Korean Journal of Nephrology 1985;4(2):245-251.

만성신부전증 환자에서 CAPD 및 혈액투석이 TRH 자극 후 TSH 및 갑상선호르몬의 반응에 미치는 영향

김치환 , 나현 , 유명희 , 황승덕 , 이희발

Abstract

To evaluate the influence of hemodialysis(HD) and continuous ambulatory peritoneal dialysis (CAPD) on hypothalamic-pituitary-thyroid dysfu- nction observed in patients with chronic renal failure(CRF) we measured serum levels of T T free' Treverse T,(rT,) and TSH before and after intravenous injection of 00mg of TRH in 33 patients with CRF(10 patients not yet on dialysis, 11 patients on HD and 12 patients on CAPD) and in 7 healthy volunteers. Serum levels of TT, and free T I, were signifi- cantly lower in all 3 groups of patients with CRF, than in ncrmal ccntrol. The erum levels of rT, were not different between norrnal control and all 3 uremic patient groups. r T, was significantly lower in paitents on CAPD when compared with undialyzed patient group(0.171±0.078 vs 0.281 0. 108 ng/dl, P<0. 05). The basal levels of serum TSH were significantly higher in HD and CAPD groups than in normal control. There was no difference in the ha eal TSH between normal control and undialyzed uremic patients. The TSH response to TRH stimulation was delayed in all 3 patient groups, and the increment was significantly less in HD and CAPD groups than in normal control. T, increased after TRH stimulation in all four groups but was significan- tly lower in patient not on dialysis than in the other groups. T4, FT4 and r T, did nct change significantly after TRH in any group. Our results suggest that hypothalamic-pituitary- thyroid dysfunction in CRF is not corrected by either HD or CAPD and therefore may be due to substances not dialyzable by hemodialysis or CAPD.