Document Detail


Impact of Thyroid Dysfunction on Erythropoietin Dosage in Hemodialysis Patients.
MedLine Citation:
PMID:  23189968     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Background: Although thyroid diseases exist in patients with renal failure, thyroid function tests aren't routine test for incident and regular hemodialysis (HD) patients. Therefore, the impact of thyroid diseases on erythropoietin (EPO) dosage in HD patients is not well defined. This study was to evaluate the relationship between the dose of EPO and the presence or absence of selected thyroid diseases in HD patients. Methods: 1,013 regular HD adult patients without malignancy, liver cirrhosis, thalassemia, iron deficiency, gastrointestinal bleeding, and major operation within 6 months prior to the thyroid functions evaluation were included in this study. The patients were defined as sick euthyroidism, euthyroidism, hypothyroidism, subclinical hypothyroidism, hyperthyroidism or subclinical hyperthyroidism according to venous blood thyroid function tests. Routine biochemistry profile, Kt/V, and personal data over the past 6-month period were collected for analysis of basic characteristics and clinical manifestations of patients with thyroid diseases. Multiple regression models were employed to assess the relationship between the dose of EPO and the presence or absence of selected thyroid diseases. Results: Mean monthly EPO dosage were 77.7 ± 37.0, 70.2 ± 40.6, 90.8 ± 68.4, 78.5 ± 46.7 and 82.3 ± 41.2 μg in the sick euthyroid syndrome, euthyroidism, hypothyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism groups, respectively (P< 0.05). After adjustment of all other variables in multiple regression, the mean monthly EPO dosage was 19.00 ± 8.59 μg more in hypothyroidism patients compared to euthyroid patients (p=0.027). Further considering interaction with diabetes, the mean monthly EPO dosage in patients with both hypothyroidism/subclinical hypothyroidism and diabetes was 54.66 ± 17.12 μg (p=0.001) and 31.51 ± 10.38 μg (p=0.002) more than that of euthyroid patients, respectively. Conclusions: In HD patients, the EPO dosage required to maintain Hb level is significantly higher in patients having both hypothyroidism/subclinical hypothyroidism and diabetes, compared to euthyroid patients.
Authors:
Yee Yung Ng; Hong-Da Lin; Shiao Chi Wu; Chih Yu Yang; Wu Chang Yang; Hung Hsiang Liou; Fen Hsiang Hu; Chun Cheng Hou; Su Shan Tseng; Nai Yung Ku; Nien Yung Hsiao; Wen Chieh Wu; Hsing Meng Tu; Tse Jen Lien; Chung Ching Lee; Kwong Kee Tsang; Chen Seng Cheng; Jean Hu; Ru Ping Lin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  -     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Taipei Veterans General Hospital, Division of Nephrology, Department of Medicine, 201, Shih-Pai Road, Shih-Pai, Taipei, Taiwan, 11217, 886-2-28712121-2993, 886-2-28204735; yyng@vghtpe.gov.tw.
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