Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients

Ea Wha Kang, Ju Young Nam, Tae Hyun Yoo, Suk Kyun Shin, Shin Wook Kang, Dae Suk Han, Seung Hyeok Han

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Abstract

Background: Despite the high prevalence of subclinical hypothyroidism in patients with chronic kidney disease, little is known about the clinical features and implications of this disorder in end-stage renal disease patients. This study aimed to investigate the clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: This is a cross-sectional study with 51 stable patients who were maintained on CAPD for more than 3 months. A thyroid function test with blood sampling and echocardiography were conducted. Subclinical hypothyroidism was defined as a thyrotropin (TSH) level over 5 mIU/l and normal free T4. Results: Of the 51 patients, subclinical hypothyroidism was detected in 14 (27.5%). Among those with subclinical hypothyroidism, only 4 (28.6%) patients had autoimmune thyroiditis. Patients with subclinical hypothyroidism had lower left ventricular ejection fractions (LVEF; 61.5 vs. 70.0%, p = 0.002) and lower fractional shortening at endocardial levels (endoFS; 33.9 vs. 40.0%, p = 0.009) compared to those with normal TSH levels. In addition, logTSH was inversely associated with LVEF (r = -0.361, p = 0.009) and endoFS (r = -0.320, p = 0.022). In a multivariate linear regression, adjusted for age, diabetes, previous coronary artery disease and logCRP (C-reactive protein), logTSH was an independent correlate with LVEF (β = -0.388, p < 0.001). Conclusion: This study suggests that subclinical hypothyroidism is common and might be implicated in cardiac dysfunction in CAPD patients.

Original languageEnglish
Pages (from-to)908-913
Number of pages6
JournalAmerican Journal of Nephrology
Volume28
Issue number6
DOIs
Publication statusPublished - 2008 Oct 1

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Continuous Ambulatory Peritoneal Dialysis
Hypothyroidism
Thyroid Function Tests
Autoimmune Thyroiditis
Thyrotropin
Chronic Renal Insufficiency
Stroke Volume
C-Reactive Protein
Chronic Kidney Failure
Echocardiography
Coronary Artery Disease
Linear Models
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

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title = "Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients",
abstract = "Background: Despite the high prevalence of subclinical hypothyroidism in patients with chronic kidney disease, little is known about the clinical features and implications of this disorder in end-stage renal disease patients. This study aimed to investigate the clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: This is a cross-sectional study with 51 stable patients who were maintained on CAPD for more than 3 months. A thyroid function test with blood sampling and echocardiography were conducted. Subclinical hypothyroidism was defined as a thyrotropin (TSH) level over 5 mIU/l and normal free T4. Results: Of the 51 patients, subclinical hypothyroidism was detected in 14 (27.5{\%}). Among those with subclinical hypothyroidism, only 4 (28.6{\%}) patients had autoimmune thyroiditis. Patients with subclinical hypothyroidism had lower left ventricular ejection fractions (LVEF; 61.5 vs. 70.0{\%}, p = 0.002) and lower fractional shortening at endocardial levels (endoFS; 33.9 vs. 40.0{\%}, p = 0.009) compared to those with normal TSH levels. In addition, logTSH was inversely associated with LVEF (r = -0.361, p = 0.009) and endoFS (r = -0.320, p = 0.022). In a multivariate linear regression, adjusted for age, diabetes, previous coronary artery disease and logCRP (C-reactive protein), logTSH was an independent correlate with LVEF (β = -0.388, p < 0.001). Conclusion: This study suggests that subclinical hypothyroidism is common and might be implicated in cardiac dysfunction in CAPD patients.",
author = "Kang, {Ea Wha} and Nam, {Ju Young} and Yoo, {Tae Hyun} and Shin, {Suk Kyun} and Kang, {Shin Wook} and Han, {Dae Suk} and Han, {Seung Hyeok}",
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Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients. / Kang, Ea Wha; Nam, Ju Young; Yoo, Tae Hyun; Shin, Suk Kyun; Kang, Shin Wook; Han, Dae Suk; Han, Seung Hyeok.

In: American Journal of Nephrology, Vol. 28, No. 6, 01.10.2008, p. 908-913.

Research output: Contribution to journalArticle

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AU - Kang, Ea Wha

AU - Nam, Ju Young

AU - Yoo, Tae Hyun

AU - Shin, Suk Kyun

AU - Kang, Shin Wook

AU - Han, Dae Suk

AU - Han, Seung Hyeok

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N2 - Background: Despite the high prevalence of subclinical hypothyroidism in patients with chronic kidney disease, little is known about the clinical features and implications of this disorder in end-stage renal disease patients. This study aimed to investigate the clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: This is a cross-sectional study with 51 stable patients who were maintained on CAPD for more than 3 months. A thyroid function test with blood sampling and echocardiography were conducted. Subclinical hypothyroidism was defined as a thyrotropin (TSH) level over 5 mIU/l and normal free T4. Results: Of the 51 patients, subclinical hypothyroidism was detected in 14 (27.5%). Among those with subclinical hypothyroidism, only 4 (28.6%) patients had autoimmune thyroiditis. Patients with subclinical hypothyroidism had lower left ventricular ejection fractions (LVEF; 61.5 vs. 70.0%, p = 0.002) and lower fractional shortening at endocardial levels (endoFS; 33.9 vs. 40.0%, p = 0.009) compared to those with normal TSH levels. In addition, logTSH was inversely associated with LVEF (r = -0.361, p = 0.009) and endoFS (r = -0.320, p = 0.022). In a multivariate linear regression, adjusted for age, diabetes, previous coronary artery disease and logCRP (C-reactive protein), logTSH was an independent correlate with LVEF (β = -0.388, p < 0.001). Conclusion: This study suggests that subclinical hypothyroidism is common and might be implicated in cardiac dysfunction in CAPD patients.

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