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hypothyroidism in hemodialysis patients

Elliot M Silver, William Ochoa
BACKGROUND Chronic intake of high-dose corticosteroids is associated with multiple adverse clinical effects, including hypertension, insulin resistance, impaired wound healing, immunosuppression, myopathy, and osteoporosis. In cases of autoimmune disease, use of steroid-sparing treatment modalities is preferred over chronic steroid therapy to limit these side effects. Glucocorticoid-induced myopathy is a less common side effect of chronic steroid use in patients treated with <10 mg/day of prednisone. However, doses exceeding 40-60 mg/day can induce clinically significant myopathy and weakness...
March 11, 2018: American Journal of Case Reports
Connie M Rhee, Yanjun Chen, Amy S You, Steven M Brunelli, Csaba P Kovesdy, Matthew J Budoff, Gregory A Brent, Kamyar Kalantar-Zadeh, Danh V Nguyen
BACKGROUND AND OBJECTIVES: In the general population, there is increasing recognition of the effect of thyroid function on patient-centered outcomes, including health-related quality of life and depression. Although hypothyroidism is highly prevalent in hemodialysis patients, it is unknown whether thyroid status is a risk factor for impaired health-related quality of life or mental health in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined the association of thyroid status, defined by serum thyrotropin, with health-related quality of life and depressive symptoms over time in a prospective cohort of 450 patients on hemodialysis from 17 outpatient dialysis facilities from May of 2013 to May of 2015 who underwent protocolized thyrotropin testing, Short-Form 36 surveys, and Beck Depression Inventory-II questionnaires every 6 months...
August 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
Seyedeh Azam Sajadi, Abbas Ebadi, Seyed Tayeb Moradian
BACKGROUND: Family caregivers are considered as hidden patients experiencing physical and mental disorders. This affects the quality of not only their lives but also the health care provided to patients.This study aimed to investigate the quality of life (QOL) and its related factors among the caregivers of patients undergoing hemodialysis. METHODS: This systematic review was conducted based on the eight-step guidelines presented by the York University. The databases relevant to the medical field including Nursing and Allied Health, Web of Science, Scopus, Pubmed, Embase, PsycINFO and Psychology Library were used...
July 2017: International Journal of Community Based Nursing and Midwifery
Hsuan-Jen Lin, Chung-Chih Lin, Hsuan Ming Lin, Hsuan-Ju Chen, Che-Chen Lin, Chiz-Tzung Chang, Che-Yi Chou, Chiu-Ching Huang
BACKGROUND: The prevalence of hypothyroidism is high in hemodialysis (HD) patients and hypothyroidism increases all-cause mortality in HD patients. Comorbidities are common in HD patients and are associated with both mortality and hypothyroidism. The aim of the study is to explore the effect of the interactions of comorbidities and hypothyroidism on all-cause mortality in HD patients. METHOD: Patients with hypothyroidism (ICD-9-CM 244.0, 244.1, and 244.9) and matched patients without hypothyroidism in the Registry for Catastrophic Illness Patient Database of Taiwan Health Insurance from 2000 to 2010 were analyzed...
March 27, 2017: Nephrology
Iwanna Dubczak, Longin Niemczyk, Zbigniew Bartoszewicz, Katarzyna Szamotulska, Marek Saracyn, Stanisław Niemczyk
Hypothyroidism in patients with renal failure (RF) causes many metabolic and clinical problems, and both these diseases can mutually exacerbate their disturbances. AIM: The aim of this study was to evaluate the effect of hypothyroidism, and end-stage renal disease (ESRD) on conversion of thyroid hormones (TH) in patients with ESRD treated with chronic hemodialysis (HD). MATERIALS AND METHODS: The study was performed in 74 patients, including 41 women (K) and 33 men (M) aged 28-83 y...
March 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Connie M Rhee, Amy S You, Danh V Nguyen, Steven M Brunelli, Matthew J Budoff, Elani Streja, Tracy Nakata, Csaba P Kovesdy, Gregory A Brent, Kamyar Kalantar-Zadeh
Context and Objective: Compared with the general population, hemodialysis patients have a substantially higher risk of hypothyroidism, as defined by an elevated serum thyrotropin (TSH) level, and cardiovascular mortality. Whereas an elevated TSH is associated with cardiovascular disease and death in the general population, associations among dialysis patients have been inconsistent. Design, Setting, Participants, and Main Outcome: We examined 541 hemodialysis patients from 17 southern California dialysis centers in the prospective Hypothyroidism, Cardiovascular Health, and Survival study who underwent protocolized measurement of repeated serum TSH levels every 6 months from 2013 to 2015...
