ECE2015 Eposter Presentations Thyroid (non-cancer) (160 abstracts)
Relationship between thyroid function tests and all-cause mortality in patients on peritoneal dialysis: a prospective analysis
Juan J Díez 1 , Sara Romero-Perez 2 , María A Bajo 3 , Pedro Iglesias 1 , Cristina Grande 4 , Gloria Del Peso 3 , Rosario Madero 5 , Marta Ossorio 3 & Rafael Selgas 3
1Department of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain; 2Department of Nephrology, Hospital Universitario del Sureste, Madrid, Spain; 3Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain; 4Department of Biochemistry, Hospital Universitario La Paz, Madrid, Spain; 5Department of Biostatistics, Hospital Universitario La Paz, Madrid, Spain.
Background: Alterations in thyroid function tests results in patients on peritoneal dialysis (PD) might represent a risk factor for cardiovascular disease (CVD) and mortality.
Objective: To investigate the relationship of serum TSH, free thyroxine (FT4), and triiodothyronine (T3) concentrations with incident CVD and mortality in PD patients.
Methods: Prospective study including all patients attending our PD unit between 2003 and 2012 who had remained at least for 3 months in the PD program. All patients were followed until death, exit of PD program, loss of follow-up, or census date (September 2012). Survival time was estimated by the Kaplan-Meier method. Unadjusted and multivariate Cox regression models were used to assess the effects of several variables on the risk of death.
Results: From 169 subjects included in our program, 139 (81.8%) were euthyroid, 4 (2.4%) had overt hypothyroidism, and 26 (15.4%) had subclinical hypothyroidism. Patients in the first tertile of T3 (<0.91 ng/ml) had a higher percentage of CVD events during follow-up (10.9%) than those in the second (0.91–1.10 ng/ml, 1.9%) and third tertiles of T3 (>1.10 ng/ml, 1.9%, P<0.05). All-cause mortality was higher in patients in the first tertile of T3 (20%) in comparison with patients in the second (3.8%) and third tertiles (5.6%, P<0.05). Kaplan-Meier analysis showed that median survival time for all-cause mortality were significantly lower in patients in the first tertile of T3 (P=0.013). Unadjusted Cox regression analysis showed an increase in the risk of death in patients in this tertile (HR, 4.3; 95% CI, 1.48–12.45, P=0.007). In the multivariate (adjusted) analysis, this risk of death remained significant (HR, 3.14, 95% CI, 1.05–9.43, P=0.041).
Conclusions: Thyroid function tests alterations are associated with long-term incidence of CVD and mortality in uremic patients undergoing PD. In particular, low T3 levels are significantly related to all-cause mortality in this population.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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