A Prospective Study on the Evaluation of Thyroid Function Status in Patients with Chronic Kidney Disease
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 9
Abstract
Background: Chronic Kidney Disease is a worldwide health problem with an increasing incidence and prevalence. Abnormalities in the structure and function of the thyroid gland and in the metabolism and plasma concentration of thyroid hormones are common in patients with Chronic Kidney Disease. In view of variability of thyroid function tests in patients with CKD in previous studies, a prospective study of various thyroid functions is undertaken to establish a correlation if any between thyroid dysfunction and severity of renal diseases. Method: Total number of 100 patients with Chronic Kidney Disease on conservative management who were admitted in MMCHRI was selected in this prospective study. Results: Out of the 100 patients with CKD 48 patients had low T3 syndrome (0.2-1.9ng/ml, mean 0.605) which accounts for 48% of the patients, 22 patients had low T4 syndrome (0.5-9.5μg/ml, mean 5.631) which accounts for 22% of the patients and 10 patients had primary hypothyroidism TSH >20μIU/ml. Excluding Primary Hypothyroidism, analysis of serum T3,T4 and TSH in the study subjects shows very high significance, p < 0.001. Distribution of Thyroid. Dysfunction in this study among various creatinine clearance levels showed that as glomerular filtration rate declines, number of patients with low T3 syndrome increased, p < 0.05, significant difference. In patients with low T3 syndrome, the mean values of TSH in various stages of renal disease are within normal range mean 4.85, values of TSH did not show any linear correlation with GFR. Number of patients with low T4 syndrome did not correlate with severity of renal disease. Conclusion: Thyroid Dysfunction occurred in 58% of the patients with chronic kidney disease in our study, it does not indicate a state of hypothyroidism, but a reflection of the state of chronic illness/malnutrition. The low T3 state of CKD can be viewed as being protective, promoting conservation of protein. The number of patient with low T3 syndrome progressively increase with the severity of renal failure.
Authors and Affiliations
Dr Kirubakaran S
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