What is chronic renal failure?

Chronic renal failure and thyroxine

Thyroxine is synthesized and secreted by the thyroid gland, and its metabolism is mainly in the liver and kidneys, and can be excreted through bile and urine. Among them, TT3 is the physiologically active thyroid hormone, which plays the most important role in the body. In addition, TT3, TT4 and FT3 are associated with a variety of chronic medical diseases, including chronic renal failure, which is combined with hypothyroidism accounts for nearly 5%. In chronic renal failure, the body is unable to degrade and excrete the metabolites in time, especially urea nitrogen, phenolics and creatinine, which leads to the blockage of T4 to T3 pathway and the decrease of T3 level, and at the same time, glomerular injury and its permeability increase, which leads to the decrease of tubular reabsorption capacity, and then TT3, FT3 filtration out due to the increase of glomerular permeability, which further leads to the decrease of its level, and finally, due to the combination of proteinuria and hypoglycemia, which is a common problem of patients. Finally, due to the combination of proteinuria and hypoproteinemia, the level of thyroid hormone is further reduced due to the decrease of the substrate for thyroid hormone synthesis.

Therefore, some scholars recommend analyzing the changes in thyroid hormone levels in patients with chronic renal failure in order to evaluate their prognosis. In addition, heart failure, as a common complication of chronic renal

Examples of studies

The study selected 40 cases of chronic renal failure admitted to our hospital from March 2020 to July 2021 as research subjects. The patients in the control group were treated conservatively with internal medicine, while the observation group was treated with hemodialysis, comparing the changes in thyroid hormone levels between the two groups, comparing the left ventricular ejection fraction, cardiac index and cardiac output in the echocardiographic indexes between the two groups, and analyzing the correlation between the thyroid hormone levels and cardiac function indexes in chronic renal failure hemodialysis patients.

It was found that the levels of TT3 and FT3 were negatively correlated with the changes of left ventricular ejection fraction, cardiac index and cardiac output, and the levels of serum TT3 and FT3 were significantly reduced in the hemodialysis interventions for patients with chronic renal failure, and the negative impact on the cardiac function of the patients increased with the prolongation of the course of the disease.

Table 1 Comparison of thyroid hormone levels between the two groups (pmol/L)

Table 2 Comparison of left ventricular ejection fraction, cardiac index and cardiac output between the two groups

Table 3 Correlation between thyroid hormone levels and cardiac function indexes in hemodialysis patients with chronic renal failure

Clinical significance

Thyroxine measurement can exclude thyroid diseases, such as hyperthyroidism and hypothyroidism, and can determine the functional status of thyroid nodules, which can help ensure health during pregnancy by diagnosing subclinical hyperthyroidism or hypothyroidism during pregnancy. Analyzing changes in thyroid hormone levels in patients with chronic renal failure can assess the patient's prognosis.

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