Thyroid dysfunction in patients with end-stage renal failure on hemodialysis: the role of the autoimmune component

BACKGROUND . Thyroid dysfunction is a common complication in patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis. However, the role of the autoimmune component in these disorders remains insufficiently studied. THE AIM : to study the features of thyroid dysfunction and the role of the autoimmune component in its development in patients with ESRD on maintenance hemodialysis. PATIENTS AND METHODS . The study included 134 patients with ESRD on maintenance hemodialysis. All participants underwent comprehensive clinical and laboratory evaluation, including measurement of thyroid-stimulating hormone (TSH), free T3 and T4, anti-thyroid peroxidase antibodies (anti-TPO), as well as basic biochemical and hematological parameters. Statistical analysis was performed using standard comparative methods. RESULTS . Hypothyroidism was diagnosed in 30.6 % of patients; however, elevated anti-TPO levels were found only in a quarter of them. In patients with hypothyroidism, the median anti-TPO level was significantly higher than in the euthyroid group (1.50 [0.70; 7.50] vs. 0.80 [0.30; 3.70] IU/mL, p = 0.021). Sex, age, body mass index, and renal disease etiology did not influence the development of hypothyroidism or elevated anti-TPO. CONCLUSION . Among patients with ESRD on hemodialysis, hypothyroidism is common, while the autoimmune mechanism is present only in a subset of cases. Thyroid dysfunction is multifactorial and should be taken into account in diagnosis and management.