Horacek J.,IV. Interni hematologickd klinika
Diabetologie Metabolismus Endokrinologie Vyziva | Year: 2013
Hypothyroidism is relatively common in patients with CKD. The risk is higher in women and positively associated with age and negatively with glomerular filtration rate; hyponatraemia may be a warning sign. Hypothyroidism is confirmed by higher serum thyrotropin (TSH) level and treated by usual levothyroxine replacement, aimed atTSH level normalization. An even more common finding in CKD patients is a decrease in serum levels of thyroxine (T4) and namely of triiodothyronine (T3). If TSH is not elevated then lowT4 and/or lowT3 are probably not due to hypothyroidism but rather due to non-thyroidal illness syndrome.This syndrome is associated with an increased risk of complications, including higher mortality; however, T4 and/or T3 replacement is not indicated.