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| 만성신부전 환자에서 신장이식술 전후의 갑상선기능 변화 |
| 우인숙 , 안재형 , 이태원 , 임천규 , 김명재 |
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| Abstract |
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No single pathogenetic event may explain the thyroid function abnormalities in ESRD. Defects at all levels of the hypothalamic-pituitary-thyroid axis have been identified. Regarding the thyroid dysfunction of pituitary-thyroid axis, it is well recognized that the TSH response to TRH is blunted, and serum concentra- tions of thyroid hormones are decreased in patients with ESRD, whether or not they are on maintenance hemodialysis. We evaluated the thyroid function to know whether the thyroid function and hypothalamic- pituitary-thyroid axis were improved with the recovery of the renal function after renal transplantation. The results were as follows. 1) The basal level of serum T, was reduced (53.6±33. 2ng/dl) in ESRD patients and increased to the low normal level after renal transplantation (87.8±25.4 ng/ dl) 2) The basal level of serum T, was within normal range both before (5.9±1.1 ug/dl) and after (6.2±1.2 ug j dl) renal transplantation. 3) The basal level of serum TSH was within normal range before (2.0±1.2 uU/ml) and after (1.1±0.7 uU/ml) renal transplantation. 4) The response of TSH to TRH was blunted, had a diminished peak and delayed fall before renal trans- platantion. After transplantation, the response of TSH to TRH was persistently blunted and showed more rapid fall of TSH. In conclusion, the abnormalities of thyroid hormones in uremic patients were partially improved after 1 month of renal transplantation. |
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