Effect of Chronic Kidney Disease on Outcome of Adult Patient Admitted With Hyperthyroidism: Analysis of the National Inpatient Sample 2016–2017

Abstract

Introduction: Kidney and thyroid function and dysfunction are interrelated through several mechanisms. Thyroid hormones can also have significant impact on kidney disease so it is important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD). Research shows that hyperthyroidism is usually not associated with CKD but is known to accelerate it. We sought to determine the effect of chronic kidney disease on patient admitted with hyperthyroidism. Methods: We queried the National Inpatient Sample (NIS) databases from 2016 to 2017 for adults aged 18 and above with hyperthyroidism as a principle diagnosis with and without hypertriglyceridemia using ICD-10 codes. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of 17,705 hyperthyroidism hospitalizations, 4% had chronic kidney disease. Chronic kidney disease with hyperthyroidism had a similar odd of inpatient mortality (AOR 0.79, CI 0.34–4.52, P= 0.787) and cardiogenic shock (AOR 2.66, CI 0.35–20.50, P=0.347). There was a statistically significant increase in odds of acute kidney injury (AOR 2.77, CI 1.60- 4.80, P <0.001) in those hospitalized with hyperthyroidism and chronic kidney disease compared to those with hyperthyroidism alone Conclusion: Chronic kidney disease is associated with similar odds of hospital mortality and cardiogenic shock among patients hospitalized for hyperthyroidism with increased odds of acute kidney injury compared to those without hyperthyroidism. It is very important to consider all clinical features and thyroid manifestations in those patients with CKD.