triiodothyronine--reverse and Kidney-Failure--Chronic

The aim of this study is to analyze thyroid hormone parameters in large homogenous patient cohorts with preterminal (stage 4) and terminal (stage 5) renal failure in an area of low iodine intake.. Thyroid parameters were measured in healthy controls (n=48), patients with preterminal renal failure (n=48) and patients with terminal renal failure undergoing hemodialysis (n=288). All patients were assessed by measurement of TSH, T4, T3, fT4, rT3, Tg and TPO-antibodies.. There was a significant decrease of T4 and fT4 from healthy controls to patients with preterminal renal failure and to patients with terminal renal failure. T3 showed a decrease from healthy controls to patients with preterminal renal failure and to patients with terminal renal failure (1.54+/-0.06 microg/l VS. 1.05+/-0.05 microg/l VS. 1.09+/-0.23 microg/l, p<0.001 VS. controls). rT3 was significantly decreased in patients with terminal renal failure (0.24+/-0.01 microg/l VS. 0.25+/-0.02 microg/l VS. 0.16+/-0.01 microg/l, p<0.001). The rT3/T3 ratio was significantly elevated in patients with preterminal renal failure (p<0.01). TSH concentrations were in the normal range in all groups.. Our data suggest different T4 degradation pathways in patients with preterminal and terminal renal failure.

Topics: Acute Kidney Injury; Adult; Cohort Studies; Diet; Disease Progression; Female; Humans; Iodine; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Thyroid hormones could affect renal function, and conversely renal function disturbances may affect thyroid function. Disturbances of the thyroid hormone concentration are often connected with thyroid gland enlargement. The aim of study was to estimate the function and morphology of the thyroid and kidney graft after kidney transplantation. As the indicator of thyroid and renal function we have used thyroid gland volume, plasma concentration of T3, reverse rT3, creatinine concentration, and renal arteries RI.. Studied group included 17 individuals after kidney transplantation, with stabile graft function. The control group included 18 individuals after various surgical procedures. The estimated parameters were: thyroid volume, renal arteries resistive index, concentrations of creatinine,T3 and rT3.The parameters were controlled before transplantation (surgery), the day after, and at 3rd, 6th and 10th day after surgery.. All patients, before and after surgical procedure, were clinically euthyroid. Mean creatinine concentration showed tendency to diminish. Statistical analysis revealed positive correlation between Delta concentration of creatinine and Delta volume of thyroid (R Spearman=0.46, p=0.05). Till the 6th day after transplantation T3 concentration diminished, and at the 10th day presented tendency to rise. We found negative correlation between T3 concentration and renal arteries RI. The rT3 concentration during 10 days after transplantation was above the reference level.. The FT3 level and thyroid volume correlates with kidney transplant function. The supplementary thyroid hormones administration should be considered before and after renal transplantation.

Topics: Adult; Aged; Case-Control Studies; Creatinine; Female; Humans; Kidney; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Thyroid Gland; Thyroid Hormones; Time Factors; Triiodothyronine; Triiodothyronine, Reverse

