Thyroid Hormones in Hemodialyzed Patients Candidate for Renal Transplantation

Chronic renal failure (CRF) may be associated with moderate to severe alteration of thyroid hormones metabolism. Dialysis does not significantly normalize these abnormalities, but transplantation leads to improve the condition. In this study to evaluate the relationship between serum levels of thyroid hormones and transplanted kidney function first thyroid hormones were measured in 30 patients under dialysis selected for renal transplantation. The results were compared with those of 40 control individuals. After renal transplantation the patients treated with Cyclosporine, Prednisolone and Azatioprine were divided into two subgroups according to their serum levels of urea nitrogen, creatinine and kidney functions: Patients with primary graft function (group I) and patients with delayed graft function (group II). The thyroid hormones were evaluated in two groups. In hemodialyzed patients, the mean levels of measured thyroid hormones were at normal range but comparing with the control, mean levels of these hormones were low except T3 uptake (T3 UP) which was increased. No changes were observed in the levels of TSH. Ten days after graft, reduction in the serum levels of thyroid hormones were observed and elevation of T3 uptake was found in both groups. The alterations in group II were more than group I. In the 30th day after graft, changes in group I reached to normal levels and comparing with those of before operation marked improvement was noticed, but comparing with that of control the levels of FT3 TT3, TT4 and FTI were still low. In the group II the levels of TT3 and FTI were lower than that of normal and comparing with those of before operation reduction in the levels of TT4, TT3, FT3, FT4 and FTI was found. It was concluded that there is relationship between the levels of thyroid hormones and function of transplanted kidney and it is more significant in the cases of TT4 and TT3.