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Alteraciones tiroideas en pacientes en diálisis
Resumen
La glándula tiroides y el riñón están estrechamente relacionados. Las hormonas tiroideas (HT) contribuyen en la homeostasis del ser humano a través de complejas interacciones de líquidos y electrolitos, síntesis de proteínas, etc. Los efectos de las HT sobre el riñón pueden ser prerenales o directos. Está demostrado que al disminuir la filtración glomerular (FG) se altera este equilibrio, sobre todo en estadios avanzados de la enfermedad renal crónica (ERC).
La ERC esta vinculada con alteraciones en los niveles de HT y/o su metabolismo, lo que resulta en una alta prevalencia de hipotiroidismo subclínico y el síndrome de T3 libre baja. Estas alteraciones están relacionadas con microinflamación, daño endotelial, alteraciones cardiacas y alta mortalidad. El presente estudio, describe las alteraciones tiroideas más frecuentes reportadas en ERC con enfoque en la etapa dialítica.
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Referencias
Iglesias P, Díez JJ. Thyroid dysfunction and kidney disease. Eur J Endocrinol. 2009;160(4):503-515.
Mohamedali M, Reddy-Maddika S, Vyas A, Iyer V, Cheriyath P. Thyroid disorders and chronic kidney disease. Int J Nephrol. 2014;2014:ID520281.
Kulkarni DP, Holley JL. Thyroid function test in endstage renal disease. Semin Dial. 2014;27(6):552-555.
National Kidney Foundation. K/DOQI Clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(1):S1-S266.
Soriano-Cabrera S. Definición y clasificación de los estadios de la enfermedad renal crónica. Prevalencia. Claves para el diagnóstico precoz. Factores de riesgo de enfermedad renal crónica. Nefrología. 2004;24(6):27-34.
Rajeev G, Chickballapur-Rayappa WDS, Vijayalakshmi R, Swathi M, Kumar S. Evaluation of thyroid hormone levels in chronic kidney disease patients. Saudi J Kidney Dis Transpl. 2015;26(1):90-93.
Basu G, Mohapatra A. Kidney disease and thyroid disorders. Indian J Endocrinol Metab. 2012;16(2):204-13.
Mariani LH, Berns JS. The renal manifestations of thyroid disease. J Am Soc Nephrol. 2012;23(1):22-26.
Dousdampanis P, Trigka K, Vagenakis GA, Fourtounas C. The thyroid and the kidney: A complex interplay in health and disease. Int J Artif Organs. 2014;37(1):1-12.
Lim VS. Thyroid function in patients with chronic renal failure. Am J Kidney Dis. 2001;38:S80-S84.
Ahmadieh H, Salti I. Tyrosine kinase inhibitors induced thyroid dysfunction: A review of its incidence, pathophysiology, clinical relevance, and treatment. Bio Med Res Int. 2013;2013:ID725410.
Pámanes-González J, Gamboa-Ortíz FA, TorresCeniceros LF. Frecuencia de alteración de los niveles de hormonas tiroideas en pacientes sometidos a diálisis peritoneal. Gac Med Mex. 2014;150(Suppl 2):222-7.
Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005;67(3):1047-1052.
Khatiwada S, Rajendra KC, Gautam S, Lamsal M, Baral N. Thyroid dysfunction and dyslipidemia in chronic kidney disease patients. BMC Endocr Disord. 2015;15:65.
Chonchol M, Lippi G, Salvagno G, Zoppini G, Muggeo M, Targher G. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2008;3:1296-1300.
Kang EW, Nam JY, Yoo TH, Shin SK, Kang SW, Han DS et al. Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients. Am J Nephrol. 2008;28(6):908-13.
Ros S, Carrero JJ. Endocrine alterations and cardiovascular risk in CKD: Is there a link? Nefrologia. 2013;33(2):181-87.
Fernández-Reyes JM, Sánchez R, Heras M, Tajada P, García L, Iglesias P et al. Can FT3 levels facilitate the detection of inflammation or catabolism and malnutrition in dialysis patients? Nefrología. 2009;29(4):304-310.
Gungor O, Kircelli F, Voroneanu L, Covic A, Ok E. Hormones and arterial stiffness in patients with chronic kidney disease. J Atheroscler Thromb. 2013;20(9):698-707.