Sulfation is an important pathway of triiodothyronine (T3) metabolism. Increased serum T3 sulfate (T3S) values have been observed during fetal life and in pathological conditions such as hyperthyroidism and selenium deficiency. Similar variations have also been reported in a small number of patients with systemic non-thyroidal illness, but the underlying mechanisms have not been elucidated. In this study, serum T3S concentrations have been measured by a specific radioimmunoassay in 28 patients with end-stage neoplastic disease (ESND) and in 44 patients with chronic renal failure (CRF); 41 normal subjects served as controls. Both ESND and CRF patients had lower serum total T4 (TT4) and total T3 (TT3) than normal controls, while serum reverse T3 (rT3) was increased significantly in ESND (0.7 +/- 0.5 nmol/l; p < 0.001 vs. controls) but not in CRF (0.3 +/- 0.1 nmol/l). The TT3/rT3 ratio, an index of type I iodothyronine monodeiodinase (type I MD) activity, was reduced significantly in both groups of patients. Serum T4-binding globulin (TBG) was decreased in CRF but not in ESND patients. Serum T3S was significantly higher both in ESND (71 +/- 32 pmol/l) and CRF (100 +/- 24 pmol/l) than in controls (50 +/- 16 pmol/l, p < 0.001). Serum T3S values showed a positive correlation with rT3 values and a negative correlation with both TT3 and FT3 values in ESND, but not in CRF. In the latter group a positive correlation was observed between T3S and TBG values. The T3S/FT3 ratio was higher both in CRF (18 +/- 5) and in ESND (23 +/- 18) as compared to controls (10 +/- 4). Serum inorganic sulfate was increased and correlated positively with T3S values in CRF patients. In conclusion, the results of this study in a large series of patients confirm that patients with systemic non-thyroidal illness have increased serum T3S levels. The mechanisms responsible for these changes appear to be different in ESND and CRF patients. In ESND the increase in serum T3S levels is mainly related to reduced degradation of the hormone by type I MD, whereas in CRF it might be driven by the enhanced sulfate ion concentration, and could be partially dependent on the impaired renal excretion of T3S. Because T3S can be reconverted to T3, it is possible that increased T3S concentrations contribute to maintenance of the euthyroid state in systemic non-thyroidal disease.

Topics: Adult; Aged; Humans; Kidney Failure, Chronic; Middle Aged; Neoplasms; Osmolar Concentration; Triiodothyronine; Triiodothyronine, Reverse

The clinical implications of nuclear T3R alterations of circulating lymphocytes in hyperthyroidism, hypothyroidism and nonthyroidal diseases were investigated. Nuclear T3R in lymphocytes was determined by radio-ligand binding analysis. The results showed that in hyper- and hypothyroid patients the nuclear affinity (Ka) for T3 was similar to that of normal subjects. In hyperthyroidism nuclear T3 maximal binding capacity (MBC) was unaltered, whereas in hypothyroidism the MBC was significantly increased. In the patients with diabetes mellitus, chronic renal failure and hepatic cirrhosis, the nuclear T3R MBC of lymphocytes was about 1.5-1.6 times of the normal controls. It was concluded that there existed hormonal regulation of nuclear T3R, and up-regulation was seen in hypothyroidism and low T3 syndrome.

Topics: Diabetes Mellitus; Graves Disease; Humans; Hypothyroidism; Kidney Failure, Chronic; Lymphocytes; Receptors, Thyroid Hormone; Triiodothyronine, Reverse

Topics: Blood Glucose; Chromatography, Affinity; Diabetes Mellitus; Diabetic Nephropathies; Fructosamine; Glycated Hemoglobin; Hexosamines; Humans; Kidney Failure, Chronic; Peritoneal Dialysis, Continuous Ambulatory; Triiodothyronine, Reverse

Thyroid hormones are displaced from their binding proteins in serum during nonthyroidal somatic illness, and FFA have been claimed to contribute. It seems mandatory to evaluate this effect using techniques for the measurements of serum free thyroid hormones in which serum remains undiluted. We measured the effect of 7 common human FFA on the free fraction of T4, T3 and rT3 in serum from healthy subjects using an ultrafiltration technique by which serum is diluted only minimally. In addition we measured the effect of oleic acid on the free fractions of the iodothyronines in pooled serum from healthy subjects and in pooled serum from patients with nonthyroidal illness. All FFA tested were able to displace both T4, T3 and rT3, but to a varying degree, arachidonic and linoleic acid being the most potent ones. A 20% increase in the free fractions of T4, T3 and rT3, respectively, was obtained by adding between 1.7-3.3 mmol/l, 1.3-4.6 mmol/l and 1.0-2.4 mmol/l of the different FFA. A serum pool obtained from patients with nonthyroidal somatic illness was more sensitive to oleic acid than a serum pool obtained from healthy subjects, since 2-3 times less oleic acid was necessary to induce a 20% increase in the free fractions of thyroid hormones. It is concluded that FFA are able to displace both T4, T3 and rT3 from their serum binding proteins in healthy subjects as well as in patients with nonthyroidal illness. However, serum from patients with nonthyroidal illness was more sensitive to the displacing activity of oleic acid than serum from healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Cerebrovascular Disorders; Fatty Acids, Nonesterified; Hepatic Encephalopathy; Humans; Kidney Failure, Chronic; Neoplasms; Respiratory Insufficiency; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse; Ultrafiltration

