Poor Thyroid Function May Affect Dialysis Patients’ Quality of Life and Daily Living

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• In hemodialysis patients, hypothyroidism was linked with impairments across multiple areas of health-related quality of life, including lower energy and greater fatigue, poorer physical function, and greater pain.

 Many patients with advanced chronic kidney disease have thyroid disease. 

Newswise — Washington, DC (July 13, 2017) — A new study indicates that impaired thyroid function may have detrimental effects on dialysis patients’ health and well-being. The findings appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Although hypothyroidism—a condition in which the thyroid gland does not produce enough thyroid hormone—is common in hemodialysis patients, it’s unclear how it affects their health and quality of life. 

To investigate, Connie M. Rhee, MD, MSc (University of California Irvine) and her colleagues examined information from 450 hemodialysis patients from 17 outpatient dialysis facilities who completed questionnaires every 6 months. To assess thyroid function, the team measured patients’ blood levels of thyrotropin, which is elevated in patients with hypothyroidism.

Higher thyrotropin levels were associated with impairments across multiple areas of health-related quality of life, including energy/fatigue, physical function, and pain.

“Given the high prevalence of thyroid dysfunction and low levels of quality of life in dialysis patients, future research is needed to determine the underlying mechanisms of these associations, and whether thyroid hormone replacement can improve the health-related quality of life of this population,” said Dr. Rhee. “In addition, as the first study in dialysis patients to document an association between higher thyrotropin levels and low levels of physical function, a strong predictor of death, future studies are needed to determine whether correction of thyroid status with exogenous thyroid hormone can improve physical function in this population.”

Study co-authors include, Yanjun Chen, MS, Amy S. You, MS,
Steven M. Brunelli, MD, MSCE, Csaba P. Kovesdy, MD, Matthew J. Budoff, MD, Gregory A. Brent, MD, Kamyar Kalantar-Zadeh, MD, MPH, PhD, and Danh V. Nguyen, MS, PhD.

Disclosures: The authors reported no financial disclosures.

The article, entitled “Thyroid Status, Quality of Life, and Mental Health in Hemodialysis Patients,” will appear online at http://cjasn.asnjournals.org/ on July 13, 2017, doi: 10.2215/CJN.13211216.

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