Studying Thyroid Function of Haemodialysis Patients in Upper Egypt (Two Centers Study).
NCT ID: NCT06500663
Last Updated: 2024-07-15
Study Results
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Basic Information
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NOT_YET_RECRUITING
160 participants
OBSERVATIONAL
2024-08-01
2026-12-30
Brief Summary
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2. Study the effects of frequent haemodialysis on thyroid function
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Detailed Description
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In hemodialysis patients, the prevalence of thyroid dysfunction is higher compared to the general population(3). This is partly due to the altered metabolism and clearance of thyroid hormones and the impact of uremic toxins on thyroid function (4). Moreover, thyroid hormones play a crucial role in cardiovascular health, which is of particular concern in hemodialysis patients who are already at an increased risk for cardiovascular events (5).
Recent studies have shown that even subclinical hypothyroidism, where patients have an elevated thyroid-stimulating hormone (TSH) level but normal thyroxine (T4) levels, can be associated with adverse outcomes in hemodialysis patients (6). This condition may contribute to an increased risk of cardiovascular disease and mortality (7).
The assessment of thyroid function in hemodialysis patients typically involves measuring serum levels of TSH, free T4, and T3 (8). However, interpreting these levels can be challenging due to the effects of medications, nutritional status, and non-thyroidal illness on the thyroid axis (9). It is also important to consider the impact of hemodilution on thyroid function tests, as it can lead to misinterpretation of the results (10).
Management of thyroid dysfunction in hemodialysis patients requires careful consideration. While thyroid hormone replacement therapy is commonly used to treat hypothyroidism, the optimal target levels of TSH and T4 in this population are still under investigation (11). Additionally, the benefits of treating subclinical hypothyroidism in hemodialysis patients remain uncertain (12).
In the context of Egypt, the prevalence of thyroid dysfunction among hemodialysis patients mirrors global trends. A study conducted in a South Indian cohort, which may have parallels in Egypt due to similar dietary and environmental factors, found a high prevalence of subclinical hypothyroidism in hemodialysis patients(13). This suggests that thyroid screening and management should be an integral part of care for hemodialysis patients in Egypt as well.
Egypt's healthcare system has been making strides in improving the management of chronic diseases, including CKD and its complications. With a growing focus on preventive care and early intervention, the management of thyroid dysfunction in hemodialysis patients is likely to receive more attention in the coming years (14).
In Upper Egypt, research has been conducted to investigate the prevalence and nature of thyroid abnormalities among hemodialysis patients. A cross-sectional observational report enrolled 160 subjects at Al-Hussein Hospital, Al-Azhar University, and the National Institute of Nephrology and Urology, revealing significant correlations between thyroid hormones and various clinical parameters (15). Another study assessed thyroid hormone levels in 200 patients with chronic renal failure undergoing maintenance hemodialysis, finding a high prevalence of thyroid hormone dysfunction even in clinically euthyroid patients(16).
In conclusion, the study of thyroid function in hemodialysis patients is essential for optimizing patient outcomes. With ongoing research and improved clinical practices, the management of thyroid dysfunction in this vulnerable population can be enhanced. As Egypt continues to develop its healthcare infrastructure, it is poised to make significant contributions to this field of study (17).
Conditions
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Study Design
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OTHER
CROSS_SECTIONAL
Study Groups
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1
patients on haemodialysis themselves and their hospital records including the participant's information (name, age, sex, admission date, clinical procedures, medications administered…etc).
haemodialysis
haemodialysis effect on thyroid function
Interventions
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haemodialysis
haemodialysis effect on thyroid function
Eligibility Criteria
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Inclusion Criteria
2. Patients aged between 18 and 75 years
3. Patients without overt hyper/hypothyroidism or thyroid hormone supplementation (for examining endogenous thyroid function).
Exclusion Criteria
6\. Pregnant or breastfeeding women. 7. Patients with other serious illnesses (e.g., cancer, severe heart disease) that could affect thyroid function or the ability to participate in the study 8. Patients receiving thyroid hormone supplementation
18 Years
75 Years
ALL
No
Sponsors
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Assiut University
OTHER
Sahar Ezeldeen Hussein Ali
OTHER
Responsible Party
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Sahar Ezeldeen Hussein Ali
Assuit
References
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Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005 Mar;67(3):1047-52. doi: 10.1111/j.1523-1755.2005.00169.x.
Kaptein EM, Quion-Verde H, Chooljian CJ, Tang WW, Friedman PE, Rodriquez HJ, Massry SG. The thyroid in end-stage renal disease. Medicine (Baltimore). 1988 May;67(3):187-97. doi: 10.1097/00005792-198805000-00005.
Lim VS. Thyroid function in patients with chronic renal failure. Am J Kidney Dis. 2001 Oct;38(4 Suppl 1):S80-4. doi: 10.1053/ajkd.2001.27410.
Schultheiss UT, Steinbrenner I, Nauck M, Schneider MP, Kotsis F, Baid-Agrawal S, Schaeffner E, Eckardt KU, Kottgen A, Sekula P; GCKD investigators. Thyroid function, renal events and mortality in chronic kidney disease patients: the German Chronic Kidney Disease study. Clin Kidney J. 2020 Jun 4;14(3):959-968. doi: 10.1093/ckj/sfaa052. eCollection 2021 Mar.
Sanai T, Okamura K, Onoue T, Ono T, Motomura K, Miyazono M, Shimamatsu K. Hemodilution Impacts Assessment of Thyroid Status before and after Hemodialysis in Patients with End-Stage Renal Disease. Am J Nephrol. 2021 Feb 1;51(12):988-994. doi: 10.1159/000512968. Online ahead of print.
Rhee CM, You AS, Nguyen DV, Brunelli SM, Budoff MJ, Streja E, Nakata T, Kovesdy CP, Brent GA, Kalantar-Zadeh K. Thyroid Status and Mortality in a Prospective Hemodialysis Cohort. J Clin Endocrinol Metab. 2017 May 1;102(5):1568-1577. doi: 10.1210/jc.2016-3616.
Other Identifiers
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faculty
Identifier Type: OTHER
Identifier Source: secondary_id
DR.sahar protocol
Identifier Type: -
Identifier Source: org_study_id
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