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NDT Advance Access published online on December 23, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn682
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone

Sang Heon Song1,2, Ihm Soo Kwak1,2, Dong Won Lee1,2, Yang Ho Kang1,2, Eun Young Seong1,2 and Jin Sup Park1,2

1 Department of Internal Medicine 2 Medical Research Institute, Pusan National University Hospital, Busan 602-739, Korea

Correspondence and offprint requests to: Ihm Soo Kwak, Department of Internal Medicine and Medical Research Institute, Pusan National University Hospital 1-10, Ami-dong, Seo-gu, Busan 602-739, Korea. Tel: +82-51-240-7225; Fax: +82-51-254-3127; E-mail: iskwak{at}pusan.ac.kr



  Abstract

Background. We hypothesized that the prevalence of low T3 would be increased according to the increase in CKD stage. This study was performed to explore the prevalence in each stage of CKD and relationship with eGFR.

Methods. A total of 2284 cases with normal thyroid-stimulating hormone (TSH) level were enrolled and retrospectively analysed during the recent period, from July 2005 to December 2007.

Results. There was an increasing trend for the population of low T3 according to the increase of a CKD stage (eGFR ≥ 90, 8.2%; ≥ 60 eGFR < 90, 10.9%; ≥ 30 eGFR < 60, 20.8%; ≥ 15 eGFR < 30, 60.6%; eGFR < 15, 78.6%). Also, there was positive relationship between eGFR and serum T3 in male, female and total subjects. After adjusting for age and sex, compared with eGFR ≥ 60 ml/min/ 1.73 m2, eGFR < 60 ml/min/1.73 m2 was associated with an increased odds of low T3 [odds ratio 2.40 (CI: 1.5315 to 3.1731)]. In multiple regression analysis, eGFR was positively related with T3 (standardized coefficient 0.143, R2 = 0.055, P < 0.001), independent of age and serum albumin.

Conclusion. This study showed that low T3 syndrome was highly prevalent in CKD and was a remarkable finding in early CKD. Furthermore, serum T3 levels were associated with severity of CKD even in the normal TSH level.

Keywords: chronic kidney disease; low T3 syndrome; triiodothyronine

Received for publication: 17. 6.08
Accepted in revised form: 17.11.08


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