Paudel K. Prevalence and clinical characteristics of hypothyroidism in a population undergoing maintenance hemodialysis. J Clin Diagn Res. 2014;8(4):MC01-4.
Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F. Low triiodothyronine: A new facet of inflammation in end-stage renal disease. J Am Soc Nephrol. 2005;16:2789-95.
Carrero JJ, Qureshi AR, Axelsson J, Yilmaz MI, Rehnmark S, Witt MR et al. Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney
disease. J Intern Med. 2007;262:690-701.
Horácék J, Sulková SD, Kubisová M, Safránek R, Malírova E, Kalousová M et al. Thyroid hormone abnormalities in hemodialyzed patients: Low triiodothyronine as well as high reverse triiodothyronine are asssociated with increased mortality. Physiol Res. 2012;61(5):495-501.
Sun W, Liu D, Gong P, Shi X, Wang Y, Wang P et al. Predicting cardiovascular mortality in chronic kidney disease (CKD) patients. Ann Transplant. 2014;19:513-518.
Meuwese CL, Dekker FW, Lindholm B, Qureshi AR, Heimburger O, Barany P et al. Baseline levels and trimestral variation of triiodothyronine and thyroxine and their association with mortality in maintenance hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(1):131-138.
Ozen K, Asci G, Gungor O, Carrero JJ, Kircelli F, Tatar E et al. Nutritional state alters the association between free triiodothyronine levels and mortality in hemodialysis patients. Am J Nephrol. 2011;33:305-312.
Abdel-Gayoum AA. Dyslipidemia and serum mineral profiles in patients with thyroid disorders. Saudi Med J. 2014;35(12):1469-1476.
Meuwese CL, Olauson H, Qureshi AR, Ripsweden J, Barany P, Vermeer C et al. Associations between thyroid hormones, calcification inhibitor levels and vascular calcification in end-stage renal disease. PLoS ONE. 2015;10(7):e0132353. doi: 10.1371/ journal.pone.0132353
Tatar E, Kircelli F, Asci G, Carrero JJ, Gungor O, Demirci MS et al. Associations of triiodothyronine levels with carotidatherosclerosisi and arterial stiffness in hemodialysis patients. Clin J Am Soc Nephrol. 2011;6(9):2240-2246.
Kocyigit I, Gungor O, Unal A, Yasan M, Orscelik O, Tunca O et al. A low serum free triiodothyro nine level is associated with epicardial adipose tissue in peritoneal dialysis patients. J Atheroscler Thromb. 2014;21(10):1066-74.
Pérez SR, Díez JJ, Bajo MA, Iglesias P, Grande C, del Peso G et al. Thyrotropin and free thyroxine concentrations do not affect cardiovascular disease and mortality in euthyroid peritoneal dialysis patients. Perit Dial Int. 2013;33(6):697-707.
Enia G, Panuccio V, Cutrupi S, Pizzini P, Tripepi G, Mallamaci F et al. Subclinical hypothyroidism is linked to micro-inflammation and predicts death in continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant. 2007;22:538-544.
Meuwese CL, Carrero JJ, Cabezas-Rodríguez I, Heimbuirger O, Barany P, Lindholm B et al. Nonthyroidal illness: A risk factor for coronary calcification and arterial stiffness in patients undergoing peritoneal dialysis? J Intern Med. 2013;274(6):584-593.
Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. EndocrPract. 2012;18(6):988-1028.
Shin DH, Lee MJ, Lee HS, Oh HJ, Ko KI, Kim CH, et al. Thyroid Hormone Replacement Therapy Attenuates the Decline of Renal Function in Chronic Kidney Disease Patients with Subclinical Hypothyroidism. Thyroid. 2013 Jun;23(6):654-61.
Rhee CM, Kim S, Gillen DL, Oztan T, Wang J, Mehrotra, et al. Association of Thyroid Functional Disease with Mortality in a National Cohort of Incident Hemodialysis Patients. J Clin Endocrinol Metab. 2015;100(4):1386-95.
Rhee CM, Alexander EK, Bhan I, Brunelli SM. Hipothyroidism and mortality among dialysis patients. Clin J Am Soc Nephrol. 2013;8(4):593-601.
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