Abstract
Thyroid function was evaluated in a group of 36 patients with acute renal failure (ARF) during the oliguric/anuric, polyuric and postpolyuric phase. Serum thyroxine (T4) and triiodothyronine (T3) concentrations were significantly decreased in the oliguric/anuric phase, as compared with the mean values obtained in the postpolyuric phase and with controls.
In contrast to T3 and T4, the concentration of serum reverse triiodothyronine (rT3) was elevated in the oliguric/anuric phase and normal in the polyuric phase. The sephadex-T3-binding index (T3I) was significantly increased in oliguric/anuric patients and in the polyuric phase. The levels of serum thyreotropin were significantly elevated during all phases of ARF as compared with the controls. From the results obtained it is concluded that abnormal peripheral metabolism of T4 seems to be the primary cause of altered plasma concentrations of thyroid hormones in patients with ARF.
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Balsam, A., Eisenstein, Z., Sexton, F., Ingbar, S. H.: Studies of the peripheral metabolism of triiodothyronine and reverse triiodothyronine in the rat: a comparison of extraction and chromatographic methods of analysis.Endocrinology, 102, 1247 (1978).
Bermudez, F., Surks, M. I., Oppenheimer, J. H.: High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease.J. Clin. Endocrinol. Metab., 41, 27 (1975).
Biersack, H. J., Raabe, K., Rommelscheim, K. G., Rohner, H. G., Fuchs, H. J., Winkler, C.: Die Schilddrüsenhormone und thyreotropes Hormon (TSH) bei Leberund Niereninsuffizienz.Nucl. Med., 15, 135 (1976).
Burger, A., Nicod, P., Suter, P., Vallotton, M. B., Vagenakis, A., Braverman, L.: Reduced active thyroid hormone levels in acute illness.Lancet, 1, 653 (1976).
Carter, J. N., Eastman, C. J., Corcoran, J. M., Lazarus, M.: Effect of severe, chronic illness on thyroid function.Lancet, 2, 971 (1974).
Carter, J. N., Eastman, C. J., Corcoran, J. M., Lazarus, L.: Inhibition of conversion of thyroxine to triiodothyronine in patients with severe chronic illness.Clin. Endocrinol., 5, 587 (1976).
Chiraseveenuprapund, P., Buergi, U., Goswami, A., Rosenberg, I. N.: Conversion of 1-thyroxine to triiodothyronine in rat kidney homogenate.Endocrinology, 102, 612 (1978).
Chopra, I. J., Solomon, D. H., Chopra, U., Young, R. T., Chua Teco, C. N.: Alterations in circulating thyroid hormones and thyrotropin in hepatic cirrhosis: Evidence for euthyroidism despite subnormal serum triiodothyronine.J. Clin. Endocrinol. Metab., 39, 501 (1974).
Chopra, I. J.: A study of extrathyroidal conversion of thyroxine to 3,3′,5-triiodothyronine in vitro.Endocrinology, 101, 453 (1977).
Chopra, I. J.: An assessment of daily production and significance of thyroidal secretion of 3,3′,5′-triiodothyronine (reverse T3) in man.J. Clin. Invest., 58, 32 (1976).
Czekalski, S., Malczewska, B., Sowiński, J., Sobieszczky S., Kozak, W., Eder, M., Baczyk, K.: Serum concentration of pituitary, thyroid and gonadal hormones in nondialysed and dialysed males with chronic renal failure.Proc. Eur. Dial. Trans. Ass., 15, 599 (1978).
Czernichow, P., Dauzet, M. C., Broyer, M., Rappaport, R.: Abnormal TSH, PRL, and GH response to TSH releasing factor in chronic renal failure.J. Clin. Endocrinol. Metab., 43, 630 (1976).
Dandona, P., Newton, D., Platts, M. M.: Long-term haemodialysis and thyroid function.Brit. Med. J., 1, 134 (1977).
Finucane, J. F., Griffiths, R. S., Black, E. G., Hall, C. L.: Effects of chronic renal disease on thyroid hormone metabolism.Acta Endocrin. 84, 750 (1977).