Topics: Adolescent; Adult; Aged; Child; Humans; Kidney Failure, Chronic; Liver Cirrhosis; Middle Aged; Thyroid Diseases; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Thyroid hormone levels were measured in 12 patients on continuous ambulatory peritoneal dialysis and in 18 patients on haemodialysis, all in stable clinical status. Values in patients on peritoneal dialysis were not different from those found in controls, whereas a highly significant decrease in T3 and r T3 was observed in patients on haemodialysis. These results are in contrast with the low T3 syndrome and the high r T3 levels of systemic diseases and malnutrition. The difference between the two groups of patients on dialysis suggests that thyroid abnormalities do not result from renal failure alone, nor from malnutrition, but from a disturbance in the calorie/carbohydrate ratio of the ingesta.

Topics: Adult; Dietary Carbohydrates; Energy Intake; Female; Glucose; Humans; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis; Thyroid Hormones; Triiodothyronine; Triiodothyronine, Reverse

Thyroid function was measured in 30 healthy subjects and 84 patients with various degrees of nephron loss (GRF: 70 +/- 15 m/min, 30 +/- 16 ml/min, 10 +/- 7 ml/min and 2.1 +/- 1.3 ml/min). A low T3 and T4 syndrome is evident when GRF is reduced to 30 +/- 16 ml/min while a blunted TSH response is detected earlier in the course of nephron loss. T3 response to TRH was normal and FT4 was not affected by renal dysfunction. The data indicate that in nephron loss hypothalamic-pituitary abnormalities occur.

Topics: Adolescent; Adult; Female; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic; Male; Middle Aged; Nephrons; Renal Dialysis; Thyroid Gland; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

A simple and accurate method for estimation of the free fractions (FFT) of T4, T3, rT3, 3,3'-diiodothyronine (3,3'-T2) and 3',5'-diiodothyronine (3',5'-T2) in serum is presented. The method is based on ultrafiltration of serum pre-incubated with tracers of high specific activity, followed by purification of the ultrafiltrate on small Sephadex columns. The addition of tracer only dilutes serum negligible (about 5%) and the ultrafiltration procedure only removes about 7% of the volume of serum, thus probably not disturbing the equilibrium between the free and protein bound fraction of iodothyronine. Progressive reduction of tracer to less than 10% of the amount usually used did not reduce the FFT of any of the iodothyronines. In contrast, addition of T4 to serum led to an increase of all FFTs except that of 3',5'-T2. These data suggest that FFT of T4, T3, rT3 and 3,3'-T2 primarily is determined by the amount of T4 present in serum and that significant amounts of these iodothyronines are bound to TBG, whereas 3',5'-T2 possibly primarily is bound to albumin. The median FFT of T4, T3, rT3, 3,3'-T2 and 3',5'-T2 in serum from euthyroid subjects (n = 38) was: 0.030, 0.29, 0.14, 1.10 and 1.07%, respectively. The corresponding median free concentrations in pmol/l were: 30, 4.79, 0.59, 0.44 and 0.77, respectively. Pregnant women in 3rd trimester had normal levels of free T4, free T3 and free rT3, whereas the median free 3,3'-T2 was reduced in contrast to elevated median free 3',5'-T2.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Diiodothyronines; Female; Humans; Hyperthyroidism; Kidney Failure, Chronic; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pregnancy; Thyronines; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse; Ultrafiltration

