Peritoneal Dialysis Patient Death Risk Linked to Thyroid Dysfunction
Hypo- and hyperthyroidism predict an increased risk of all-cause mortality.
Both low and high thyroid hormone levels are associated with elevated mortality risk among patients on peritoneal dialysis (PD), a finding consistent with what is known in the hemodialysis population, researchers concluded.
Connie M. Rhee, MD, MS, of the University of California Irvine, and colleagues examined the association between thyroid function, as reflected by serum thyroid-stimulating hormone (TSH) levels, and all-cause mortality in a national cohort of 1,484 PD patients. At baseline, 18% and 7% of patients had hypothyroidism and hyperthyroidism, respectively.
Compared with TSH levels of 0.5-<3.0 mIU/L (reference), levels <0.1, 0.1-<0.5, 3.0-<5.0, 5.0-<10, and ≥10.0 mIU/L are associated with 2.09, 1.53, 1.05, 1.63, and 3.1 times increased risk of all-cause mortality in case-mix adjusted analyses, according to a paper published online ahead of print in the Journal of Clinical Endocrinology and Metabolism.
In addition, compared with euthyroid patients, hypothyroid and hyperthyroid patients, respectively, had a 1.69 and 2.08 times increased risk of all-cause mortality. The researchers defined euthyroidism, hypothyroidism, and hyperthyroidism as TSH levels of 0.5-<5.0, <0.5, and ≥5.0 mIU/L, respectively.
The study demonstrated for the first time that hyperthyroidism is associated with an increased mortality risk in PD patients.