PREVALENCE OF ENDOCRINE DISORDERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE VD
Goal. To study the structure and prevalence of endocrine disorders (thyroid dysfunction, hyperprolactinemia) in patients with CKD VD.
Materials and methods. 118 patients with stage CKD treated hemodialysis (HD) or peritoneal dialysis (PD) were included in the prospective cohort study. Serum levels of thyroid-stimulating hormone (TSH), T4 (thyroxine free), T3 (triiodothyronine free) and prolactin (PL) were determined in all patients (98 on HD and 20 patients on PD). Ultrasound examination of the thyroid gland was performed in 92 patients with HD and 19 patients with PD.
Results and discussion. The proportion of patients with hypothyroidism was 23.7%. At the same time, overt hypothyroidism was diagnosed in 21 people (17.8%) and in 7 people (5.9%) subclinical hypothyroidism. The prevalence of hypothyroidism in our observation exceeds the prevalence of hypothyroidism in the general population in Ukraine – 6.4%. The syndrome of “low” T3 (low level of T3 in normal TSH, T4) was found in 29 patients (24.6%). The level of serum PL was elevated in 93 (78.8%) patients and did not differ from normal values in 25 (21.2%). The ultrasound changes of the thyroid gland were diagnosed from 111 examined in 81 patients (73%). According to the signs of ultrasound of the thyroid gland, 29 patients (26.1%) had signs of thyroiditis, 37 (33.3%) – single-nodular goiter, 44 (39.6%) – multi-nodular goiter. There was no statistically significant difference in the prevalence of ultrasound changes in HD patients and PD patients (χ2 1.8, p> 0.05).
Conclusions. Endocrine disorders, including hypothyroidism, low T3 syndrome, and hyperprolactinemia, are common in patients receiving renal replacement therapy and require further study.
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