Thyroid function and morphology after a successful kidney transplantation

• Published in: Journal of endocrinological investigation 2006-07, Vol.29 (7), p.625-632
• Main Authors: Tauchmanovà, L, Carrano, R, Musella, T, Orio, F, Sabbatini, M, Lombardi, G, Fenzi, G, Federico, S, Colao, A
• Format: Article
• Language: English
• Subjects: Adult; Autoantibodies - blood; Autoantigens - immunology; Case-Control Studies; Cross-Sectional Studies; Female; Humans; Immunosuppressive Agents - pharmacology; Iodide Peroxidase - immunology; Iodine - urine; Iron-Binding Proteins - immunology; Kidney Transplantation - physiology; Male; Middle Aged; Risk Factors; Sex Characteristics; Thyroglobulin - blood; Thyroglobulin - immunology; Thyroid Diseases - diagnostic imaging; Thyroid Diseases - epidemiology; Thyroid Function Tests; Thyroid Gland - anatomy & histology; Thyroid Gland - diagnostic imaging; Thyroid Gland - physiology; Thyroid Hormones - blood; Thyrotropin - blood; Ultrasonography
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/BF03344162

Although thyroid disorders related to the end-stage renal disease (ESRD) are well known, there are discordant data on the function and morphology of the thyroid gland after renal transplantation (RT). The objective of this cross-sectional, case-control study was to investigate the prevalence and risk factors for disorders in the thyroid function and morphology after a successful RT. Fifty consecutive patients (25 females, 25 males) with fully functioning allograft were enrolled. Their age at transplant ranged from 23 to 44 yr (median, 38) and their post-RT follow-up lasted 15-86 months (median, 23). One hundred healthy subjects matched for sex, age and body mass index (BMI) were included as controls. Serum free thyroid hormones, TSH, thyroglobulin, thyroid hormone-binding globulin (TBG) and iodine urinary excretion were determined; ultrasonographic exam of the thyroid gland was performed in all subjects. Age, gender, time elapsed from RT, dialysis duration, kidney function, type of immunosuppression and corticosteroid dose were considered as possible influencing factors for the thyroid function. Hypothyroidism was found in 6% of patients, "low T3 syndrome" in 52%, while another 26% had free T3 (FT3), free T4 (FT4) and TSH in the lowest third of the normal range, suggesting inhibition of the whole hypothalamic-pituitary-thyroid (HPT) axis. Iodine excretion and prevalence of anti-thyroid antibodies were similar in both patients and controls. There was no significant difference in the thyroid function according to different immunosuppressive regimens. In patients, an ultrasonographic exam revealed a very variable thyroid volume ranging from 7.2 to 24.8 ml. Solid nodules were detected in 12 (24%) cases and cystic lesions in another four (8%); they were proven negative at cytological examination. Dialysis duration was longer in patients with thyroid nodules than in those without (p