PREVALENCE OF SUBCLINICAL HYPOTHYROIDISM IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 2
Abstract
Context Subclinical hypothyroidism,an independent predictor of cardiovascular morbidity and mortality, is 4 -10% prevalent in the general population. A higher prevalence of clinical and subclinical primary hypothyroidism exists in CKD patients leading to ESRD earlier. Aims To study the prevalence of Subclinical Hypothyroidism and its correlation with various stages of chronic kidney disease. Settings and Design: This Analytical study was conducted in patients coming to the OPD in Govt. Stanley Medical College Hospital. Methods and Material: 50 CKD patients in the predialysis phase and 50 healthy controls, who attend the regular OPD in Govt. Stanley Medical College Hospital were selected for our study. Staging of CKD done with the eGFR calculated using MDRD formula and the prevalence of subclinical hypothyroidism with TSH levels <10mIU/mL were studied in these patients and compared with the control population. Statistical analysis used Chi-square test, Regression analysis and Pearson’s correlation coefficient applied with the help of Microsoft Excel Software for studying the prevalence of Subclinical Hypothyroidism and its correlation with various stages of chronic kidney disease Results Subclinical hypothyroidism is more prevalent in CKD patients (40%) when compared with the general population (6%). Subclinical hypothyroidism was found to be 8%, 10%, 20% and 12% in the stages II, III, IV and V of CKD patients and it gradually increases as the stage of the CKD advances. As the eGFR falls, TSH starts increasing and it may be due to alteration in the hypothalamo-pituitary axis, TSH glycosylation and diurnal rhythm. It may also be due to altered metabolism of thyroid hormones and decreased peripheral conversion of T4 to T3.The exact mechanisms linking CKD and hypothyroidism are still unclear. Conclusions From the results of our study, we conclude that the prevalence of Subclinical hypothyroidism is high among all the stages of CKD patients. Need for treatment depends on the patient’s clinical scenario and decision of the clinician based on the presentation. Many more clinical trials are needed to prove the need for thyroxine replacement.
Authors and Affiliations
Siva Somana J, Mahalakshmi R, Vijayalakshmi M
Keywords
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