Persistent pituitary-thyroid dysfunction patients following renal transplantation
Bratusch-Marrain, P.; Kopsa, H.; Pils, P.; Waldhäusl, W.; Zazgornik, J.; Schmidt, P.
Clinical Nephrology 14(2): 66-70
1980
ISSN/ISBN: 0301-0430 PMID: 6773712 Document Number: 159247
Pituitary-thyroid function, which is altered in patients with chronic renal insufficiency, were evaluated after successful kidney transplantation in 36 patients and compared to that in 15 healthy subjects. Thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) was in the low range of normal 24 and decreased in 12 patients (< 0.0005). In the former group, serum thyroxine was normal; triiodothyronine was lowered. In the latter group, thyroxine, although within the normal range, and triiodothyronine levels were reduced when compared to that of healthy controls. This differential TSH response to TRH was unrelated to kidney transplant function, duration of renal insufficiency or duration of the preceding hemodialysis or to the dose and dosing schedule of prednisolone therapy. A slight negative correlation between the dose of prednisolone administered and TSH responsiveness to TRH and serum triiodothyronine was established (P < 0.05). Corticoid treatment may, in part, be responsible for the alteration in TSH secretion and in the peripheral conversion of thyroxine to triiodothyronine. Other undefined factors, such as patient variability in pituitary susceptibility to the polypragmatic therapy administered, have to be suspected as the major causes of the persistent pathological pituitary-thyroid function tests observed after renal transplantation.