Gavin, L. A., McMahon, F. A., Castle, J. N., Cavalieri, R. R.: Alterations in serum thyroid hormones and thyroxine-binding globulins in patients with nephrosis.J. Clin. Endocrinol. Metab., 46, 125 (1978).
Gavin, L. A., Castle, J., McMahon, F., Martin, P., Hammond, M., Cavalieri, R. R.: Extrathyroidal conversion of thyroxine to 3,5,3′-triiodothyronine (T3) in humans.J. Clin. Endocrinol. Metab., 44, 733 (1977).
Hasegawa, K., Matsushita, Y., Otomo, S., Hamada, N., Nishizawa, Y., Okamoto, T., Morii, H., Wada, M.: Abnormal response of thyrotrophin and growth hormone to thyrotrophin releasing hormone in chronic renal failure.Acta Endocrin., 79, 635 (1975).
Joasoo, A., Murray, I. P. C., Parkin, J., Robertson, M. R., Jeremy, D.: Abnormalities of in vitro thyroid function tests in renal disease.Quart. J. Med., 43, 245 (1974).
Katz, A. I., Emmanouel, D. S., Lindheimer, M. D.: Thyroid hormone and the kidney.Nephron, 15, 223 (1975).
Lim, S. V., Fang, V. S., Refetoff, S., Katz, A. I.: T3 hypothyroidism in uremia impaired T4 and T3 conversion. 6th International Congress of Nephrology, Firenze, 1975.
Neuhaus, K., Baumann, G., Walser, A., Tholen, H.: Serum thyroxine and thyroxine-binding proteins in chronic renal failure without nephrosis.J. Clin. Endocrinol. Metab., 41 395 (1975).
Nomura, S., Pittman, C. S., Chambers, J. B., Buck, M. W., Shimizu, T.: Reduced peripheral conversion of thyroxine to triiodothyronine in patients with hepatic cirrhosis.J. Clin. Invest., 56, 643 (1975).
Portnay, G. I., O'Brian, J. T., Bush, J., Vagenakis, A. G., Azizi, F., Arky, R. A., Ingbar, S. H. Braverman, L. E.: The effect of starvation on the concentration and binding of thyroxine and triiodothyronine in serum and on the response of TRH.J. Clin. Endocrinol. Metab., 39, 191 (1974).
Ramirez, G., Jubiz, W., Gutch, C. F., Kolff, W.: Thyroid function in chronic renal failure: effects of chronic hemodialysis.Trans. Amer. Soc. Artif. Int. Organs, 18, 244 (1972).
Ramirez, G., O'Neill, W., Jubiz, W., Bloomer, H. A.: Dysfunction in uremia: evidence for thyroid and hypophyseal abnormalities.Ann. Intern. Med. 84 673 (1976).
Schimmel, M., Utiger, R. D.: Thyroidal and peripheral production of thyroid hormones.Ann. Intern. Med., 87, 760 (1977).
Shapiro, B., Rabinowitz, J. L.: A chromatographic method utilizing Sephadex for the separation of free iodide, protein-bound and unbound triiodothyronine in sera. Clinical correlations with the Hamolsky T-3-RBC uptake method (108 cases).J. Nucl. Med., 3, 417 (1962).
Spector, D. A., Davis, P. J., Helderman, H. J., Bell, B., Utiger, R. D.: Thyroid function and metabolic state in chronic renal failure.Ann. Intern. Med., 85, 724 (1976).
Talwar, K. K., Sawhney, R. C., Rastogi, G. K.: Serum levels of thyrotropin, thyroid hormones and their response to thyrotropin releasing hormone in infective febrile illnesses.J. Clin. Endocrinol. Metab., 44, 398 (1977).
Wartofsky, L., Martin, D., Earll, J. M.: Alterations in thyroid iodine release and the peripheral metabolism of thyroxine during acute falciparum malaria in man.J. Clin. Invest., 51, 2215 (1972).
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Bodziony, D., Kokot, F. & Czekalski, S. Thyroid function in patients with acute renal failure. International Urology and Nephrology 13, 81–88 (1981). https://doi.org/10.1007/BF02082076
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DOI: https://doi.org/10.1007/BF02082076