Evluation of Thyroid Functions in Hemodialysis Childern in Sohag University Hospital

Not Applicable

• Conditions: Chronic Renal Failure
• Interventions: Diagnostic Test: thyroid function tests; Diagnostic Test: complete blood count; Diagnostic Test: serum creatinine; Diagnostic Test: blood urea; Diagnostic Test: serum electrolyte; Diagnostic Test: serum calcium; Diagnostic Test: serum phosphorus; Diagnostic Test: parathyroid hormone level; Diagnostic Test: liver function test; Diagnostic Test: arterial blood gases; Diagnostic Test: complete urine analysis

• Registration Number: NCT05451472
• Lead Sponsor: Sohag University

Brief Summary

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.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design

Study Timeline

• Study First Submitted: 2022-06-20
• Status Verified: 2022-07
• Study Start: 2022-07-01
• Study First Submitted QC: 2022-07-06
• Last Update Submitted: 2022-07-06
• Study First Posted: 2022-07-11
• Last Update Posted: 2022-07-11
• Primary Completion: 2023-01-01
• Study Completion: 2023-01-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 39

Inclusion Criteria

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

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Exclusion Criteria

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

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
pediatric group	serum electrolyte	-
pediatric group	thyroid function tests	-
pediatric group	complete blood count	-
pediatric group	liver function test	-
pediatric group	complete urine analysis	-
pediatric group	blood urea	-
pediatric group	serum phosphorus	-
pediatric group	arterial blood gases	-
pediatric group	serum creatinine	-
pediatric group	serum calcium	-
pediatric group	parathyroid hormone level	-

Primary Outcome Measures

Name	Time	Method
Detection of thyroid function in hemodialysis childern	6 months	Detection of decrease thyroid function(T3_T4_TSH) in hemodialysis childern Detection of increase thyroid function(T3_T4_TSH) in hemodialysis childern