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Thyroid Function and Metabolic State in Chronic Renal Failure

DAVID A. SPECTOR, M.D.; PAUL J. DAVIS, M.D., F.A.C.P.; J. HAROLD HELDERMAN, M.D.; BARBARA BELL, M.D.; and ROBERT D. UTIGER, M.D.
[+] Article and Author Information

Grant support: in part by NIH Research Grants AM 19177 and AM 14039.

This paper was presented in part at the 8th Annual Meeting of the American Society of Nephrology, Washington, D.C., 25 November 1975.

▸Requests for reprints should be addressed to Paul J. Davis, M.D.; E. J. Meyer Memorial Hospital; Buffalo, NY 14215.


Baltimore, Maryland; Buffalo, New York; Bethesda, Maryland; and Philadelphia, Pennsylvania


Ann Intern Med. 1976;85(6):724-730. doi:10.7326/0003-4819-85-6-724
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Thirty-eight patients with chronic renal insufficiency who were in a dialysis program underwent studies of thyroid function and metabolic status. Mean values for serum total and free thyroxine (T4) concentrations and thyroxine-binding globulin capacity were within normal limits. Although mean serum total triiodothyronine (T3) concentration was normal, 43% of the group had low serum T3 and 54% had low serum free T3 concentrations. Serum thyrotrophin (TSH) concentrations were normal in all but four subjects who had very slight elevations. Metabolic status was assessed by various metabolic tests; mean values for each of these tests were normal, and the clinical index scores indicated that all patients were euthyroid. Results of metabolic testing were similar in patients with low and those with normal serum T3 concentrations. Low serum T3 measurements did not accurately reflect metabolic state in patients with chronic renal failure, whereas serum free T4 and TSH concentrations were reliable indicators of thyroid state.

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