinicheskaia nefrologiia 2012:4–26]Фадеев ВВ. По материалам клинических рекомендаций Американской ассоциации клинических эндокринологов и Американской тиреоидной ассоциации по диагностике и лечению гипотиреоза у взрослых. Клиническая и экспериментальная тиреоидология 2012;8:9–16. doi:10.4158/EP12280. GL [Fadeev VV. Based on the clinical recommendations of the American Association of Clinical Endocrinologists and the American Thyroid Association for Diagnosis and Treatment of Hypothyroidism in Adults. Clinicheskaia i e`ksperimental`naia tireoidologiia 2012;8:9–16. doi:10.4158/EP12280.GL]Фадеев ВВ. По материалам клинических рекомендаций Американской ассоциации клинических эндокринологов и Американской тиреоидной ассоциации по диагностике и лечению гипотиреоза у взрослых. Клиническая и экспериментальная тиреоидология 2012;8:9–16. doi:10.4158/EP12280. GL [Fadeev VV. Based on the clinical recommendations of the American Association of Clinical Endocrinologists and the American Thyroid Association for Diagnosis and Treatment of Hypothyroidism in Adults. Clinicheskaia i e`ksperimental`naia tireoidologiia 2012;8:9–16. doi:10.4158/EP12280.GL]Сазонова ЕГ, Мохорт ТВ. Тиреоидная функция при сахарном диабете, осложненном хронической болезнью почек. Международный эндокринологический журнал 2013;50:62–67. [Sazonova EG, Mohort TV. Thyroid function in diabetes mellitus complicated by chronic kidney disease. Mezhdunarodny`i` e`ndokrinologicheskii` zhurnal 2013;50:62–67]Сазонова ЕГ, Мохорт ТВ. Тиреоидная функция при сахарном диабете, осложненном хронической болезнью почек. Международный эндокринологический журнал 2013;50:62–67. [Sazonova EG, Mohort TV. Thyroid function in diabetes mellitus complicated by chronic kidney disease. Mezhdunarodny`i` e`ndokrinologicheskii` zhurnal 2013;50:62–67]Орлова ММ, Родионова ТИ. Состояние функции почек у пациентов с гипотиреозом (обзор). Медицинский альманах 2013:112–114. [Orlova MM, Rodionova TI. Kidney function in patients with hypothyroidism (review). Meditcinskii` al`manakh 2013:112-114]Орлова ММ, Родионова ТИ. Состояние функции почек у пациентов с гипотиреозом (обзор). Медицинский альманах 2013:112–114. [Orlova MM, Rodionova TI. Kidney function in patients with hypothyroidism (review). Meditcinskii` al`manakh 2013:112-114]Schultheiss UT, Daya N, Grams ME et al. Thyroid function, reduced kidney function and incident chronic kidney disease in a community-based population: the Atherosclerosis Risk in Communities study. Nephrol Dial Transplant 2017;32:1874–1881. doi:10.1093/ndt/gfw301Schultheiss UT, Daya N, Grams ME et al. Thyroid function, reduced kidney function and incident chronic kidney disease in a community-based population: the Atherosclerosis Risk in Communities study. Nephrol Dial Transplant 2017;32:1874–1881. doi:10.1093/ndt/gfw301Åsvold BO, Bjøro T, Vatten LJ. Association of thyroid function with estimated glomerular filtration rate in a population-based study: The HUNT study. Eur J Endocrinol 2011;164:101– 105. doi:10.1530/EJE-10-0705Åsvold BO, Bjøro T, Vatten LJ. Association of thyroid function with estimated glomerular filtration rate in a population-based study: The HUNT study. Eur J Endocrinol 2011;164:101– 105. doi:10.1530/EJE-10-0705Inoue K, Tsujimoto T, Saito J et al. Association Between Serum Thyrotropin Levels and Mortality Among Euthyroid Adults in the United States. Thyroid 2016;26:thy.2016.0156. doi:10.1089/thy.2016.0156Inoue K, Tsujimoto T, Saito J et al. Association Between Serum Thyrotropin Levels and Mortality Among Euthyroid Adults in the United States. Thyroid 2016;26:thy.2016.0156. doi:10.1089/thy.2016.0156Meuwese CL, Gussekloo J, de Craen AJ et al. Thyroid status and renal function in older persons in the general population. J Clin Endocrinol Metab 2014;99:2689–2696. doi:10.1210/jc.2013-3778Meuwese CL, Gussekloo J, de Craen AJ et al. Thyroid status and renal function in older persons in the general population. J Clin Endocrinol Metab 2014;99:2689–2696. doi:10.1210/jc.2013-3778Lo JC, Chertow GM, Go AS et al. