SERIAL CONCENTRATION OF THYROID-HORMONES IN BLOOD AFTER SUCCESSFUL KIDNEY-TRANSPLANTATION

Concentrations of total and free thyroid hormones, thyrotropin (TSH), and thyroid hormone-binding proteins were measured in the sera of 7 pa tients with end-stage renal disease while they were on maintenance hem odialysis pre-renal transplant (pre-Tx), and serially at 2, 4, and 8 d ays, followed by 1, 2, 3, and 4 months after the renal transplant surg ery. All of the patients were clinically euthyroid and nongoiterous. R esults obtained from patients before and serially after transplantatio n were compared. These results were also compared with a group of norm al subjects. Serum levels of BUN and creatinine were normal within 48 hours. Serum triiodothyronine (T3) and free T3 (FT3) levels were signi ficantly reduced to 45 +/- 25 ng/dl and 2.4 +/- 0.7 pg/ml, respectivel y, in pretransplant patients, compared to 128 +/- 33 ng/dl (p<0.001) a nd 3.9 +/- 0.8 pg/ml (p<0.01), respectively, in normal controls. These pretransplant levels gradually increased and returned to normal at 1 month, but continued to show a rising trend and reached 133 +/- 46 ng/ dl (p<0.01 vs. pre-Tx) and 4.4 +/- 0.5 pg/ml (p<0.001 vs. pre-Tx), res pectively, at 4 months after surgery. Thyroxine (T4) levels also incre ased after 8 days. Levels of free T4 (FT4), TSH, and thyroxine-binding globulin (TBG) were in the normal range and remained more or les simi lar up to 4 months after surgery. Serum prealbumin levels were elevate d to 403 +/- 151 mg/L in the pretransplant patients and dropped to 281 +/- 139 mg/L after 4 months. Serum albumin levels were significantly low in pretransplant patients in comparison to controls (p<0.01). The results were also analyzed by multiple regression analysis to see whet her various doses of prednisolone administered to these patients durin g the period of study, as well as the change in diet, affects thyroid hormones, TSH, and thyroid hormone-binding proteins. Significant negat ive correlation was observed between doses of prednisolone and serum T 3 (r = -0.592, p<0.001), T4 (r = 0.567, p<0.001, FT3 (r = -0.565, p<0. 001), and FT4 (r = -0.356, p<0.01), while serum TSH did not show any s ignificant correlation. It is concluded that after transplantation, th e renal function returns to normal within 48 hours, while it takes a m uch longer time for various thyroid hormones to return to a normal sta te.