Role of chronic hemodialysis in thyroid gland morphology disorders.

UNLABELLED: Thyroid gland morphology is affected in patients with chronic kidney disease.

THE AIM: The purpose of this study was to compare thyroid gland morphology among patients on chronic hemodialysis (HD) and healthy participants and to assess the duration of dialysis on thyroid disorders.

MATERIAL AND METHODS: Prospective study included 80 participants divided into two groups. Study group included 40 patients on (HD) who were divided in two subgroups, according to the time spent on dialysis (i.e. under and over 72 months). The exclusion critheria was represented by the previous thyroid disorders and systemic illnesses. The control group included 40 healthy participants. The blood samples were taken for standard laboratory analysis, total and free thyroid hormone levels.

RESULTS: Thyroid ultrasound was performed, thyroid wolume was calculated and the echostructure assessed. Mean values of thyroid volume were increased in HD patients (e.g.18,88 +/- 3,20 ml, p < 0.01). Diffuse goiter was found in 35% (n = 14) patients on HD (p = 0.01). In a subgroup of patients (i.e. with time on HD < 72 months), the significant and more frequent was multinodular goiter, in 15.38% (n = 4) (p = 0.03). There was no significant correlation between the time on dialysis , thyroid volume (r = -0.05, NS) and TSH levels (r = 0.14, NS). A significant, positive correlation between the thyroid volume and TSH levels was observed in HD group of patients (r = 0.24 p < 0.05).

CONCLUSION: Thyroid disorders are more common in patients on HD compared to general population. These findings suggest that thyroid morphology screening should be performed in HD patients.