Topics: Diabetes Mellitus; Glucose Tolerance Test; Humans; Kidney Failure, Chronic; Thyroid Gland; Triiodothyronine; Triiodothyronine, Reverse

The present study evaluates the sequential extra-thyroidal monodeiodination of thyroid hormones through tri-, di-, and monoiodothyronines in chronic renal failure (CRF) in man. Simultaneous turnover studies of T4, T3, rT3, 3,5-diiodothyronine (3,5-T2), 3,3'-T2, 3',5'-T2, 3'5'-T2, and 3'-monoiodothyronine (3--T1) were conducted in six patients with CRF (creatinine clearance, 9-18 ml/min) using the single-injection, noncompartmental approach. Serum levels of T4, T3, and 3,5-T2 were reduced to two thirds of control levels (P less than 0.05), whereas serum rT3 and 3,3'-T2 levels were reduced to a minor degree. Serum 3'-5'-T1 was doubled (p less than 0.05). The MCRs of T4, rT3, and 3',5'-T2 were enhanced to 168%, 127%, and 187% of normal (P less than 0.05), respectively, whereas those of T3, 3,5-T2, 3,3'-T2, and 3'-T1 were unaffected. The mean production rates (PRs) of the iodothyronines in CRF were as follows (CRF vs. control values, expressed as nanomoles per day/70 kg): T4, 119 vs. 125; T3, 26 vs. 44 (P less than 0.01); rT3, 49 vs, 48; 3,5-T2, 3.5 vs. 7.2 (P less than 0.001); 3,3'-T2, 25 vs. 35 (P less than 0.01); 3',5'-T2, 25 vs. 14 (P less than 0.01); and 3'-T1, 39 vs. 30. Previous studies have demonstrated reduced phenolic ring (5'-) deiodination of T4 in CRF, which is supported by the present finding of unaltered PR of T4 and reduced PR of T3. In contrast the 5'-deiodination of T3 leading to the formation of 3,5-T2 was found unaffected by CRF, since the conversion rate (CR) of T3 to 3,5-T2 (PR 3,5-T2/PR T3) was unaltered (16% vs. 15% in controls). The tyrosylic ring (5-) deiodination of T4 to rT3 was unaffected in patients with CRF, the CR being 42% vs. 40% in controls, in contrast to an enhanced CR of rT3 to 3',5'-T2 (53% vs. 29%, P less than 0.01), which also is a 5-deiodination step. In conclusion, our data show that CRF profoundly changes the kinetics of all iodothyronines studied. Furthermore, our data are compatible with the existence of more than one 5'-deiodinase as well as more than one 5-deiodinase in man.

Topics: Adult; Aged; Diiodothyronines; Female; Humans; Iodine Radioisotopes; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Serum Albumin; Thyroid Hormones; Thyronines; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

ātients with end-stage chronic renal failure (CRF) and those receiving dialysis therapy have normal or decreased serum total T4 (TT4), reduced serum total T3 (TT3), and normal total reverse T3 (TrT3) levels. Those with nonrenal nonthyroidal illnesses or malnutrition have low TT4 and TT3 but elevated TrT3 values. To evaluate the mechanism(s) for the normal TrT3 levels in CRF, we performed intravenous bolus kinetic studies of rT3 and T4 in patients with CRF, in those treated with chronic hemodialysis, in patients with nonrenal nonthyroidal illnesses, and in normal subjects. The CRF patients were selected to have good nutritional status as indicated by normal serum transferrin, relative body weight, and body mass index values. The CRF patients had normal TrT3, TT4, and free T4 values, increased free fraction of rT3, free rT3, and thyroxine-binding globulin levels, and decreased TT3 concentrations. Noncompartmental analysis of the rT3 kinetics indicated normal production rate, reduced cellular clearance rate, and increased pool size and residence time values in both the CRF and nonrenal patients. In CRF, the serum clearance rate was normal, but the fractional rate of exit, permeability, extravascular binding, and the apparent volume of distribution were increased. In contrast, the nonrenal patients had reduced serum clearance rate, permeability, and extravascular binding, whereas the fractional rate of exit and apparent volume of distribution were not significantly altered. The T4 kinetics in CRF paralleled those of the nonrenal patients, with a reduced fractional rate of exit and permeability in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Body Weight; Chronic Disease; Female; Humans; Infections; Kidney Failure, Chronic; Kinetics; Liver Diseases; Male; Middle Aged; Nutritional Physiological Phenomena; Renal Dialysis; Respiratory Insufficiency; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse; Uremia

