Subclinical Hypothyroidism as a Risk Factor for Vascular Calcification in ESRD Patients

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Marwa A. Abdelhameid, Ahmed Aboelhagag Ali , Hassan Abdelraheem Soltan, Omaima M. Ali


Subclinical Hypothyroidism, Vascular Calcification, ESRD


Subclinical hypothyroidism (SCH) is defined as the absence of symptoms accompanied by an increase in thyroid-stimulating hormone (TSH) levels and normal free T3 and free T4 levels. End-stage renal disease (ESRD) is the last stage of chronic kidney disease (stage 5), characterized by an irreversible, gradual loss of renal function. Vascular calcification is the abnormal and pathological deposition of calcium salts inside vascular tissues.

Aim and objectives: To evaluate how vascular calcifications in ESRD patients are affected by SCH and study the relationship between them.

Subjects and methods: In this cross-sectional study, 100 patients were enrolled and diagnosed by ESRD patients on regular hemodialysis. All the included patients were subjected to investigate Thyroid stimulating hormone (TSH), carotid artery atherosclerosis, arterial stiffness, and vascular calcification at Aswan University Hospital, Internal Medicine Department, Faculty of Medicine.

Results: Carotid and its Correlates (age, SCH, PTH, TSH, T3, and T4) and the independent effect of SCH on carotid calcification (CAAC) differed significantly among the examined population (PTH, TSH, and SCH).

There was an insignificant difference between the studied population regarding Carotid and its Correlates (sex, DM, and PH) and the independent effect of SCH on CAAC (age, sex, T3, and T4).

Conclusion: With high sensitivity and specificity, SCH is a risk factor for vascular calcification in ESRD patients.

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1. Lamb EJ, Levey AS, Stevens PE. The Kidney Disease Improving Global Outcomes (KDIGO) guideline update for chronic kidney disease: evolution, not revolution. Clinical chemistry. 2013 Mar 1;59(3):462-5.

2. Perrone RD, Mouksassi MS, Romero K, Czerwiec FS, Chapman AB, Gitomer BY, Torres VE, Miskulin DC, Broadbent S, Marier JF. Total kidney volume is a prognostic biomarker of renal function decline and progression to end-stage renal disease in patients with autosomal dominant polycystic kidney disease. Kidney international reports. 2017 May 1;2(3):442-50.

3. Leopold JA. Vascular calcification: an age-old problem of old age. Circulation. 2013 Jun 18;127(24):2380-2.

4. Krishna A, Schwarz N. Sensory marketing, embodiment, and grounded cognition: A review and introduction. Journal of consumer psychology. 2014 Apr 1;24(2):159-68.

5. Neil T. Mobile design pattern gallery: UI patterns for smartphone apps. " O'Reilly Media, Inc."; 2014 Apr 23.

6. Nakamoto K, Hayakawa J, Kawamura T, Kodama M, Yamada H, Kitagawa T, Watanabe Y. Data on species list and the amount of macrophytes and mobile epi-benthic invertebrates in a subtropical seagrass-seaweed mixed bed in Ishigaki Island, Japan. Data in brief. 2018 Aug 1;19:2442-4.

7. Sirohi T, Singh H. Estimation of serum prolactin levels and determination of prevalence of hyperprolactinemia in newly diagnosed cases of subclinical hypothyroidism. Journal of family medicine and primary care. 2018 Nov;7(6):1279.

8. Quan G, Wang H, Zhu F, Yan J. Porous biomass carbon coated with SiO2 as high performance electrodes for capacitive deionization. BioResources. 2018;13(1):437-49.

9. El-Ballat MA, El-Sayed MA, Emam HK. Epidemiology of end stage renal disease patients on regular hemodialysis in El-Beheira governorate, Egypt. The Egyptian Journal of Hospital Medicine. 2019 Jul 1;76(3):3618-25.

10. Tajbakhsh R, Joshaghani HR, Bayzayi F, Haddad M, Qorbani M. Association between pruritus and serum concentrations of parathormone, calcium and phosphorus in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2013 Jul 1;24(4):702-6.

11. Tatar A, Tok S, Saltukoğlu G. Gözden geçirilmiş Schutte duygusal zeka ölçeğinin Türkçe'ye uyarlanması ve Psikometrik özelliklerinin incelenmesi. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology. 2011 Dec 1;21(4):325-38.

12. Rhee CM, Kalantar-Zadeh K, Ravel V, Streja E, You AS, Brunelli SM, Nguyen DV, Brent GA, Kovesdy CP. Thyroid status and death risk in US veterans with chronic kidney disease. InMayo Clinic proceedings 2018 May 1 (Vol. 93, No. 5, pp. 573-585). Elsevier.

13. Nakayama M, Ura Y, Nagata M, Okada Y, Sumida Y, Nishida K, Ikeda H, Kaizu Y. Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study. BMC nephrology. 2011 Dec;12(1):1-1.

14. Shantha GP, Kumar AA, Bhise V, Khanna R, Sivagnanam K, Subramanian KK. Prevalence of subclinical hypothyroidism in patients with end-stage renal disease and the role of serum albumin: a cross-sectional study from South India. Cardiorenal medicine. 2011 Oct 1;1(4):255-60.

15. Lim VS. Thyroid function in patients with chronic renal failure. American Journal of Kidney Diseases. 2001 Oct 1;38(4):S80-4.

16. Pamuk N, Akkan T, Dağdeviren M, Koca AO, Beyan E, Ertuğrul DT, Altay M. Central and peripheral blood pressures and arterial stiffness increase in hypoparathyroidism. Archives of Endocrinology and Metabolism. 2020 Apr 6;64:374-82.

17. Rhee CM, Budoff M, Brent G, You AS, Stenvinkel P, Novoa A, Flores F, Hamal S, Dailing C, Kinninger A, Nakata T. Serum thyrotropin elevation and coronary artery calcification in hemodialysis patients. Cardiorenal medicine. 2022 Sep 5;12(3):106-16.

18. Meuwese CL, Olauson H, Qureshi AR, Ripsweden J, Barany P, Vermeer C, Drummen N, Stenvinkel P. Associations between thyroid hormones, calcification inhibitor levels and vascular calcification in end-stage renal disease. PloS one. 2015 Jul 6;10(7):e0132353.