DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20203679

Occurrence of subclinical and overt hypothyroidism among chronic kidney disease patients

Dilip Kumar Jha, Gregory Minj, Umesh Prasad, Yuvraj Lahre, Diljeet Bodra

Abstract


Background: Chronic kidney disease (CKD) is one of the vital health problems worldwide leading to increased global morbidity and mortality. Thyroid dysfunction including hypothyroidism, hyperthyroidism and non-thyroidal illness has been reported in CKD patients. This study was conducted to determine the prevalence of subclinical and overt hypothyroidism among chronic kidney disease patients. This study also tried to correlate thyroid function abnormalities with severity of renal failure.

Method: In this observational and cross sectional study, 100 patients of CKD who were admitted in Department of Medicine, Rajendra institute of medical sciences, Ranchi were studied for thyroid function abnormalities. 

Result: This study found that glomerular filtration rate (GFR) is positively correlated with serum T3 and T4 level (i.e. with decreasing renal function both T3 and T4 levels decreased). Serum creatinine levels were negatively correlated with serum T3 and T4 level.

Conclusions: From this study it was established that CKD is associated with thyroid dysfunction characterized by low serum fT3 and fT4 with high TSH in some cases.


Keywords


Chronic kidney disease, Glomerular filtration rate, Overt hypothyroidism, Subclinical hypothyroidism, Thyroid dysfunction

Full Text:

PDF

References


Levey AS, Coresh J, Balk E, Kausz AT, Perrone RD. National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification and stratifiction. MD Ann Intern Med. 2003;139:137-47.

Bargman JM, Korecki KS. Chronic kidney disease. In: Dan L. Lango, Anthony S. Fauci, Dennis Kasper et al. Harrison’s Principles of Internal Medicine, Vol. 2, 18th edn., McGraw Hill, USA; 2011:2289-93;2308-13.

Ramirez G, Jubiz W, Gutch CF, Bloomer HA, Siegler R, Kolff WJ. Thyroid abnormalities in renal failure: A study of 53 patients on chronic hemodialysis. Ann Intern Med. 1973;79:500-4.

Hegedus L. Thyroid gland volume and serum concentrations of thyroid hormone in chronic renal failure. Nephron. 1985;171-4.

Giordano C. Thyroid Status and nephron loss-a study in patients with chronic renal faialure, end stage renal disease and/or on hemodialysis. Mt J Artif Organs. 1984;17:119-22.

Singh PA, Bobby Z, Selvaraj N, Vinayagamoorthi R. An evaluation of thyroid hormone status and oxidative stress in undialyzed chronic renal failure patients. Indian J Physiol Pharmacol. 2006;50:279-84.

Iglesias P, Di´Ez JJ. Thyroid dysfunction and kidney disease. Eur J Endocrino. 2009;160:503-15.

Spector DA, Davis PJ, Helderman JH, Bell B, Utiger RD. Thyroid function and metabolic state in chronic renal failure. Ann Intern Med.1976;85:724-30.

Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005;67:1047-52.

Quion-verde. Prevalence of thyroid disease in chronic renal failure and dialysis patients. IXt1’ mt Congr of Nephrol. 1984;120.

Kaptein EM. Thyroid function in renal failure. Contribut Nephrol. 1986;50:64-72.

Kaptein E. The Thyroid in end stage renal diseases. Med. 1988;187-97.

Hegedus L. Thyroid gland volume and serum concentrations of thyroid hormone in chronic renal failure. Nephron. 1985;171-4.

Kayima JK. Thyroid hormones profile in patients with chronic renal failure on conservative management and regular hemodialysis. East Afr Med J. 1992;69:333-6.

Lukinac L, Kusić Z, Kes P, Nöthig-Hus D. Effect of chronic hemodialysis on thyroid function tests in patients with end-stage renal disease. Acta Med Croatica. 1996;50(2):65-8.