To investigate the thyroid hormonal changes and their mechanisms in patients with chronic renal failure (CRF), the author measured serum levels of the thyroid hormones using radioimmunoassay and calculated each ratio of serum thyroid hormones in 17 patients with CRF. Ten patients were on hemodialysis therapy and seven patients had not undergone hemodialysis.
The following results were obtained.
1) The serum T3 and T4 concentrations were significantly lower in patients with CRF(0.7± 0.47 ㎍/l and 5.53± 2.95㎍/dl, respectively) than in normal subjects(1.21± 0.18㎍/l and 9.46± 1.92 ㎍/dl, respectively).
2) The serum FT4(free T4) concentration was significantly lower in patients with CRF(1.20± 0.50μu/ml) than in normal subjects(1.71± 0.27μu/ml).
3) The serum TSH level in patients with CRF(1.97± 1.58μu/ml) was significantly greater than in normal subjects(1.01± 0.48μu/ ml).
4) The serum rT3(reverse T3) concentration in patients with CRF(285.7± 148.1pg/ml) tends to be greater than normal subjects(204.6± 43.3pg/ml). But it was not significant statistically.
5) The calculated serum concentration ratio of T3/T4 in patients with CRF(0.17± 0.04： presented as Mean± SEM) did not differ significantly from that of normal subjects(0.13± 0.01). But the serum concentration ratio of rT3/T4 in patients with CRF(78.78± 18.98) was signicantly greater than in normal subjects(21.90± 1.04).
6) There was no significant difference in thyroid functions between male and female patients with CRF, and also between patients on hemodialysis and non-dialyzed uremic patients.
It was concluded that the serum T3, T4, FT4 concentations were significantly decreased in patients with CRF, while the serum TSH concentration was significantly increased. The calculated serum concentration ratio of rT3/T4 was also significantly increased in patients with CRF. Thus it appears that abnormalities found in patients with CRF may reflect both the possible intrathyroidal abnormalities and alteration of serum rT3 metabolism with increased peripheral generation of rT3 from T4.
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