THYROID DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: THE STATE OF THE PROBLEM AND THE WAYS OF SOLVING

2018 ◽  
Vol 22 (4) ◽  
pp. 40-49 ◽  
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
B. G. Lukichev ◽  
S. V. Dora ◽  
O. V. Galkina
Keyword(s):  
Chronic Kidney Disease ◽  
Thyroid Gland ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
The Body ◽  
Type I ◽  
Low T3 ◽  
Iodine Excretion

Disturbance of the thyroid function is often detected in patients with different profiles. A special feature of patients with chronic kidney  disease is the higher incidence of various thyroid function  disturbances, especially hypothyroidism. It is known that in patients  with chronic kidney disease (CKD) iodine excretion from the body is  violated, since normally 90% of iodine is excreted in urine.  Accumulation of high concentrations of inorganic iodine leads to the  formation of the Wolf-Chaikoff effect: suppression of iodine  organization in the thyroid gland and disruption of the thyroid  hormones synthesis. Peripheral metabolism of thyroid hormones is  also disturbed, namely, deiodinase type I activity is suppressed and  peripheral conversion of T4 into T3 is inhibited (so-called low T3  syndrome). Therefore, patients with CKD are often diagnosed with  hypothyroidism, and the origin of hypothyroidism is not always  associated with the outcome of autoimmune thyroiditis. The article  presents an overview of a large number of population studies of  thyroid gland dysfunction in patients with CKD, as well as  experimental data specifying the pathogenetic mechanisms of  thyroid dysfunction in patients with CKD. Therapeutic tactics are still  not regulated. However, in a number of studies, replacement therapy with thyroid hormones in patients with CKD had some advantages.

scholarly journals Thyroid Function Test in Patients with Chronic Kidney Disease

2021 ◽  
pp. 150-158
Author(s):  
V. Abhinaya ◽  
S. Magesh Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Function Test ◽  
Free T4 ◽  
Cross Sectional ◽  
Male Predominance ◽  
Low T3

Background: Kidneys have a significant role in the metabolism, degradation and excretion of thyroid hormones. Both thyroid hormones and kidney functions have a multifaceted mutual interdependence. Objectives: To find out the possible association between the severity of chronic kidney disease and thyroid dysfunction; To estimate the correlation between thyroid dysfunction and various stages of chronic kidney disease. Materials and Methods: A prospective Cross-sectional study was done on 50 patients with Chronic kidney disease who were not on dialysis and fulfilled all the inclusion criteria at Saveetha medical college over a period of 6 months. Free T3, Free T4 and TSH levels were estimated for those patients. Results: Results of this study showed that majority of subjects included in our study were in the age group of 50-60 years with Male predominance. Out of 50 patients included in our study, 8 patients(16%) were found to hypothyroidism; 5 patients (10%) were having subclinical hypothyroidism; 20 patients (40%) were having low T3 syndrome and 17 patients (34%) were having normal functioning thyroid gland. Staging of CKD was done in relation to the glomerular filtration rate .Most of the patients(n=20) were in Stage 5 of Chronic kidney disease out of which 18 patients were having thyroid disorders. Conclusion: There is a positive correlation between the severity of CKD and thyroid dysfunction. Hence a routine thyroid function status should be evaluated in each and every patient of CKD to reduce the morbidity and mortality rate of CKD patients as well as reduce the social burden and health expenditure.

Associations between thyroid dysfunction and chronic kidney disease

2014 ◽  
Vol 21 (1) ◽  
pp. 37-42
Author(s):  
Rucsandra Dănciulescu Miulescu ◽  
Marius Cristian Neamţu ◽  
Denisa Margină ◽  
Cătălina Poiană ◽  
Diana Loreta Păun
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Diabetic Patients ◽  
Low T3 Syndrome ◽  
Low T3 ◽  
Patients With Diabetes