Topics: Adult; Female; Humans; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Renal Dialysis; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

We studied various tests of thyroid function in sick patients with nonthyroidal illness (NTI) in order to determine the utility of each test for differentiating these patience from a group with hypothyroidism. We evaluated each test in 22 healthy volunteers who served as controls, 20 patients with hypothyroidism, 14 patients admitted to medical intensive care unit whose serum T4 was less than 5 micrograms/dl, 13 patients with chronic liver disease, 32 patients on chronic hemodialysis for renal failure, 13 ambulatory oncology patients receiving chemotherapy, 16 pregnant women, 7 women on estrogens, and 20 hyperthyroid patients. On all samples, we measured serum T4, the free T4 index by several methods, free T4 by equilibrium dialysis, free T4 calculated from thyronine-binding globulin (TBG) RIA, free T4 by three commercial kits (Gammacoat, Immophase, and Liquisol), T3, rT3, and TSH (by 3 different RIAs). Although all of the methods used for measuring free T4 (including free T4 index, free T4 by dialysis, free T4 assessed by TBG, and free T4 assessed by the 3 commercial kits) were excellent for the diagnosis of hypothyroidism, hyperthyroidism, and euthyroidism in the presence of high TBG, none of these methods showed that free T4 was consistently normal in patients with NTI; with each method, a number of NTI patients had subnormal values. In the NTI groups, free T4 measured by dialysis and the free T4 index generally correlated significantly with the commercial free T4 methods. Serum rT3 was elevated or normal in NTI patients and low in hypothyroid subjects. Serum TSH provided the most reliable differentiation between patients with primary hypothyroidism and those with NTI and low serum T4 levels.

Topics: Alpha-Globulins; Chronic Disease; Female; Humans; Hyperthyroidism; Hypothyroidism; Kidney Failure, Chronic; Liver Diseases; Neoplasms; Pregnancy; Radioimmunoassay; Reagent Kits, Diagnostic; Renal Dialysis; Thyroid Function Tests; Thyrotropin; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

In order to study the hypothalamic-pituitary-thyroid function in children with chronic renal failure (CRF), the serum levels of L-thyroxine (L-T4), L-triiodothyronine (L-T3), reverse T3 (rT3), thyrotrophin (TSH) and prolactin (Prl) were measured by radioimmunoassay (RIA). Values were compared with those of normal subjects. Low levels of L-T4 were present in CRF patients as compared to controls. L-T3 was also found to be low but less than L-T4, and rT3 was lower in patients with long evolution. No alterations were observed in TSH basal levels, whereas Prl values in patients were high. After thyrotrophin-releasing hormone (TRH) administration, TSH and Prl rose to similar levels in both groups, but high values were maintained throughout (120 min) in CRF. A significant negative correlation was found between the peak rise of the TSH response and the CRF evolution time. The L-T3 response to TRH administration (120 min) was similar in both CRF and controls. The rate of in vivo and in vitro exogenous TRH degradation was decreased in patients with CRF or by their sera, respectively. Our data seem to confirm that the hypothyroid syndrome described in CRF patients is of hypothalamic origin, and the low in vivo and in vitro TRH degradation rates are a consequence of this state.

