FUNCTION OF THE HYPOTHALAMO-HYPOPHYSIAL-THYROID AXIS IN CHRONIC RENAL FAILURE

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Abstract
Twenty-five patients with chronic renal failure were studied. Eight were receiving conservative treatment, 9 peritoneal dialysis and 8 hemodialysis. All were clinically euthyroid. Total thyroxine (T4) and triiodothyronine (T3) levels were reduced but free T4 levels were normal, while free T3 was reduced in patients with the most severe renal failure. The binding of thyroid hormones by the transport proteins is reduced and peripheral conversion of T4 to T3 is impaired in renal failure. The thyrotropin response to thyrotropin-releasing hormone (TRH) is reduced in renal failure but this reduction is probably independent of alterations in thyroid hormone metabolism. Growth hormone was released by TRH in 7 of the patients studied, possibly as a result of protein malnutrition.