May 1, 2017: Journal of Clinical Endocrinology and Metabolism
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Minwei Li, Glenn M Chertow
INTRODUCTION: End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function. METHODS: Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD. Among those with endogenous thyroid function (without overt hyper/hypothyroidism or thyroid hormone supplementation), we examined the association of thyroid hormone concentration with multiple parameters of self-reported health status, and physical and cognitive performance, and the effects of hemodialysis frequency on serum thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) levels...
October 2017: Hemodialysis International
Toru Sanai, Ken Okamura, Shuichi Rikitake, Makoto Fukuda, Koji Onozawa, Mai Sanematsu, Tsuyoshi Takashima, Motoaki Miyazono, Yuji Ikeda
BACKGROUND: We examined the thyroid function of non-dialysis-dependent chronic kidney disease (CKD) patients in Japan. METHODS: Serum-free thyroxine, free triiodothyronine, thyroid-stimulating hormone (TSH), and thyroglobulin (Tg) levels were evaluated in 37 CKD patients. CKD was defined as sustained kidney damage for more than 3 months and was classified as CKD 1+2 (n = 11), 3+4 (n = 10), or 5 (n = 16), which were defined by glomerular filtration rates of ≥ 60, 15 - 59, or < 15 mL/min/1...
May 2017: Clinical Nephrology
Pedro Iglesias, María Auxiliadora Bajo, Rafael Selgas, Juan José Díez
Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment...
March 2017: Reviews in Endocrine & Metabolic Disorders
Connie M Rhee, Vanessa A Ravel, Elani Streja, Rajnish Mehrotra, Steven Kim, Jiaxi Wang, Danh V Nguyen, Csaba P Kovesdy, Gregory A Brent, Kamyar Kalantar-Zadeh
CONTEXT AND OBJECTIVE: End-stage renal disease patients have a higher risk of thyroid disease compared with those without kidney disease. Although thyroid dysfunction is associated with higher death risk in the general population and those undergoing hemodialysis, little is known about the effect of thyroid disease upon mortality in patients treated with peritoneal dialysis (PD). Design, Setting, Participants, and Main Outcome: We examined the association of thyroid status, assessed by serum TSH, with all-cause mortality among PD patients from a large national dialysis organization who underwent one or more TSH measurements over 5 years (January 2007 to December 2011)...
November 2016: Journal of Clinical Endocrinology and Metabolism
Maryam Pakfetrat, Mohammad Hossein Dabbaghmanesh, Zahed Karimi, Alireza Rasekhi, Leila Malekmakan, Mohammad Hossein Nikoo
INTRODUCTION: End stage renal disease (ESRD) reasons several changes in the function of thyroid gland as; lower levels of thyroid hormones, altered hormone metabolism, and increased iodine storage. The aim of this study was to evaluate the prevalence of nodular goiter and hypothyroidism in hemodialysis (HD) patients compared with normal population. METHODS: This cross-sectional study was conducted among HD patients and healthy people as the control group for thyroid function evaluation...
January 2017: Hemodialysis International
Abbas Ali Tasneem, Asad Ali Khan, Zaigham Abbas, Nasir Hassan Luck, Syed Mujahid Hassan
OBJECTIVE: To describe the causes, characteristics and factors associated with ascites in patients on maintenance hemodialysis. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, from November 2007 to November 2014. METHODOLOGY: All patients on maintenance hemodialysis and age > 16 years with ascites were included...
May 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Mohammad Reza Abassi, Amin Safavi, Masoumeh Haghverdi, Babak Saedi
Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected...
March 2016: Acta Medica Iranica
Selma Jusufovic, Emir Hodzic
INTRODUCTION: Thyroid function disorders are common in patients with chronic kidney disease. The aim of this study was to compare thyroid function among patients on chronic hemodialysis (HD) and healthy participants and to assess duration of dialysis on thyroid disorders. MATERIAL AND METHODS: Prospective study included 80 participants divided in two groups. Study group included 40 patients on HD who were divided in two subgroups, according to time on dialysis (under and over 72 months)...