Abstract Background and Aims. The interactions between kidney and thyroid functions are well established: thyroid hormones are necessary for the maintenance of electrolyte and water homeostasis and kidney is involved in the regulation of thyroid hormones metabolism. The aim of our study was to estimate the prevalence of thyroid dysfunction in patients with diabetes mellitus and chronic kidney disease (CKD). Material and Method. 23 patients with diabetes mellitus and CKD in pre-dialysis phase were recruited for this study. All subjects were investigated with thyroid ultrasound and laboratory tests to determine thyroid function, including: serum triiodothyronine (T3), free thyroxine (free T4), thyroid-stimulating hormone (TSH) and antithyroid peroxidase antibodies (ATPO). Results were compared with the same measurements in 21 patients with diabetes mellitus but without CKD. Results. The prevalence of goiter (52.17% vs. 19.04%, p<0.05), subclinical hypothyroidism (23.80% vs. 9.52%, p<0.05), hypothyroidism (8.69% vs. 4.76 %, p<0.05) and low T3 syndrome (23.80% vs. 0.00% p<0.05) were significant high in diabetic patients with CKD compared with patients with diabetes mellitus but without CKD. Conclusions. We observed high prevalence of thyroid morphology abnormalities and thyroid function disorders in diabetic patients with CKD. Low T3 syndrome and subclinical hypothyroidism are the most frequently thyroid function disorders in CKD patients.

To Study Thyroid Function and Lipid Profile Levels in Chronic Kidney Disease Patients in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (32) ◽  
pp. 2980-2987
Author(s):  
Navjot Kaur Layal ◽  
Tejinder Sikri ◽  
Jaskiran Kaur ◽  
Jasmine Kaur ◽  
Hardeep Singh Deep
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Profile ◽  
Thyroid Dysfunction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Care Hospital ◽  
Low T3 ◽  
Group A

BACKGROUND Chronic kidney disease (CKD) includes a spectrum of different pathophysiology processes associated with abnormal kidney function, and a progressive decline in GFR. Progression of CKD is associated with having a number of complications, including thyroid dysfunction, dyslipidaemia, and cardiovascular diseases. METHODS The present study was conducted among 60 CKD patients (cases) and 60 healthy controls to compare their thyroid and lipid profile, who attended the Department of Medicine in SGRDIMSR, Sri Amritsar from January 2019 to December 2020.These 60 CKD patients were grouped as group A. Group A was further divided into various stages as per KIDGO staging according to GFR. 60 healthy individuals were taken as controls and were kept as Group B. Demographic features (age and sex) and medical history of diabetes mellitus, hypertension were noted and blood samples (5mL) were analysed for blood urea, serum creatinine, free triiodothyronine (T3), free thyroxine (T4), thyroid stimulating hormone (TSH), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low density lipoprotein (VLDL) and triglycerides. RESULTS Thyroid dysfunction was observed in patients of CKD, the most common being overt hypothyroidism (56.6 %) followed by subclinical hypothyroidism (16.6 %), low T3 (15 %), and hyperthyroidism (1.6 %). Hypercholesterolemia, low HDL, elevated LDL, VLDL and triglyceride levels were observed in 74.9 %, 85.0 %, 38.3 %, 41.6 % and 76.6 % patients, respectively. Patients with CKD with 5 had significantly higher risk of having thyroid dysfunction and dyslipidaemia as compared to patients with stage 3 and 4. CONCLUSIONS Thyroid dysfunction and dyslipidaemia were common in patients with CKD. Prevalence of hypothyroidism, dyslipidaemia increases with progression of CKD. Hence early detection of thyroid dysfunction and dyslipidaemia is imperative to improve mortality and morbidity of CKD patients. KEYWORDS Chronic Kidney Disease, Dyslipidaemia, Thyroid Dysfunction

scholarly journals Relationships of Chronic Kidney Disease and Thyroid Dysfunction in Non-Dialysis Patients: A Pilot Study

2019 ◽  
Vol 44 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Binbin Pan ◽  
Xin Du ◽  
Hao Zhang ◽  
Xi Hua ◽  
Xin Wan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Thyroid Hormone ◽  
Kidney Disease ◽  
Thyroid Dysfunction ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hemoglobin C ◽  
Low T3 ◽  
Ckd Stage

