Thyroid Problems Up Cardiac Death Risk in Diabetic HD Patients

Researchers find link between subclinical hyperthyroidism and euthyroid sick syndrome.
Researchers find link between subclinical hyperthyroidism and euthyroid sick syndrome.

Subclinical hyperthyroidism and euthyroid sick syndrome may increase the risk of sudden cardiac death among diabetic hemodialysis (HD) patients, a prospective study found.

The study, by Christiane Drechsler, MD, PhD, of University Hospital Würzburg, Würzburg, Germany, and colleagues included 1,000 diabetic HD patients, of whom 78.1% had euthyroidism, 13.7% had subclinical hyperthyroidism, 1.6% had subclinical hypothyroidism, and 5.4% had euthyroid sick syndrome.

Compared with patients who had euthyroidism, those who had subclinical hyperthyroidism and euthyroid sick syndrome had a 2.0 times and 2.7 times increased short-term (within 12 months) risk of sudden cardiac death, respectively, according to a report in the American Journal of Kidney Diseases (2014;63:988-996).

Results showed that euthyroid sick syndrome was associated with a 3-fold increased risk of short-term mortality, but no increased risk in the long term (2-4 years). Subclinical hypothyroidism was not associated with cardiovascular events or all-cause mortality. Thyroid disorders had no meaningful effect on the risks of myocardial infarction and stroke.

“Regular assessment of thyroid status may help estimate the cardiac risk of dialysis patients,” the researchers concluded.

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