Abnormal endocrine tests in a hemodialysis patient.

Abstract

A home hemodialysis patient with abnormal thyroid function tests and hyperprolactinemia is presented. Abnormal thyroid tests included low total triiodothyronine and low total thyroxine and free thyroxine; the latter was documented by the use of both RIA and direct dialysis equilibrium techniques. Serum thyroid-stimulating hormone was normal, and the thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation was in the low-normal range. Serum prolactin was elevated to more than twice the normal level, and the prolactin response to thyrotropin-releasing hormone was also blunted. The interpretation, pathogenesis, physiologic significance, and management of these abnormalities are discussed.