ESPN 53rd Annual Meeting

ESPN 2021


 
Thyroid functions in Pediatric Patients after Renal Transplantation
DEMET ALAYGUT 1 GÖKÇEN ERFIDAN 1 EREN SOYALTIN 1 ÖZGÜR ÖZDEMIR ŞIMŞEK 1 CEMALIYE BAŞARAN 1 SEÇIL ARSLANSOYU ÇAMLAR 2 FATMA MUTLUBAŞ 2 BUMIN NURI DÜNDAR 3 BELDE KASAP DEMIR 4

1- IZMIR UNIVERSITY OF HEALTH SCIENCES TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- UNIVERSITY OF HEALTH SCIENCES IZMIR FACULTY OF MEDICINE DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY
3- KATIP CELEBI UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC ENDOCRINOLOGY
4- KATIP CELEBI UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC NEPHROLOGY AND RHEUMATOLOGY
 
Introduction:

 

Kidney transplantation is the preferred replacement therapy for patients with end-stage renal disease (ESRD). However, long-term immunosuppression may be responsible of a variety of complications, including the development of thyroid disease. This study evaluated the incidence of thyroid disease  in a pediatric population of kidney transplant recipients performed in a single center.

Material and methods:

 

This retrospective study included 24 pediatric patients who received kidney transplantation between 2009-2019 and with regular follow-up. After transplantation, in all transplant recipients Free T3 (normal range 1.8–4.2 pg/mL) and free T4 (normal range 0.8–1.9 ng/dL) levels were measured on a yearly basis and an ultrasonography of the neck was performed every 2 years.

Results:

 

Data of 24 patients, 16 of whom (66.7%) were male, were obtained. Mean transplantation ages were 11.16 ± 4.21 (1-17) years. There were 11 (45.8%) living / 13 (54.2%) cadaveric transplants. When primary diseases were examined, 12 (50.0%) had CAKUT, 6 (25%) had chronic glomerulonephritis, 5 (20.8%) had chronic tubulopathy, and 1 had HUS. Preemptive transplantation was performed in three cases. 12 (50.0%) patients were followed up in the peritoneal dialysis program before transplantation. When the dialysis periods were examined, the mean was 1.96 ± 1.72 (0-6) years. 22 cases were using the steroid + MMF + Tacrolimus regimen immunosuppressively. Induction was performed in 14 (58.3%) cases with basiliximab. In 13 cases, post-transplantation developed acute graft dysfunction (AGD) at different times. When the mean fT3, fT4 and TSH levels are evaluated, 3.53 ± 0.67 (1.89-4.45), 0.93 ± 0.22 (0.60-1.65) and 2.07 ± 1,25 (0.52-5.59) were detected respectively. Anti-thyroid peroxidase antibody and anti-thyroglobulin antibody (Anti Tg) were only high in one patient. fT3 was above 4.2 pg / mL in three cases and all three cases had AGD.

Conclusions:

 

Thyroid diseases are common in transplant recipients. Thyroid disease may evolve after transplantation, probably as a consequence of immunosuppression. but we did not find abnormalities in this series.