Low Triiodothyronine Syndrome Predicts The Outcome Of Peritoneal Dialysis Patients

Background:Most patients with chronic kidney disease?CKD?and hemodialysis have a high incidence of low T3 syndrome?LT₃S?.LT₃S has closely related to all-cause mortality and cardiovascular disease?CVD?mortality in these patients.However,the prevalence of LT₃S in peritoneal dialysis?PD?patients and its relationship with prognosis are still poorly studied.So we observed the incidence of LT₃S in peritoneal dialysis patients and explored their relationship with long-term outcomes.Objective:To investigate the prevalence of LT₃S in PD patients and its predictive value of LT₃S for all-cause and CVD mortality.Methods:This study included patients who started PD in our center between January 1^st,2009 to August 31^st,2015.Measurement of thyroid hormones was performed.Patients with FT3<3.5pmol/l or TT3<0.92nmol/l were group LT₃S,and other patients were normal T3group.The association between FT3 and mortality in PD patients was estimated using Cox proportional hazards models.Results:A total of 472 PD patients with mean age is 59.4±16.08years.Among them 253?53.6%?were males,125?26.5%?with diabetes mellitus and 123?26.1%?had CVD comorbidity.Compared to the patients with normal T3,patients with LT₃S showed lower hemoglobin?97.79±23.48 vs 105.12±24.68g/l?,serum albumin?33.78±6.95vs35.96±5.02g/l??prealbumin?304.53±92.05 vs 336.90±98.19mg/l?and serum corrected calcium?2.05±0.36 vs 2.16±0.31mmol/l??P all<0.01?.LT₃S patients were higher in serum phosphorus?1.67±0.57 vs1.47±0.47mmol/l?,BNP[251.20?128.50,604.50?vs 153.50?58.78,380.25?pg/ml],hrCRP[2.70?0.94,6.40?vs 1.33?0.54,3.33?mg/l]and serum cholesterol?3.26±1.31 vs 2.83±1.03mmol/l??Pall<0.01??LVMI of LT₃S group?151.53±57.29 vs 123.50±41.80g/m2?was higher than that in the patients with normal T3?P<0.01?.The survival rate of LT₃S group was significantly lower than that of normal T3 group?Log-rank 38.14,P<0.05?.Cox proportional hazards model analysis indicated that FT3 was an independent predictor for all-cause mortality[HR 0.60,95%CI 0.48-0.75;P<0.01]and CVD mortality[HR 0.66,95%CI 0.50-0.88;P<0.01]in PD patients.Conclusion:LT₃S is common in peritoneal dialysis patients.FT3level predicts all-cause and cardiovascular mortality in PD patients.