Prevalence and Clinical Characteristics of Hypothyroidism in a Population Undergoing Maintenance Hemodialysis

Abstract

The prevalence of hypothyroidism in persons with chronic kidney disease is documented to be higher, compared to the normal population. However, no data is available about the prevalence rate of hypothyroidism among hemodialysis patients in Nepal. A cross-sectional analysis was done on consecutive patients enrolled for maintenance hemodialysis in the Hemodialysis Unit of Gandaki Medical College Teaching Hospital, Pokhara, Nepal, during the period of one year (1(st) January 2011 to 31(st) December 2011). Total 64 subjects with end stage renal disease were recruited for the study. Thyroid function tests were performed at the time of starting regular hemodialysis. Classical symptoms and signs of hypothyroidism were assessed in all patients. Among the study subjects 17 (26.6%) had serum thyroid stimulating hormone levels above the laboratory reference range (>6.16 μIU/ml). Among them 12 (18.7%) patients had clinically significant symptoms or signs requiring thyroxin replacement. Cold intolerance, constipation, tingling sensation, dry skin, periorbital odema, pericardial effusion, pleural effusion and ascites were found at significantly higher rate in the hypothyroid patient group (p<0.05). The diagnosis of hypothyroidism can be easily missed in the end-stage kidney disease population, because the symptoms of chronic kidney disease and hypothyroidism overlap. In our study we have found high prevalence of hypothyroidism. Clinicians should pay attention on this factor and screen routinely for thyroid disorders in the chronic kidney disease population.