Alteration of thyroid physiology in chronic kidney disease

Abstract

Introduction: Endocrine abnormalities are very common in CKD and among them thyroid dysfunction is most commonly occurring in CRF patients. Hyperthyroidism, hypothyroidism & euthyroid state have all been reported by various workers but hypothyroidism incidence was found to be more common. Aim: To assess the prevalence of alteration of thyroid physiology among patients chronic renal failure patients and to correlate between the thyroid hormone levels and the severity of chronic kidney disease. Materials and Methods: A cross-sectional observational study was conducted at our hospital for a period of one year. A total of 73 patients with chronic renal failure were included in the study. A detailed clinical history and clinical examination was conducted with preference to thyroid and renal diseases. Serum fT3, fT4 and TSH were measured using standard technique. Results: Majority of the study subjects were in stage V (end stage renal disease) CRF followed by stage IV CRF and only 5 – 8% of the subjects were in stage 1 and stage II CRF. The thyroid profile of our study subjects showed hypothyroidism was present in 43.8% of the CRF patients and in that majority of them had low T3 levels, followed by low T4 levels (36.9%) and an increased TSH levels (19.1%). The correlation between the T3, T4 levels and the various stages of CRF had shown a strong negative correlation, as the stages of CRF increases the number of patients with reduced T3 and T4 levels were found to be increasing and this was found to be statistically significant (p.05). Conclusion: Alteration of thyroid physiology among CRF patients found to be increasingly common and so thyroid screening should be made mandate for all patients with CKD. Keywords: Chronic kidney disease, Thyroid physiology, Free T3, Free T4 and TSH.