Abstract
IntroductionThere is limited data on the prevalence of thyroid dysfunction in Ghanaian individuals with chronic kidney disease (CKD). Studies exploring the effect of thyroid hormones on renal function decline are also scanty. Unrecognized thyroid dysfunction in CKD may increase the burden of adverse health outcomes. The aim of this study was to determine thyroid hormone status and lipid profiles in patients with CKD attending the Renal Unit of the Korle-Bu Teaching Hospital.Methods60 clinically euthyroid patients with CKD, and 65 clinically euthyroid subjects without CKD were recruited for this study. Estimation of effective glomerular filtration rate (eGFR) was done using the 4-variable Modification of Diet in Renal Disease (MDRD) formula with subsequent staging of CKD (stages 2-4). Collected venous blood samples from all study participants were analyzed for creatinine, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), total cholesterol (TC), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) and triglycerides (TG).ResultsLevels of TC, HDL, LDL, and TSH levels did not differ significantly between the two study groups. However, TG, VLDL, FT3 and FT4 levels were significantly higher in CKD patients than in the control group. TC, TG, HDL, LDL, VLDL and TSH levels were not significantly different between stages of CKD in study subjects, although FT4 and FT3 levels were significantly different between all stages of CKD.ConclusionHigher levels of FT3 and FT4 but not TSH, are associated with the incidence of CKD and eGFR decline in Ghanaian CKD patients.
Highlights
There is limited data on the prevalence of thyroid dysfunction in Ghanaian individuals with chronic kidney disease (CKD)
Blood pressure was significantly higher in CKD patients when compared to the control group
FT3 and FT4 levels were found to be significantly higher in CKD patients than in the control group, mean FT3 and FT4 values, as well as that of thyroid stimulating hormone (TSH) were all within the reference range
Summary
There is limited data on the prevalence of thyroid dysfunction in Ghanaian individuals with chronic kidney disease (CKD). Alterations in thyroid hormone status have been observed in patients with CKD, alongside the prevalence of thyroid dysfunction which has been shown to increase with progression of CKD [2, 4]. The ability to detect subtle changes in the status of thyroid hormones has improved with the array of modern laboratory testing currently available, no recommendations are available regarding the treatment of mild abnormalities of thyroid hormone levels in patients with CKD not requiring dialysis These mild abnormalities in thyroid hormone levels may represent risk factors for adverse health outcomes such as cardiovascular disease, and could be implicated in kidney disease progression [4]. In view of the reported altered thyroid function and dyslipidemia observed in some CKD patients in other populations and the lack of data on thyroid status and lipid profile changes in the Ghanaian subjects with CKD, we undertook this study to determine the thyroid hormone status in Ghanaian patients with CKD and its association with lipid parameters
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