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int 2005;67:1047–1052. doi:10.1111/j.1523-1755.2005.00169.xLo JC, Chertow GM, Go AS et al. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int 2005;67:1047–1052. doi:10.1111/j.1523-1755.2005.00169.xChonchol M, Lippi G, Salvagno G et al. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol 2008;3:1296–1300. doi:10.2215/CJN.00800208Chonchol M, Lippi G, Salvagno G et al. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol 2008;3:1296–1300. doi:10.2215/CJN.00800208Chandra A. Prevalence of hypothyroidism in patients with chronic kidney disease: a cross-sectional study from North India. Kidney Res Clin Pract 2016;35:165–168. doi:10.1016/j.krcp.2016.06.003Chandra A. Prevalence of hypothyroidism in patients with chronic kidney disease: a cross-sectional study from North India. Kidney Res Clin Pract 2016;35:165–168. doi:10.1016/j.krcp.2016.06.003Chaker L, Sedaghat S, Hoorn EJ et al. The association of thyroid function and the risk of kidney function decline: a population- based cohort study. Eur J Endocrinol 2016;175:653– 660. doi:10.1530/EJE-16-0537Chaker L, Sedaghat S, Hoorn EJ et al. The association of thyroid function and the risk of kidney function decline: a population- based cohort study. Eur J Endocrinol 2016;175:653– 660. doi:10.1530/EJE-16-0537Rhee CM, Ravel VA, Streja E et al. Thyroid Functional Disease and Mortality in a National Peritoneal Dialysis Cohort. J Clin Endocrinol Metab 2016;101:4054–4061. doi:10.1210/jc.2016-1691Rhee CM, Ravel VA, Streja E et al. Thyroid Functional Disease and Mortality in a National Peritoneal Dialysis Cohort. J Clin Endocrinol Metab 2016;101:4054–4061. doi:10.1210/jc.2016-1691Rhee CM, Kalantar-Zadeh K, Streja E et al. The relationship between thyroid function and estimated glomerular filtration rate in patients with chronic kidney disease. Nephrol Dial Transplant 2015;30:282–287. doi:10.1093/ndt/gfu303Rhee CM, Kalantar-Zadeh K, Streja E et al. The relationship between thyroid function and estimated glomerular filtration rate in patients with chronic kidney disease. Nephrol Dial Transplant 2015;30:282–287. doi:10.1093/ndt/gfu303Chuang M-H, Liao K-M, Hung Y-M et al. Abnormal Thyroid-Stimulating Hormone and Chronic Kidney Disease in Elderly Adults in Taipei City. J Am Geriatr Soc 2016;64:1267–1273. doi:10.1111/jgs.14102Chuang M-H, Liao K-M, Hung Y-M et al. Abnormal Thyroid-Stimulating Hormone and Chronic Kidney Disease in Elderly Adults in Taipei City. J Am Geriatr Soc 2016;64:1267–1273. doi:10.1111/jgs.14102Chuang M-H, Liao K-M, Hung Y-M et al. Association of TSH Elevation with All-Cause Mortality in Elderly Patients with Chronic Kidney Disease. PLoS One 2017;12:e0168611. doi:10.1371/journal.pone.0168611Chuang M-H, Liao K-M, Hung Y-M et al. Association of TSH Elevation with All-Cause Mortality in Elderly Patients with Chronic Kidney Disease. PLoS One 2017;12:e0168611. doi:10.1371/journal.pone.0168611Lee DY, Jee JH, Jun JE et al. The effect of TSH change per year on the risk of incident chronic kidney disease in euthyroid subjects. Endocrine 2017;55:503–512. doi:10.1007/s12020-016-1138-8Lee DY, Jee JH, Jun JE et al. The effect of TSH change per year on the risk of incident chronic kidney disease in euthyroid subjects. Endocrine 2017;55:503–512. doi:10.1007/s12020-016-1138-8Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med 2001; 344:501–509. doi:10.1056/NEJM200102153440707Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med 2001; 344:501–509. doi:10.1056/NEJM200102153440707Klein I, Danzi S. Thyroid