2011: Materia Socio-medica
Ana Beatriz B A Da Costa, Caio Pellizzari, Gisah A Carvalho, Beatriz C Sant'Anna, Rafaela L Montenegro, Roberto G Zammar Filho, Cleo O Mesa Junior, Patrícia R Hauck Prante, Marcia Olandoski, Mauricio Carvalho
Chronic kidney disease has been known to affect thyroid hormone metabolism. Low serum levels of T3 and T4 are the most remarkable laboratorial findings. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end-stage renal disease (ESRD). Our objective is to evaluate the prevalence of laboratorial and morphologic alterations in the thyroid gland in a cohort of patients with ESRD on hemodialysis (HD). Sixty-one patients with ESRD on HD were selected and compared with 43 healthy subjects matched by age, gender, and weight...
January 2016: Hemodialysis International
Karim Zouaghi, Lilia Ben Fatma, Saida Hajri, Rania Khedher, Madiha Krid, Wided Smaoui, Soumaya Béji, Lamia Rais, Fatma Ben Moussa
Crow-Fukase syndrome, also known as POEMS syndrome, is a rare plasma dyscrasia characterized by monoclonal gammopathy and various combinations of polyneuropathy, organomegaly, endocrinopathy and dermatological changes, and their initials stand for the acronym POEMS. Substantial kidney involvement is rarely related to this disease. Our report is about five patients suffering from the POEMS syndrome with kidney involvement that rapidly progressed to end-stage renal disease. Our report is about three females and two males with a mean age of 60...
July 2015: Saudi Journal of Kidney Diseases and Transplantation
Alma Halilcevic, Emir Hodzic, Enisa Mesic, Senaid Trnacevic
UNLABELLED: Thyroid disorders are common in chronic kidney disease. THE AIM: The purpose of this study was to compare thyroid gland disorders among healthy participants and renal transplant patients and to assess the duration of dialysis on thyroid disorders before transplantation. MATERIAL AND METHODS: Prospective study during 12 months period included 80 participants divided into two groups. Study group of 40 patients with transplanted kidney was divided in two subgroups, according to the time spent on dialysis (i...
April 2015: Materia Socio-medica
Yahya Osman Malik, Syed Mohsin Raza, Sophia Arunselvan
INTRODUCTION: The clinical syndrome of uremia is a bedside diagnosis which mimics a wide spectrum of other clinical disorders, most commonly thyroid disease. End-stage renal disease (ESRD), as a disorder, frequently alters thyroid hormone metabolism, and this is not significantly normalized by dialysis. Although the thyroid and parathyroid glands are considered independent organs, their anatomical juxtaposition in the neck, as well as sharing a common embryological origin, might play a role in some of the possible association between thyroid and parathyroid disease...
March 2015: Nephro-urology Monthly
Maurizio Bossola, Luigi Tazza
The increased frequency of cardiovascular disease observed in hemodialysis patients is secondary to the combination of many traditional (age, male sex, hypertension, smoking, diabetes mellitus, and dyslipidemia) and novel and uremia-related (inflammation, uremic toxins, adipokine imbalance, coagulation disorders, protein-energy wasting, volume overload, endothelial dysfunction, hyperparathyroidism, and subclinical hypothyroidism) risk factors. Usually, in the latter group, oxidative stress is included. However, after decades of research, it remains essentially unknown if oxidative stress has a causative role in the development of cardiovascular disease in long-term hemodialysis patients because adequate longitudinal studies are lacking...
May 2015: Seminars in Dialysis
Connie M Rhee, Steven Kim, Daniel L Gillen, Tolga Oztan, Jiaxi Wang, Rajnish Mehrotra, Sooraj Kuttykrishnan, Danh V Nguyen, Steven M Brunelli, Csaba P Kovesdy, Gregory A Brent, Kamyar Kalantar-Zadeh
CONTEXT: Hypothyroidism is a common condition that disproportionately affects hemodialysis patients. In the general population, hypothyroidism is associated with higher mortality, particularly in populations with underlying cardiovascular risk. Despite their heightened cardiovascular mortality, the impact of hypothyroidism on the survival of hemodialysis patients remains uncertain. OBJECTIVE: To examine whether hypothyroidism is independently associated with higher mortality in hemodialysis patients...
April 2015: Journal of Clinical Endocrinology and Metabolism
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