Skip Navigation



NDT Advance Access published online on November 2, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl605
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/2/538    most recent
gfl605v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Enia, G.
Right arrow Articles by Zoccali, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Enia, G.
Right arrow Articles by Zoccali, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received July 7, 2006
Accepted September 19, 2006

Original Article

Subclinical hypothyroidism is linked to micro-inflammation and predicts death in continuous ambulatory peritoneal dialysis

Giuseppe Enia 1 *, Vincenzo Panuccio 1, Sebastiano Cutrupi 1, Patrizia Pizzini 1, Giovanni Tripepi 1, Francesca Mallamaci 1, and Carmine Zoccali 1

1 CNR-IBIM, Institute of Biomedicine, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension & Nephrology Unit of Reggio Calabria, Italy

* To whom correspondence should be addressed.
Giuseppe Enia, E-mail: eniag{at}libero.it



  Abstract

Background. Low T3 is a frequent alteration in patients with ESRD. This derangement has been recently linked to inflammation in haemodialysis patients. Whether this association holds true in peritoneal dialysis patients has not been studied.

Methods. We investigated the relationship between low-grade inflammation [IL-6, C-reactive protein (CRP) and serum albumin levels] and free tri-iodothyronine (fT3) in a cohort of 41 CAPD patients (mean age, 66 years; M, 26; F, 15) without heart failure and inter-current illnesses.

Results. CAPD patients had lower fT3 levels (2.7 ± 0.8 pg/ml) than healthy subjects (3.7 ± 1.0 pg/ml, P < 0.001) of similar age. Free T3 levels were directly related to those of serum albumin (r = 0.52, P = 0.001) and inversely to IL-6 (r = -0.30, P = 0.05) and CRP (r = -0.54, P < 0.001). Age (r = -0.61, P < 0.001), haemoglobin levels (r = 0.32, P = 0.05) and diastolic blood pressure (r = 0.50, P = 0.001) were also related to fT3. In multiple regression models adjusting for all variables related to fT3, CRP and albumin were retained as independent correlates of fT3.

During the follow-up (2.8 ± 1.7 years) 27 patients died. Plasma fT3 levels were lower in patients who died (2.5 ± 0.8 pg/ml) compared with survivors (3.3 ± 0.5 pg/ml P = 0.001). In Cox analyses, fT3 was a significant predictor of mortality independent of the main traditional as well as non-traditional risk factors.

Conclusions. The relationship between fT3, CRP and serum albumin suggests that inflammation-malnutrition might be involved in the low T3 syndrome in CAPD patients. Thyroid dysfunction might be implicated in the pathogenic pathway which links micro-inflammation to survival in PD patients.

Keywords: CAPD; inflammation; low T3 syndrome; thyroid.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J EndocrinolHome page
P Iglesias and J J Diez
Thyroid dysfunction and kidney disease
Eur. J. Endocrinol., April 1, 2009; 160(4): 503 - 515.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EndocrinolHome page
P. Haentjens, A. Van Meerhaeghe, K. Poppe, and B. Velkeniers
Subclinical thyroid dysfunction and mortality: an estimate of relative and absolute excess all-cause mortality based on time-to-event data from cohort studies
Eur. J. Endocrinol., September 1, 2008; 159(3): 329 - 341.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
M. Chonchol, G. Lippi, G. Salvagno, G. Zoppini, M. Muggeo, and G. Targher
Prevalence of Subclinical Hypothyroidism in Patients with Chronic Kidney Disease
Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1296 - 1300.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
N. Ochs, R. Auer, D. C. Bauer, D. Nanchen, J. Gussekloo, J. Cornuz, and N. Rodondi
Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality
Ann Intern Med, June 3, 2008; 148(11): 832 - 845.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
P. Stenvinkel, J. J. Carrero, J. Axelsson, B. Lindholm, O. Heimburger, and Z. Massy
Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient: How Do New Pieces Fit into the Uremic Puzzle?
Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 505 - 521.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
H. Volzke, C. Schwahn, H. Wallaschofski, and M. Dorr
The Association of Thyroid Dysfunction with All-Cause and Circulatory Mortality: Is There a Causal Relationship?
J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2421 - 2429.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.