P1488RECOVERY OF LOW TRIIODOTHYRONINE CAN IMPROVE MORTALITY IN HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Low circulating triiodothyronine (T3) levels are the most frequently encountered thyroid functional test derangement in end-stage renal disease (ESRD) patients on hemodialysis. Low T3 is known as independent predictive value for all-cause mortality and, particularly, for cardiovascular-related death in patients with ESRD on hemodialysis. This study investigated that recovery of low T3 level to normal can lower mortality in ESRD patients on hemodialysis. Method We have constructed the 500 K-cohort of ESRD patients attending the hemodialysis center of 6 tertiary hospitals of South Korea to evaluate the mortality of the ESRD patients since 2016. From this prospective cohort, we invited patients with ESRD from June 2016 to May 2019 The participants were divided into four groups based on the change of the T3 level: normal group showed the normal T3 continuously, low group showed the low T3 continuously, recovery group showed the low T3 change to normal and decrease group showed the normal T3 change to low. We evaluate relationships between change of the T3 level and mortality. Statistical analysis was carried out by using SPSS. Results Of the total 500 patients in K-cohort, 333 patients were enrolled with detailed thyroid hormone profile including T3 level. 167 (50.2 %) patients out of the 333 patients showed low T3 level initially. Normal group include 126 patients(37.8%), low group include 135 patients(40.5%), recovery group include 32 patients(9.6%) and decrease group include 40 patients(12.0%). Patients with the low T3 level were older and more diabetic compare to those with normal T3 level. They had lower K-MMSE score than the others, Low T3 group had lower free T4 level but thyroid stimulating hormone(TSH) showed no significant different comparing normal T3 group. The mortality of normal group was lowest and that of decrease group was highest. The mortality of recovery group recovered to similar with that of the normal group and mortality of decrease group was highest. Lowering of T3 level would affect to mortality than low T3 level continuously. Conclusion Therefore, the change of T3 level is significantly associated with the mortality. Recover lower T3 to normal level can lower the mortality.