Evluation of Thyroid Functions in Hemodialysis Childern in Sohag University Hospital

NCT05451472 | Unknown

• 1 other identifier: soh-22-06-09
• Study Type: interventional
• Target: 39
• Locations: 0 countries
• Sites: N/A

Brief Summary

Thyroid gland and its hormones play an important role in organ development and the homeostatic control of many physiological mechanisms such as body growth and energy expenditure. The two main thyroid hormones are triiodothyronine (T3) and thyroxine (T4) affect renal development and metabolism so any impairment in thyroid functions lead to or aggravate kidney diseases. On the other hand, kidneys play an important role in the thyroid metabolism as it normally contributes to the clearance of iodide, primarily by glomerular filtration. Among patients with renal failure, there is diminished iodide excretion and an increase in plasma inorganic iodide, which results in increased uptake of the iodide by the thyroid gland. Increases in total body inorganic iodide can potentially block thyroid hormone production (the Wolff-Chaik off effect). Such a change may explain the slightly higher frequency of goiter and hypothyroidism in patients with chronic kidney diseases. The kidneys affect the hypothalamic pituitary-thyroid axis, so any impairment in kidney functions leads to disturbed thyroid physiology. All levels of the hypothalamic-pituitary-thyroid axis may be involved, including alterations in hormone production, distribution, and excretion. End stage renal disease (ESRD) and hemodialysis (HD) affect the levels of all thyroid hormones. The earliest and the most common thyroid function abnormality in patients with ESRD on HD is low T3 level (especially total T3 than free T3). This is called 'low T3 syndrome. The prevalence of subclinical hypothyroidism has been reported to be much higher in patients with ESRD on HD than in the general population. Due to similarity of signs and symptoms, sometimes it is difficult to identify subjects with ESRD also has hypothyroidism; therefore, different studies have been carried out to establish the incidence of these conditions.

Conditions

Chronic Renal Failure

Outcome Measures

Primary Outcomes (1)

• Detection of thyroid function in hemodialysis childern

  Detection of decrease thyroid function(T3\_T4\_TSH) in hemodialysis childern Detection of increase thyroid function(T3\_T4\_TSH) in hemodialysis childern

  6 months

Study Arms (1)

pediatric group

EXPERIMENTAL

Diagnostic Test: thyroid function tests; Diagnostic Test: complete blood count; Diagnostic Test: serum creatinine; Diagnostic Test: blood urea; Diagnostic Test: serum electrolyte; Diagnostic Test: serum calcium; Diagnostic Test: serum phosphorus; Diagnostic Test: parathyroid hormone level; Diagnostic Test: liver function test; Diagnostic Test: arterial blood gases; Diagnostic Test: complete urine analysis

Interventions

thyroid function tests DIAGNOSTIC_TEST

Thyroid function tests:thyroid stimulating hormone (TSH), total thyroxine (T4), free thyroxine (FT4), total triiodothyronine (T3), and free triiodothyronine (FT3)

pediatric group

complete blood count DIAGNOSTIC_TEST

complete blood count

pediatric group

serum creatinine DIAGNOSTIC_TEST

serum creatinine

pediatric group

blood urea DIAGNOSTIC_TEST

blood urea

pediatric group

serum electrolyte DIAGNOSTIC_TEST

serum electrolyte

pediatric group

serum calcium DIAGNOSTIC_TEST

serum calcium

pediatric group

serum phosphorus DIAGNOSTIC_TEST

serum phosphorus

pediatric group

parathyroid hormone level DIAGNOSTIC_TEST

parathyroid hormone level

pediatric group

liver function test DIAGNOSTIC_TEST

ALT\_AST\_Total biliruin\_total protein \_serum albumin

pediatric group

arterial blood gases DIAGNOSTIC_TEST

PH\_PCO2\_PO2\_HCO3\_base deficit

pediatric group

complete urine analysis DIAGNOSTIC_TEST

complete urine analysis

pediatric group

Eligibility Criteria

• Age: 2 Years - 16 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children started hemodialysis for end stage renal disease at age of 2 to 16 years will be included in the study.

You may not qualify if:

• Patients with known thyroid disease. Patients with a history of autoimmune disease .

Sponsors & Collaborators

• Sohag University: lead

Related Publications (2)

• Pan B, Du X, Zhang H, Hua X, Wan X, Cao C. Relationships of Chronic Kidney Disease and Thyroid Dysfunction in Non-Dialysis Patients: A Pilot Study. Kidney Blood Press Res. 2019;44(2):170-178. doi: 10.1159/000499201. Epub 2019 Apr 23.

  PMID: 31013508 BACKGROUND

• Naseem F, Mannan A, Dhrolia MF, Imtiaz S, Qureshi R, Ahmed A. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease on maintenance hemodialysis. Saudi J Kidney Dis Transpl. 2018 Jul-Aug;29(4):846-851. doi: 10.4103/1319-2442.239646.

  PMID: 30152421 BACKGROUND

MeSH Terms

Conditions

Kidney Failure, Chronic

Interventions

Thyroid Function Tests; Blood Cell Count; Blood Urea Nitrogen; Liver Function Tests; Blood Gas Analysis

Condition Hierarchy (Ancestors)

Renal Insufficiency, Chronic; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Diagnostic Techniques, Endocrine; Diagnostic Techniques and Procedures; Diagnosis; Cell Count; Cytological Techniques; Clinical Laboratory Techniques; Hematologic Tests; Investigative Techniques; Cell Physiological Phenomena; Blood Physiological Phenomena; Circulatory and Respiratory Physiological Phenomena; Blood Chemical Analysis; Clinical Chemistry Tests; Kidney Function Tests; Diagnostic Techniques, Urological; Diagnostic Techniques, Digestive System; Respiratory Function Tests; Diagnostic Techniques, Respiratory System

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: resident doctor at pediatric department

Study Record Dates

• First Submitted: June 20, 2022
• First Posted: July 11, 2022
• Study Start: July 1, 2022
• Primary Completion: January 1, 2023
• Study Completion: January 1, 2023
• Last Updated: July 11, 2022

Record last verified: 2022-07