Disease and the Heart. Curr Probl Cardiol 2016;41:65–92. doi:10.1016/j.cpcardiol.2015.04.002Klein I, Danzi S. Thyroid Disease and the Heart. Curr Probl Cardiol 2016;41:65–92. doi:10.1016/j.cpcardiol.2015.04.002Cini G, Carpi A, Mechanick J et al. Thyroid hormones and the cardiovascular system: pathophysiology and interventions. Biomed Pharmacother 2009;63:742–753. doi:10.1016/j.biopha.2009.08.003Cini G, Carpi A, Mechanick J et al. Thyroid hormones and the cardiovascular system: pathophysiology and interventions. Biomed Pharmacother 2009;63:742–753. doi:10.1016/j.biopha.2009.08.003Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116:1725–1735. doi:10.1161/CIRCULATIONAHA.106.678326Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116:1725–1735. doi:10.1161/CIRCULATIONAHA.106.678326Koch CA, Chrousos GP. Overview of Endocrine Hypertension. In: De Groot LJ, Chrousos G, Dungan K et al. Endotext. South Dartmouth (MA): 2000Koch CA, Chrousos GP. Overview of Endocrine Hypertension. In: De Groot LJ, Chrousos G, Dungan K et al. Endotext. South Dartmouth (MA): 2000Danzi S, Klein I. Thyroid hormone and blood pressure regulation. Curr Hypertens Rep 2003;5:513–520Danzi S, Klein I. Thyroid hormone and blood pressure regulation. Curr Hypertens Rep 2003;5:513–520Kotsis V, Alevizaki M, Stabouli S et al. Hypertension and hypothyroidism: results from an ambulatory blood pressure monitoring study. J Hypertens 2007;25:993–999. doi:10.1097/HJH.0b013e328082e2ffKotsis V, Alevizaki M, Stabouli S et al. Hypertension and hypothyroidism: results from an ambulatory blood pressure monitoring study. J Hypertens 2007;25:993–999. doi:10.1097/HJH.0b013e328082e2ffStabouli S, Papakatsika S, Kotsis V. Hypothyroidism and hypertension. Expert Rev Cardiovasc Ther 2010;8:1559–1565. doi:10.1586/erc.10.141Stabouli S, Papakatsika S, Kotsis V. Hypothyroidism and hypertension. Expert Rev Cardiovasc Ther 2010;8:1559–1565. doi:10.1586/erc.10.141Vargas F, Moreno JM, Rodriguez-Gomez I et al. Vascular and renal function in experimental thyroid disorders. Eur J Endocrinol 2006;154:197–212. doi:10.1530/eje.1.02093Vargas F, Moreno JM, Rodriguez-Gomez I et al. Vascular and renal function in experimental thyroid disorders. Eur J Endocrinol 2006;154:197–212. doi:10.1530/eje.1.02093Ichihara A, Kobori H, Miyashita Y et al. Differential effects of thyroid hormone on renin secretion, content, and mRNA in juxtaglomerular cells. Am J Physiol 1998;274: E224-31Ichihara A, Kobori H, Miyashita Y et al. Differential effects of thyroid hormone on renin secretion, content, and mRNA in juxtaglomerular cells. Am J Physiol 1998;274: E224-31Vargas F, Rodriguez-Gomez I, Vargas-Tendero P et al. The renin-angiotensin system in thyroid disorders and its role in cardiovascular and renal manifestations. J Endocrinol 2012; 213: 25–36. doi:10.1530/JOE-11-0349Vargas F, Rodriguez-Gomez I, Vargas-Tendero P et al. The renin-angiotensin system in thyroid disorders and its role in cardiovascular and renal manifestations. J Endocrinol 2012; 213: 25–36. doi:10.1530/JOE-11-0349van Hoek I, Daminet S. Interactions between thyroid and kidney function in pathological conditions of these organ systems: a review. Gen Comp Endocrinol 2009; 160:205–215. doi:10.1016/j.ygcen.2008.12.008van Hoek I, Daminet S. Interactions between thyroid and kidney function in pathological conditions of these organ systems: a review. Gen Comp Endocrinol 2009; 160:205–215. doi:10.1016/j.ygcen.2008.12.008Barlet C, Doucet A. Lack of stimulation of kidney Na-KATPase by thyroid hormones in long-term thyroidectomized rabbits. Pflugers Arch 1986;407:428–431Barlet C, Doucet A. Lack of stimulation of kidney Na-KATPase by thyroid hormones in long-term thyroidectomized rabbits. Pflugers Arch 1986;407:428–431Zimmerman RS, Ryan J, Edwards BS et al. Cardiorenal