Elevated serum thyroglobulin levels as a marker of reversible hypothyroidism in patients with end-stage renal disease due to chronic glomerulonephritis

Figures & data

Table 1. Clinical data and thyroid function in end-stage renal disease on haemodialysis: Comparison between CGN and non-CGN

	CGN	Non-CGN	Healthy control
n	82	42	166
Age (year)	58 ± 14+	65 ± 14	60 ± 15
Sex (M:F)	45:37	31:11	31:135
Duration of HD (year)	7.9 (0.1–30.7)+	2.7 (0.1–7.9)
Dry weight (kg)	53.3 ± 12.2	53.6 ± 13.8	nd
Haematocrit (%)	35 ± 4^*	35 ± 4^*	41 ± 3
T. cholesterol (mg/dl)	159 ± 36^*	151 ± 32^*	206 ± 44
CPK (U/L)	108 ± 93+	80 ± 45	99 ± 48
Creatinine (mg/dl)	12.3 ± 3.1^*	10.1 ± 3.3^*	0.7 ± 0.3
BUN (mg/dl)	76 ± 17^*	70 ± 21^*	14 ± 5
Kt/V	1.46 ± 0.28	1.29 ± 0.24
CTR (%)	49.2 ± 4.2	49.8 ± 5.6	nd
Calcium (mg/dl)	9.7 ± 0.9+	8.8 ± 0.8	9.3 ± 0.6
iP (mg/dl)	5.9 ± 1.5^*	6.5 ± 7.2^*	3.4 ± 0.5
iPTH (pg/ml)	155 (15–720)	169 (2–450)	nd
fT3 (pg/ml)	2.2 ± 0.4^*	2.1 ± 0.6^*	2.9 ± 0.4
fT4 (ng/dl)	0.9 ± 0.2	1.0 ± 0.2	1.1 ± 0.2
TSH (mU/L)	2.42 (1.07–5.45)^*	2.03 (0.90–4.58)	1.33 (0.67–2.67)
fT3/fT4 (pg/ml/ng/dl)	2.5 ± 0.7	2.2 ± 0.5^*	2.6 ± 0.6
Thyroglobulin (ng/ml)	28 (5–540.0) +	18.5 (0–79.0)	nd
Thyroid volume (ml)	14.6 ± 5.9	14.9 ± 6.3	nd

Notes: Non-CGN group include 30 patients due to diabetes mellitus and 12 patients due to hypertension.

Values shown were mean ± SD or median (range).

T. Cholesterol: total cholesterol; CPK: creatine phosphokinase; BUN: blood urea nitrogen; Kt/V: K: urea kinetics; K: the whole-body clearance rate of urea; t: effective treatment time; V: total body water; CTR: cardiothoracic ratio; iP: inorganic phosphate; iPTH: intact parathyroid hormone; fT4: free thyroxine; fT3: free triiodothyronine; TSH: thyroid stimulating hormone; nd; not done.

*p < 0.05 compared with healthy control.

+ p < 0.05 compared with the Non-CGN group.

Otherwise the difference was not significant.

Table 2. Prevalence of hypothyroidism in end-stage renal failure on haemodialysis: Comparison between the chronic glomerulonephritis (CGN) and the non-CGN groups

	CGN	Non-CGN
n	82	42
Overt hypothyroidism	2 (2.4%)	0	p = 0.0170
Subclinical hypothyroidism	9 (11.0%)	4 (9.5%)
Estimated thyroid weight 20–39 ml	13 (15.9%)	6 (14.3%)	not significant
Estimated thyroid weight >40 ml	0	0
Serum thyroglobulin 30–100 ng/ml	26 (31.7%)	11 (26.2%)
Serum thyroglobulin >100 ng/ml	12 (14.6%)	0 (0%)	p = 0.0335

Note: ns: not significant.

Figure 1. Correlation between elevated serum thyroglobulin (Tg) and TSH levels in the patients with ESRD on maintenance haemodialysis in the CGN group or the non-CGN group (nephropathy due to lifestyle related systemic disease, such as DM or HTN).

Notes: Goitrous patients in the CGN group was shown in rectangular open mark. Reference values for ESRD are shown in shaded area. The correlation between serum TSH and serum Tg levels was r = 0.5921 (p < 0.001) in the CGN, and r = 0.0838 (not significant) in the non-CGN groups.

Table 3. Clinical data and thyroid function in end-stage renal disease on haemodialysis: Comparison between the patients with normal or elevated serum thyroglobulin

Serum thyroglobulin	Normal	High	p
n	75	49
Age (year)	60 ± 14	62 ± 14	0.3797
Sex (M:F)	53:22	23:26	0.1475
CGN : NonCGN	44:31	38:11	0.0529
Duration of HD (year)	4.8 (0.1–30.7)	6.2 (0.1–27.1)	0.3657
Dry weight (kg)	54.2 ± 11.2	52.2 ± 14.9	0.8631
Haematocrit (%)	35 ± 4	35 ± 4	0.4500
T. cholesterol (mg/dl)	153 ± 32	162 ± 38	0.3606
CPK (U/L)	96 ± 89	101 ± 67	0.8763
Creatinine (mg/dl)	11.5 ± 3.4	11.7 ± 3.1	0.4217
BUN (mg/dl)	73 ± 18	76 ± 17	0.8858
Kt/V	1.37 ± 0.28	1.45 ± 0.27	0.7941
CTR (%)	49.1 ± 4.9	49.8 ± 4.4	0.6578
Calcium (mg/dl)	9.4 ± 0.9	9.5 ± 1.0	0.4994
iP (mg/dl)	5.6 ± 1.4	5.9 ± 1.5	0.1548
iPTH (pg/ml)	150 (26–710)	183 (15–720)	0.3694
fT3 (pg/ml)	2.2 ± 0.5	2.1 ± 0.4	0.7723
fT4 (ng/dl)	1.0 ± 0.2	0.9 ± 0.2	0.8596
TSH (mU/L)	1.92 (0.98–3.74)	2.96 (1.15–7.62)	0.0014
fT3/fT4 (pg/ml/ng/dl)	2.4 ± 0.7	2.1 ± 0.4	0.3315
Thyroglobulin (ng/ml)	16 (5–30.0)	55 (32–540)
Thyroid volume (ml)	14.2 ± 5.9	15.4 ± 6.3	0.0121

Notes: High serum thyroglobulin level was defined as >30 ng/ml.

Values shown were mean ± SD or median (range).

Mean ± SD of serum TSH was calculated after logarithmic conversion.

See legend for Table 1 for abbreviation.