Thyroid dysfunction in patients with end-stage renal failure on hemodialysis: the role of the autoimmune component

BACKGROUND. Thyroid dysfunction is a common complication in patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis. However, the role of the autoimmune component in these disorders remains insufficiently studied.
THE AIM: to study the features of thyroid dysfunction and the role of the autoimmune component in its development in patients with ESRD on maintenance hemodialysis.
PATIENTS AND METHODS. The study included 134 patients with ESRD on maintenance hemodialysis. All participants underwent comprehensive clinical and laboratory evaluation, including measurement of thyroid-stimulating hormone (TSH), free T3 and T4, anti-thyroid peroxidase antibodies (anti-TPO), as well as basic biochemical and hematological parameters. Statistical analysis was performed using standard comparative methods.
RESULTS. Hypothyroidism was diagnosed in 30.6 % of patients; however, elevated anti-TPO levels were found only in a quarter of them. In patients with hypothyroidism, the median anti-TPO level was significantly higher than in the euthyroid group (1.50 [0.70; 7.50] vs. 0.80 [0.30; 3.70] IU/mL, p = 0.021). Sex, age, body mass index, and renal disease etiology did not influence the development of hypothyroidism or elevated anti-TPO.
CONCLUSION. Among patients with ESRD on hemodialysis, hypothyroidism is common, while the autoimmune mechanism is present only in a subset of cases. Thyroid dysfunction is multifactorial and should be taken into account in diagnosis and management.

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