Evluation of Thyroid Functions in Hemodialysis Childern in Sohag University Hospital

Sohag University

Status: Not yet enrolling

Conditions: Chronic Renal Failure

Treatments: Diagnostic Test: serum phosphorus; Diagnostic Test: complete urine analysis; Diagnostic Test: serum creatinine; Diagnostic Test: thyroid function tests; Diagnostic Test: parathyroid hormone level; Diagnostic Test: serum calcium; Diagnostic Test: serum electrolyte; Diagnostic Test: complete blood count; Diagnostic Test: liver function test; Diagnostic Test: arterial blood gases; Diagnostic Test: blood urea

Study type: Interventional

Funder types: Other

Identifiers

NCT05451472

soh-22-06-09

Details and patient eligibility

About

Thyroid gland and its hormones play an important role in organ development and the homeostatic control of many physiological mechanisms such as body growth and energy expenditure. The two main thyroid hormones are triiodothyronine (T3) and thyroxine (T4) affect renal development and metabolism so any impairment in thyroid functions lead to or aggravate kidney diseases.

On the other hand, kidneys play an important role in the thyroid metabolism as it normally contributes to the clearance of iodide, primarily by glomerular filtration. Among patients with renal failure, there is diminished iodide excretion and an increase in plasma inorganic iodide, which results in increased uptake of the iodide by the thyroid gland. Increases in total body inorganic iodide can potentially block thyroid hormone production (the Wolff-Chaik off effect). Such a change may explain the slightly higher frequency of goiter and hypothyroidism in patients with chronic kidney diseases.

The kidneys affect the hypothalamic pituitary-thyroid axis, so any impairment in kidney functions leads to disturbed thyroid physiology. All levels of the hypothalamic-pituitary-thyroid axis may be involved, including alterations in hormone production, distribution, and excretion.

End stage renal disease (ESRD) and hemodialysis (HD) affect the levels of all thyroid hormones. The earliest and the most common thyroid function abnormality in patients with ESRD on HD is low T3 level (especially total T3 than free T3). This is called 'low T3 syndrome. The prevalence of subclinical hypothyroidism has been reported to be much higher in patients with ESRD on HD than in the general population.

Due to similarity of signs and symptoms, sometimes it is difficult to identify subjects with ESRD also has hypothyroidism; therefore, different studies have been carried out to establish the incidence of these conditions.

Enrollment: 39 estimated patients

Sex: All

Ages: 2 to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children started hemodialysis for end stage renal disease at age of 2 to 16 years will be included in the study.

Exclusion criteria

• Patients with known thyroid disease. Patients with a history of autoimmune disease .

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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39 participants in 1 patient group

pediatric group

Experimental group

Treatment:

Diagnostic Test: blood urea

Diagnostic Test: complete blood count

Diagnostic Test: serum phosphorus

Diagnostic Test: liver function test

Diagnostic Test: complete urine analysis

Diagnostic Test: thyroid function tests

Diagnostic Test: parathyroid hormone level

Diagnostic Test: serum creatinine

Diagnostic Test: arterial blood gases

Diagnostic Test: serum calcium

Diagnostic Test: serum electrolyte