endocrine dynamics during volume expansion in hypothyroid dogs. Am J Physiol 1988;255:R61-6. doi:10.1152/ajpregu.1988.255.1.R61Zimmerman RS, Ryan J, Edwards BS et al. Cardiorenal endocrine dynamics during volume expansion in hypothyroid dogs. Am J Physiol 1988;255:R61-6. doi:10.1152/ajpregu.1988.255.1.R61Singer MA. Of mice and men and elephants: metabolic rate sets glomerular filtration rate. Am J Kidney Dis 2001;37:164–178Singer MA. Of mice and men and elephants: metabolic rate sets glomerular filtration rate. Am J Kidney Dis 2001;37:164–178Schmid C, Brandle M, Zwimpfer C et al. Effect of thyroxine replacement on creatinine, insulin-like growth factor 1, acidlabile subunit, and vascular endothelial growth factor. Clin Chem 2004;50:228–231. doi:10.1373/clinchem.2003.021022Schmid C, Brandle M, Zwimpfer C et al. Effect of thyroxine replacement on creatinine, insulin-like growth factor 1, acidlabile subunit, and vascular endothelial growth factor. Clin Chem 2004;50:228–231. doi:10.1373/clinchem.2003.021022Sato Y, Nakamura R, Satoh M et al. Thyroid hormone targets matrix Gla protein gene associated with vascular smooth muscle calcification. Circ Res 2005;97: 550–557. doi:10.1161/01.RES.0000181431.04290.bdSato Y, Nakamura R, Satoh M et al. Thyroid hormone targets matrix Gla protein gene associated with vascular smooth muscle calcification. Circ Res 2005;97: 550–557. doi:10.1161/01.RES.0000181431.04290.bdSuher M, Koc E, Ata N et al. Relation of thyroid disfunction, thyroid autoantibodies, and renal function. Ren Fail 2005;27:739–742Suher M, Koc E, Ata N et al. Relation of thyroid disfunction, thyroid autoantibodies, and renal function. Ren Fail 2005;27:739–742Michael UF, Barenberg RL, Chavez R et al. Renal handling of sodium and water in the hypothyroid rat. Clearance and micropuncture studies. J Clin Invest 1972;51:1405–1412. doi:10.1172/JCI106936Michael UF, Barenberg RL, Chavez R et al. Renal handling of sodium and water in the hypothyroid rat. Clearance and micropuncture studies. J Clin Invest 1972;51:1405–1412. doi:10.1172/JCI106936Hanna FW, Scanlon MF. Hyponatraemia, hypothyroidism, and role of arginine- vasopressin. Lancet (London, England) 1997;350:755–756. doi:10.1016/S0140-6736(05)62563-9Hanna FW, Scanlon MF. Hyponatraemia, hypothyroidism, and role of arginine- vasopressin. Lancet (London, England) 1997;350:755–756. doi:10.1016/S0140-6736(05)62563-9Montenegro J, Gonzalez O, Saracho R et al. Changes in renal function in primary hypothyroidism. Am J Kidney Dis 1996;27:195–198Montenegro J, Gonzalez O, Saracho R et al. Changes in renal function in primary hypothyroidism. Am J Kidney Dis 1996;27:195–198Sato K, Okamura K, Yoshinari M et al. Reversible primary hypothyroidism and elevated serum iodine level in patients with renal dysfunction. Acta Endocrinol (Copenh) 1992;126:253–259Sato K, Okamura K, Yoshinari M et al. Reversible primary hypothyroidism and elevated serum iodine level in patients with renal dysfunction. Acta Endocrinol (Copenh) 1992;126:253–259Gardner DF, Mars DR, Thomas RG et al. Iodine retention and thyroid dysfunction in patients on hemodialysis and continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1986;7:471–476Gardner DF, Mars DR, Thomas RG et al. Iodine retention and thyroid dysfunction in patients on hemodialysis and continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1986;7:471–476Кеттайл ВМ, Арки РА. Патофизиология эндокринной системы. BINOM Publishers 2001. 81. [Kettai`l VM, Arki RA. Patofiziologiia e`ndokrinnoi` sistemy`. BINOM Publishers 2001. 81.]Кеттайл ВМ, Арки РА. Патофизиология эндокринной системы. BINOM Publishers 2001. 81. [Kettai`l VM, Arki RA. Patofiziologiia e`ndokrinnoi` sistemy`. BINOM Publishers 2001. 