Thyroid profile in nondialysis-dependent patients with chronic kidney disease in a tertiary hospital in southern Nigeria

Abstract

Background: Chronic kidney disease (CKD) affects the hypothalamus–pituitary–thyroid axis and peripheral metabolism of thyroid hormones, which affects the concentration and activity of the hormones. Subclinical hypothyroidism (SCH) is the most common thyroid abnormality reported among patients with CKD and it has been associated with increased cardiovascular risk. The objective of this study was to determine thyroid hormone levels and thyroid disorders among Nigerian nondialysis-dependent patients with CKD. Materials and Methods: A cross-sectional, observational study was conducted in a tertiary hospital in southern Nigeria. Nondialysis-dependent patients with CKD attending the renal outpatient clinic of the hospital were recruited over a period of 3 months. Control participants were recruited from healthy consenting hospital staff. Patients with known thyroid disease were excluded. Serum thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH) levels were assayed using the enzyme-linked immunosorbent assay method. Results: Forty patients with CKD (26 men and 14 women) and 20 healthy adults (10 men and 10 women) were studied. The mean age of patients and controls were 54.9 ± 13 years and 44.7 ± 7.3 years, respectively. The mean T4 levels for patients and controls were 4.98 ± 1.23 μg/ml and 5.49 ± 1.06 μg/ml, respectively. The median (interquartile range) values of T3 and TSH for patients were 0.8 (0.7) ηg/ml and 2.6 (3.1) μIU/ml, while that of the controls were 1.85 (2.1) ηg/ml and 1.4 (3.1) μIU/ml. Overt biochemical hypothyroidism was seen in 22% of patients while 10% of patients had SCH. Conclusion: Overt biochemical hypothyroidism was more prevalent among nondialysis-dependent patients with CKD compared to SCH in this study. A larger population study should be performed to confirm this finding among Nigerian patients with CKD.