HEMATOLOGICAL AND THYROID DISTURBANCE IN AN ALGERIAN POPULATION OF CHRONIC HEMODIALYSIS PATIENTS

Abstract

Objective: Hemodialysis patients suffer in the majority of cases from normocytic normochromic anemia, due to the decrease of erythropoietin production. Thyroid abnormalities are also observed in these patients. They are represented by hypothyroidism which is characterized by low levels of FT3, normal levels of free thyroxine, and often high levels of TSH The objective is to estimate the prevalence of hypothyroidism and anemia in an Algerian population with end-stage chronic renal failure on hemodialysis. Design and method: This is a descriptive cross-sectional study carried out in the Biochemistry laboratory in collaboration with the Hematology laboratory of CPMC. 94 patients with end-stage chronic renal failure . Results and discussion Results: The mean age of our hemodialysis patients was 59.62 years, with a sex ratio of 0.69. Most of our patients (47%) had arterial hypertension (AH) and 20% of patients had diabetes. Our results show a prevalence of normocytic normochromic anemia in 88.30% of hemodialysis patients. The TSH and FT3 hormone assays in our patients revealed a prevalence of hypothyroidism of 38%, with a female predominance. FT3 was low in 24 patients, 12 patients had high TSH levels. The hypothyroid profile was characterized by normal TSH levels associated with low FT3 levels (25% of patients), 12 patients had high TSH levels associated with normal FT3 concentrations. Thyroid abnormalities in chronic hemodialysis patients (CDH) are secondary to hormonal disorders. They are often represented by hypothyroidism. (Captein, 1996). The results of the comparison of the distribution of hypothyroid and anemic patients show an independence of the distribution of the number of cases according to the symptoms of hypothyroidism. Conclusions: The similarity of symptoms between anemic and hypothyroid hemodialysis patients can mislead the clinician if he does not think to measure thyroid hormones, knowing that the therapeutic conduct is different in the two situations, and the impact on the health economy is very important.