81.]Beckers C, Machiels J, Soyez C et al. Metabolic clearance rate and production rate of thyroid-stimulating hormone in man. Horm Metab 1971; 3:34–36. doi:10.1055/s-0028- 1095044Beckers C, Machiels J, Soyez C et al. Metabolic clearance rate and production rate of thyroid-stimulating hormone in man. Horm Metab 1971; 3:34–36. doi:10.1055/s-0028- 1095044Bartalena L, Pacchiarotti A, Palla R et al. Lack of nocturnal serum thyrotropin (TSH) surge in patients with chronic renal failure undergoing regular maintenance hemofiltration: a case of central hypothyroidism. Clin Nephrol 1990; 34:30–34Bartalena L, Pacchiarotti A, Palla R et al. Lack of nocturnal serum thyrotropin (TSH) surge in patients with chronic renal failure undergoing regular maintenance hemofiltration: a case of central hypothyroidism. Clin Nephrol 1990; 34:30–34Medri G, Carella C, Padmanabhan V et al. Pituitary glycoprotein hormones in chronic renal failure: evidence for an uncontrolled alpha-subunit release. J Endocrinol Invest 1993; 16: 169–174. doi:10.1007/BF03344939Medri G, Carella C, Padmanabhan V et al. Pituitary glycoprotein hormones in chronic renal failure: evidence for an uncontrolled alpha-subunit release. J Endocrinol Invest 1993; 16: 169–174. doi:10.1007/BF03344939Kaptein EM, Feinstein EI, Nicoloff JT et al. Serum reverse triiodothyronine and thyroxine kinetics in patients with chronic renal failure. J Clin Endocrinol Metab 1983; 57: 181–189. doi:10.1210/jcem-57-1-181Kaptein EM, Feinstein EI, Nicoloff JT et al. Serum reverse triiodothyronine and thyroxine kinetics in patients with chronic renal failure. J Clin Endocrinol Metab 1983; 57: 181–189. doi:10.1210/jcem-57-1-181Hershman JM, Krugman LG, Kopple JD et al. Thyroid function in patients undergoing maintenance hemodialysis: unexplained low serum thyroxine concentration. Metabolism 1978;27:755–759Hershman JM, Krugman LG, Kopple JD et al. Thyroid function in patients undergoing maintenance hemodialysis: unexplained low serum thyroxine concentration. Metabolism 1978;27:755–759Faber J, Heaf J, Kirkegaard C et al. Simultaneous turnover studies of thyroxine, 3,5,3’ and 3,3’,5’-triiodothyronine, 3,5-, 3,3’-, and 3’,5’- diiodothyronine, and 3’-monoiodothyronine in chronic renal failure. J Clin Endocrinol Metab 1983; 56: 211–217. doi:10.1210/jcem-56-2-211Faber J, Heaf J, Kirkegaard C et al. Simultaneous turnover studies of thyroxine, 3,5,3’ and 3,3’,5’-triiodothyronine, 3,5-, 3,3’-, and 3’,5’- diiodothyronine, and 3’-monoiodothyronine in chronic renal failure. J Clin Endocrinol Metab 1983; 56: 211–217. doi:10.1210/jcem-56-2-211Kaptein EM, Quion-Verde H, Chooljian CJ, et al. The thyroid in end-stage renal disease. Medicine (Baltimore) 1988; 67:187–197Kaptein EM, Quion-Verde H, Chooljian CJ, et al. The thyroid in end-stage renal disease. Medicine (Baltimore) 1988; 67:187–197Lim VS, Fang VS, Katz AI et al. Thyroid dysfunction in chronic renal failure. A study of the pituitary-thyroid axis and peripheral turnover kinetics of thyroxine and triiodothyronine. J Clin Invest 1977;60: 522–534. doi:10.1172/JCI108804Lim VS, Fang VS, Katz AI et al. Thyroid dysfunction in chronic renal failure. A study of the pituitary-thyroid axis and peripheral turnover kinetics of thyroxine and triiodothyronine. J Clin Invest 1977;60: 522–534. doi:10.1172/JCI108804Wartofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the ‘euthyroid sick syndrome’. Endocr Rev 1982;3:164–217. doi:10.1210/edrv-3-2-164Wartofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the ‘euthyroid sick syndrome’. Endocr Rev 1982;3:164–217. doi:10.1210/edrv-3-2-164Kaptein EM. Thyroid hormone metabolism and thyroid diseases in chronic renal failure. Endocr Rev 1996;17:45–63. doi:10.1210/edrv-17-1-45Kaptein EM. Thyroid hormone metabolism and thyroid diseases in chronic renal failure. Endocr Rev 1996;17:45–63. doi:10.1210/edrv-17-1-45US