Purpose of review: Chronic kidney disease is characterized by multiple abnormalities in the thyroid hormone physiology. In the present review, we will briefly discuss the effects of uremia on thyroid hormone synthesis, metabolism, transport, and action.
Recent findings: Uremic toxins have been shown to interfere at various levels of the thyroid hormone action, including thyroid hormone transport across plasma membrane and thyroid hormone receptor activity. These abnormalities could explain the resistance to thyroid hormone action in uremia, at least in some tissues.
Summary: The pathogenesis of thyroid axis abnormalities in uremia is incompletely understood, and its clinical significance remains unclear. The increasing prevalence of chronic kidney disease underscores the need for further efforts to understand the metabolic consequences of uremia and address questions such as the impact of thyroid hormone therapy.