Topics: Adolescent; Adult; Child; Female; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic; Male; Prolactin; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine, Reverse; Urea

The levels of tri-iodothyronine (T3), free T3 index (FT3I), thyroxine (T4), free T4 index (FT4I), thyrothopine (TSH), reverse T3(rT3), T3 resin uptake (T3U) and thyroxine-binding globulin (TBG) were investigated in 30 conservatively treated euthyrodic kidney patients with varying degrees of disturbance to kidney function. The authors found that the phenomena of the so-called "low T3 syndrome" (low T3 and FT3 while T4 is low to normal and FT4 and TSH are normal) appear not only in patients with advanced chronic renal insufficiency but also in patients who are in the 2nd state of chronic renal insufficiency (serum creatinine 4--8 mg%). The incidence and degree of reduced T3 were equal in both groups of patients. It must however be stressed that, in contrast to other chronic diseases with "low T3 syndrome", the low T3 concentrations in kidney patients are not accompanied by a simultaneous increase in the synthesis of rT3. The high levels detected of the quotients T4/T3 and the normal levels of TBG allow the reduced capacity of thyroxine-binding globulin (TBG) to be ruled out as the cause of the low levels of T3.

Topics: Adult; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Thyroid Hormones; Thyrotropin; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adult; Aged; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adolescent; Adult; Aged; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Serum 3'monoiodothyronine (3'-T1) levels were estimated by means of a specific radioimmunoassay (RIA) preceded by an ethanol extraction. The recovery of 3'T1 was in mean (+/-SEM) 110 +/- 9%, and the lower detection limit was 23 pmol/l. Serum levels of 3'T1 in 34 euthyroid healthy subjects were (median (range)) 55 pmol/l (less than 23 - 168 pmol/l), in 13 hyperthyroid patients 133 pmol/l (70 - 265 pmol/l) (P less than 0.01) and in 13 hypothyroid patients less than 23 pmol/l (less than 23 - 68 pmol/l) (P less than 0.01). In 11 patients with chronic renal failure serum 3'-T1 levels were highly increased 285 pmol/l (115 - 1538 pmol/l) (P less than 0.01) and correlated inversely to creatinine clearance (R = -0.68, P less than 0.05). In patients with liver cirrhosis serum 3'-T1 levels were unaffected, whereas in 19 patients with endogenous depression studied before and after recovery from the depression serum levels decreased from 70 pmol/l (less than 23 - 248 pmol/l) to 30 pmol/l (less than 23 - 95 pmol/l) (P less than 0.01). Administration of propranolol 40 mg b.i.d. for 2 weeks did not affect serum 3'-T1 levels. The study shows that 3'-T1 is present in serum from euthyroid man and varies with thyroid function. Further, it is suggested that 3'-T1 in contrast to other iodothyronines primarily is eliminated by the kidneys.

Topics: Adult; Depression; Female; Humans; Hyperthyroidism; Hypothyroidism; Kidney Failure, Chronic; Male; Middle Aged; Propranolol; Thyronines; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Topics: Humans; Kidney Failure, Chronic; Renal Dialysis; Triiodothyronine; Triiodothyronine, Reverse

Serum reverse triiodothyronine (reverse T3), triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH) concentrations were determined by radioimmunoassay in end-stage chronic renal failure, hypothyroidism and control subjects. In advanced chronic renal failure serum reverse T3 was normal or elevated and serum T3 concentrations were frequently, and serum T4 occasionally, lowered. Serum TSH was normal even where serum T3 and T4 concentrations were low. Normal or elevated serum reverse T3 associated with normal serum TSH in chronic renal failure clearly differentiates this disease from primary hypothyroidism in which low serum reverse T3 and high serum TSH are constantly found.

Topics: Adult; Female; Humans; Hypothyroidism; Kidney Failure, Chronic; Male; Middle Aged; Thyroid Gland; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adult; Female; Growth Hormone; Humans; Kidney Failure, Chronic; Male; Middle Aged; Pituitary Gland; Pituitary Hormones; Prolactin; Renal Dialysis; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse