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Palmer
Thyroid function in chronic renal failurePalmer BF, Henrich WL
"The kidney normally contributes to the clearance of iodide, primarily by glomerular filtration. Thus, iodide excretion is diminished in advanced renal failure, leading sequentially to an elevated plasma inorganic iodide concentration and an initial increment in thyroidal iodide uptake. The ensuing marked increase in the intrathyroidal iodide pool results in diminished uptake of radiolabeled iodide by the thyroid in uremic patients. Increases in total body inorganic iodide can potentially block thyroid hormone production (the Wolff-Chaikoff effect). Such a change may explain the slightly higher frequency of goiter and hypothyroidism in patients with chronic renal failure."
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