Prevalence of subclinical hypothyroidism in patients with chronic kidney disease on maintenance hemodialysis.

Abstract

The prevalence of subclinical hypothyroidism (SHT) has been reported to be much higher in patients with chronic kidney disease (CKD) than in the general population. SHT has been identified as a strong predictor of mortality and a risk factor for cardiovascular disease in CKD. The study aimed to provide local data on the prevalence of SHT in CKD patients on maintenance hemodialysis (MHD). A total of 72 patients with CKD on MHD were enrolled. Nonprobability consecutive sampling was performed on patients of either gender aged 14-50 years who met the inclusion and exclusion criteria. Thyroid-stimulating hormone and free thyroxine four levels were obtained and interpreted for the presence of SHT. SHT was present in 22 patients (30.6%). When stratified according to age, 22.7% of patients were younger than 30 years, 20.8% between 30 and 40 years and 46.2% were above 40 years. The percentage of patients above 40 years with SHT was much higher, but not statistically significant (P = 0.096). When stratified according to gender, 21.6% were male, and 46.2% were female (P = 0.03). When stratified according to duration on hemodialysis (HD), 4.5% of patients on HD for two years or less had SHT; 25.9% on HD for three to five years and, 60.9% on HD for more than five years had SHT (P <0.01). The study shows a considerably high prevalence of SHT in CKD patients on HD. Routine screening of thyroid functions in these patients, especially in females and those on HD for >5 years, may help in reducing the morbidity and mortality associated with SHT through early detection and timely intervention.