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Changes in thyroid hormones following renal transplantation

Introduction: Chronic renal failure is associated with certain abnormalities in thyroid function. There is a paucity of information on thyroid function after renal transplantation. The aim of this study was to evaluate and compare results of thyroid function tests in patients with chronic renal failure, before and after renal transplantation. Materials and Methods: We designed a case-control study; the case group consisted of 30 patients, with no thyroid dysfunction, under dialysis, selected for renal transplantation. The control group had 40 healthy individuals, without any thyroid abnormality. Serum levels of thyroid related hormones including FT4, TT4, FT3 ,TT3 and TSH were measured using commercially available radioimmunoassay (RIA) kits. After renal transplantation, patients that had been treated with Cyclosporine, Prednisolone and Azathioprine, were divided into two subgroups based on their serum levels of blood urea nitrogen, creatinine and kidney function: patients with primary graft function (group I) and patients with delayed graft function (group II). Thyroid function tests were evaluated 10 and 30 days after transplantation. Results: In hemodialyzed patients, the mean levels of measured thyroid function tests were within normal range but when compared with controls, mean levels of thyroid hormones were low and no changes were observed in TSH levels. Ten days after graft, reduction in the serum levels of thyroid hormones and TSH were seen in both the groups. There were more alterations in group II than in group I. On the 30th day following the transplant, the changes in group I returned to normal levels and compared to those seen before the operation showed a marked improvement; when compared, however, to those of the controls, the levels of FT3, TT3, TT4 were still low. In group II, the TT3 levels were below normal and in comparison to those prior to the operation, reduction in the levels of TT4, TT3 and FT4 were observed. Conclusion: It is concluded that there is a possible relationship between the levels of thyroid hormones and renal function following transplantation.