THYROID-DYSFUNCTION AND NODULAR GOITER IN HEMODIALYSIS AND PERITONEAL-DIALYSIS PATIENTS

Objective: To investigate the prevalence of nodular goiter and thyroid dysfunction in uremic patients undergoing hemodialysis (HD) and perit oneal dialysis. Design: Cross-sectional study. Setting: Single dialysi s unit and outpatient clinic. Patients:The study included 221 patients [143 HD and 78 continuous ambulatory peritoneal dialysis (CAPD) patie nts] along with 135 consecutively selected outpatients as controls. Ma in Outcome Measures: Ultrasonography was used to detect patients' thyr oid function and nodular goiter. Results: Nodular goiter was detected in 54.8% of the uremic patients and in 21.5% of the controls. Uremic p atients had higher prevalence of thyroid dysfunction, which included r educed serum concentration of total T3, total T4, and free T4, and inc reased serum level of TSH. Hypothyroidism was also observed more frequ ently in uremic patients than in the control group (5.4% vs 0.7%, p < 0.05). Nodular goiter was more frequently found in females than in mal es (63.5% vs 48%, p < 0.05). Moreover, the prevalence of nodular goite r increased with age (p < 0.02) in uremic patients. Hemodialysis patie nts had a higher frequency of reduced total T3 level (46.9% vs 29.5%, p < 0.02). However, CAPD patients had lower T4 levels (6.23 +/- 1.82 m u g/dL vs 7.15 +/- 1.99 mu g/dL, p < 0.05).Conclusion: Because of the high incidence of hypothyroidism and nodular goiter in uremic patients , screening of thyroid function and goiter detection with ultrasound s hould be considered in evaluation of end-stage renal disease patients.