Thyroid Dysfunction in Chronic Renal Failure

This work was presented in part at the 50th Annual Meeting of the American Thyroid Association, St. Louis, Mo., 18-21 September 1974, and at the 6th International Congress of Nephrology, Florence, Italy, 8-12 June 1975. Received for publication 21 May 1976 and in revised form 25 April 1977. cent±SD of metabolized T4 converted to T3 was 37.2±5.8 in normal subjects, 15.7±3.1 in non-HD, 12.8±1.7 in HD, and 34.0±14.7 in RT patients. In contrast, thyroidal T3 secretion rate was not different between the control and the three patient groups. Thus, it appears that uremia affects thyroid function at several levels: (a) subnormal pituitary TSH response to TRH; (b) possible intrathyroidal abnormalities as suggested by slightly decreased TT4 and high incidence of goiter; and (c) abnormal peripheral generation of T3 from T4. Restoration of renal function with RT resulted in normalization of all parameters of thyroid function with the exception of blunted or absent TSH response to TRH. The latter may be a direct consequence of glucocorticoid administration.