Prevalence of Thyroid Function Abnormalities in Patients with Chronic Renal Failure under Regular Hemodialysis

Abstract

Background: There are various changes in the thyroid gland and its function in end stage renal disease (ESRD). It is not surprising that impairment of kidney function leads to disturbed thyroid physiology. Objective: Is to detect thyroid function abnormalities in hemodialysis patients. Patients and Methods: 100 patients on maintenance hemodialysis (HD) were enrolled, they were excluded if they had the following criteria: history of thyroid disease, thyroid and parathyroid surgery, under interferon therapy, exposed to radiation, antithyroid drugs or thyroid replacement therapy, and those under 30 years. They were subjected to history taking, clinical examination and laboratory investigations including hepatitis C virological state, renal functions and thyroid functions. Results: 92% of patients had normal thyroid-stimulating hormone (TSH) levels, 8% had abnormal TSH levels. Regarding fT3 levels, 67 % had normal fT3 while 33 % had abnormal fT3, and only 11 patients had abnormal fT4. In respect to the thyroid hormone status, only one was hyperthyroid, 92% were in euthyroid status, 2% were clinically hypothyroid, 5% were subclinically hypothyroid, and 1% was hyperthyroid. There was significant negative correlation between TSH levels and dialysis duration, 8 patients having abnormal thyroid functions ere females, and 60% had HCV positive status. No significant associations were found between HCV infection and the thyroid hormones levels. However, HCV positive patients experienced lower levels of T4 and TSH. Conclusion: The average percentage of patients under regular hemodialysis with abnormal thyroid state is 8% with females having abnormal fT4 and TSH levels compared to males. TSH levels were inversely correlated with dialysis duration.