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Association of thyroid status prior to transition to end-stage renal disease with early dialysis mortality

Nephrology Dialysis Transplantation Dec 09, 2019

You AS, Sim JJ, Kovesdy CP, et al. - In order to determine if mortality after dialysis initiation could be influenced by thyroid status in the pre-end-stage renal disease (ESRD) period, researchers performed this study utilizing the national Veterans Affairs database. They focused on the link of pre-ESRD serum thyrotropin (TSH) concentrations averaged over the 1-year prior to dialysis (‘prelude’) period with all-cause death in the first year after dialysis initiation in US veterans with chronic kidney disease. In expanded case-mix Cox models, higher mortality was observed in relation to TSH levels >5.0 mIU/L among 15,335 patients in the 1-year prelude cohort. They noted similar results for TSH > 5.0 mIU/L and mortality in the 2- and 5-year cohorts. Overall, a dose-dependent link between higher pre-ESRD TSH levels > 5.0 mIU/L and post-ESRD mortality was revealed among new ESRD patients.
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