Estimation of Thyroid Function Tests in Patients with Chronic Kidney Disease: A Cross Sectional Observational Study
Keywords:
Chronic kidney disease, Hypothyroidism, Thyroid function testAbstract
Introduction: Abnormal thyroid functions tests are frequently observed in patients of chronic kidney
disease (CKD). Kidneys play a significant role in thyroid hormone metabolism by converting T4 to T3
(the active metabolite). Low plasma T3 in end stage renal disease is a marker of inflammation and
endothelial dysfunction and also a known cause for mortality.
Objectives: The study was undertaken to assess the biochemical abnormalities of thyroid function
tests in CKD patients and to correlate the severity of CKD with thyroid function tests.
Methodology: A total of 45 (n=45) CKD patients attending outpatient or inpatient departments of
general medicine and nephrology were included in this study. Informed consent was obtained from
all the patients. All the biochemical reports of the patients viz. blood urea, serum creatinine, thyroid
profile (TSH, TT3, TT4) were collected from the patients and values were entered in the individual
patient case report form. Patient’s symptoms with respect to renal and thyroid abnormality were also
noted in the forms. Correlation between thyroid abnormalities and CKD stage were analyzed using
Chi square test and ANOVA tests.
Results: The mean age of the CKD patients was 51.4 ± 12.6 years of which 35 were male and 10 were
females. The mean value of TT3 in CKD stage III, IV and V were 112.5 ±15.8; 98.8±24.9; and 77.9±29
ng/ml, respectively (p= 0.02 significant). The mean value of TT4 in CKD stage III, IV and V were 6.47±
0.67; 5.12±1.16; 4.41±1.52 ?g/ml, respectively (p=0.003 significant).
Conclusion: Total T3 and T4 were found to be progressively decreased as stage of CKD advances. There
was a significant correlation between the prevalence of thyroid dysfunction and the stage of chronic
kidney disease. Higher the degree of renal insuffiency, the greater was the prevalence of thyroid
hormone abnormalities. The thyroid hormones i.e. T3, T4 level decreases and the TSH increases as
the severity of renal failure advances. Thyroid hormone abnormalities could represent a risk factor
for cardiovascular disease and might also be implicated in kidney disease progression.
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