A study on thyroid function assessment in patients with chronic kidney disease: An investigative analysis

Abstract

Background: Chronic Kidney Disease (CKD) and thyroid dysfunction often coexist, and understanding their relationship is crucial for diagnosis and management. Aims and Objectives: This study aimed to explore the prevalence, clinical significance, and implications of thyroid function abnormalities in CKD patients, providing valuable insights for improving patient care and outcomes. Methods: This observational cross-sectional study included 46 CKD patients undergoing conservative management at Aditya Hospitals and Diagnostics, Dibrugarh, from July 2021 to July 2022. Participants met predefined inclusion criteria and provided informed consent. Exclusion criteria encompassed active treatment with dialysis or kidney transplantation, nephrotic-range proteinuria, hypoalbuminemia, acute illness, diabetes mellitus, recent surgery, trauma, burns, liver diseases, and medications affecting thyroid function. Results: The study involved 31 male (67.39%) and 15 female (32.60%) CKD patients aged 19 to 69 years. CKD symptoms' duration ranged from 4 to 30 months (mean 9.8 months). Serum T3 levels ranged from 0.2 to 2.0 ng/ml (mean 0.67 ng/ml), T4 levels from 0.9 to 8.5 μg/dl (mean 5.7 μg/dl), and TSH levels from 0.6 to 38 μIU/ml (mean 6.5 μIU/ml). Hypothyroidism symptoms were observed in 31 patients (67%). Low T3 syndrome was found in 27 patients, low T4 syndrome in 11 patients, and hypothyroidism in 3 patients. Conclusion: The study revealed that the incidence of low T3 syndrome increased with age and CKD severity. Patients with lower GFR exhibited decreased serum T3 levels. Interestingly, in patients with low T3 syndrome, TSH values remained within the normal range and did not correlate with GFR. The findings suggest that low T3 levels in CKD may play a protective role in protein conservation. This investigation sheds light on the complex relationship between thyroid function and CKD, emphasizing the need for regular thyroid assessments in CKD patients for better management and improved clinical outcomes. Early identification and appropriate intervention for thyroid abnormalities in CKD may contribute to optimizing patient care and overall well-being.