Renal Data System 1994 annual data report, the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney diseases, Bethesda, MD. Am J kidney Dis 1994;24 (suppl.: S12–94).US Renal Data System 1994 annual data report, the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney diseases, Bethesda, MD. Am J kidney Dis 1994;24 (suppl.: S12–94).Namba H, Yamashita S, Kimura H et al. Evidence of thyroid volume increase in normal subjects receiving excess iodide. J Clin Endocrinol Metab 1993; 76: 605–608. doi:10.1210/jcem.76.3.8445017Namba H, Yamashita S, Kimura H et al. Evidence of thyroid volume increase in normal subjects receiving excess iodide. J Clin Endocrinol Metab 1993; 76: 605–608. doi:10.1210/jcem.76.3.8445017Konno N, Makita H, Yuri K et al. Association between dietary iodine intake and prevalence of subclinical hypothyroidism in the coastal regions of Japan. J Clin Endocrinol Metab 1994; 78: 393–397. doi:10.1210/jcem.78.2.8106628Konno N, Makita H, Yuri K et al. Association between dietary iodine intake and prevalence of subclinical hypothyroidism in the coastal regions of Japan. J Clin Endocrinol Metab 1994; 78: 393–397. doi:10.1210/jcem.78.2.8106628Kantor AF, Hoover RN, Kinlen LJ et al. Cancer in patients receiving long-term dialysis treatment. Am J Epidemiol 1987; 126: 370–376Kantor AF, Hoover RN, Kinlen LJ et al. Cancer in patients receiving long-term dialysis treatment. Am J Epidemiol 1987; 126: 370–376Penn I. The effect of immunosuppression on pre-existing cancers. Transplantation 1993; 55: 742–747Penn I. The effect of immunosuppression on pre-existing cancers. Transplantation 1993; 55: 742–747Schneider AB. Carcinoma of follicular epithelium. In: Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text. 1991. 1121–1129Schneider AB. Carcinoma of follicular epithelium. In: Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text. 1991. 1121–1129Brunner FP, Landais P, Selwood NH. Malignancies after renal transplantation: the EDTA- ERA registry experience. European Dialysis and Transplantation Association-European Renal Association. Nephrol Dial Transplant 1995;10 Suppl 1:74–80Brunner FP, Landais P, Selwood NH. Malignancies after renal transplantation: the EDTA- ERA registry experience. European Dialysis and Transplantation Association-European Renal Association. Nephrol Dial Transplant 1995;10 Suppl 1:74–80Shin DH, Lee MJ, Kim SJ et al. Preservation of renal function by thyroid hormone replacement therapy in chronic kidney disease patients with subclinical hypothyroidism. J Clin Endocrinol Metab 2012; 97: 2732–2740. doi:10.1210/jc.2012-1663Shin DH, Lee MJ, Kim SJ et al. Preservation of renal function by thyroid hormone replacement therapy in chronic kidney disease patients with subclinical hypothyroidism. J Clin Endocrinol Metab 2012; 97: 2732–2740. doi:10.1210/jc.2012-1663den Hollander JG, Wulkan RW, Mantel MJ et al. Correlation between severity of thyroid dysfunction and renal function. Clin Endocrinol (Oxf) 2005; 62: 423–427. doi:10.1111/j.1365-2265.2005.02236.xden Hollander JG, Wulkan RW, Mantel MJ et al. Correlation between severity of thyroid dysfunction and renal function. Clin Endocrinol (Oxf) 2005; 62: 423–427. doi:10.1111/j.1365-2265.2005.02236.xHataya Y, Igarashi S, Yamashita T et al. Thyroid hormone replacement therapy for primary hypothyroidism leads to significant improvement of renal function in chronic kidney disease patients. Clin Exp Nephrol 2013;17:525–531. doi:10.1007/s10157-012-0727-yHataya Y, Igarashi S, Yamashita T et al. Thyroid hormone replacement therapy for primary hypothyroidism leads to significant improvement of renal function in chronic kidney disease patients. Clin Exp Nephrol 2013;17:525–531. doi:10.1007/s10157-012-0727-y

The authors declare that there are no conflicts of interest present.