Context: Patients with chronic kidney disease (CKD) usually manifest with disorder of thyroid hormone; however, the correlation is unknown. Objective: The study was designed to explore the relationships between CKD and thyroid dysfunction. Design, Setting, and Participants: A total number of 905 non-dialysis participants were collected at Nanjing First Hospital from August 2009 to October 2012 according to the case records system. Patients were grouped via the estimated glomerular filtration rate (eGFR) according to the KDIGO guideline. Levels of thyroid hormone and biomarkers in different CKD groups were compared by ANOVA. Prevalence of different thyroid diseases was calculated by χ2 test. Results: We found that FT3 or T3 became more prevalent with increasing eGFR with the lowest level in CKD5 (p < 0.01). No significant differences were found between groups in FT4, T4, or TSH (p > 0.05). Frequency of euthyroid sick syndrome (ESS) in CKD groups was high, especially in CKD stage 5 (69.1%, p < 0.01). eGFR had positive correlation with T3 and FT3 (r = 0.239, p = 0.0001; r = 0.292, p = 0.0001). ESS had correlations with prealbumin, β2-microglobin, eGFR, and C-reactive protein (r = 0.095, p = 0.004; r = –0.12, p = 0.001; r = 0.091, p = 0.007; r = –0.096, p = 0.008; r = 0.154, p = 0.001). After adjustment for prealbumin, uric acid, HbA1c, age, gender, eGFR, and β2-microglobin, binary regression revealed that hemoglobin, C-reactive protein, and albumin were independent influence factors of ESS (p = 0.016, r = 1.014; p = 0.023, r = 1.007; p = 0.029, r = 0.996). Conclusion: CKD patients have a high morbidity of ESS, mainly low T3 syndrome. Anemia, inflammation, and malnutrition may contribute to ESS in CKD.

scholarly journals FREQUENCY OF THYROID DYSFUNCTION IN CHRONIC KIDNEY DISEASE PATIENTS

2021 ◽  
Vol 31 (03) ◽  
pp. 142-145
Author(s):  
Adil Mehmood ◽  
Roshina Anjum ◽  
Muhammad Shahbaz ◽  
Rizwan Hafeez ◽  
Zahra Fatima ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Dopamine Antagonists ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Female Ratio

Objectives: To determine the frequency of thyroid dysfunction in chronic kidney disease patients. Methods: It was a Cross-sectional Study at department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Duration of the study was from 20th October 2018 to 19th April 2019. 72 patients with chronic kidney disease, 20 to 60 years of age and of both genders were included. Patients with known thyroid disorders or taking medication that can affect thyroid function (dopamine antagonists, antiepileptic, oral contraceptives, lithium, and glucocorticoids) were excluded. Venous blood sample was taken and sent to the laboratory for thyroid function tests. Results: Age of the patients included in this study was from 20 to 60 year and mean age was 41.97 ± 9.76 years. Most of them 42 (58.33%) were between 41 to 60 years of age. Out of 72 patients, 44 (61.11%) were male and 28 (38.89%) were female with male to female ratio of 1.6:1. Mean duration of disease in our study was 5.71 ± 2.50 years .Mean BMI was 27.75 ± 3.01 kg/m2.Thyroid dysfunction was present in 23 (31.94%) patients of chronic kidney disease. Conclusion: Thyroid dysfunction is frequently found in chronic kidney disease patients.

THYROID DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2019 ◽  
Vol 23 (1) ◽  
pp. 60-66
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
I. M. Abramova ◽  
E. V. Nechaeva ◽  
O. V. Galkina ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Comparison Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Low T3 ◽  
Iodine Excretion ◽  
Advanced Stages ◽  
Peripheral Metabolism ◽  
Hypothyroid Patients

It is known that patients with chronic kidney disease (CKD) often have hypothyroidism. In patients with CKD, iodine excretion in the urine is disrupted. The high content of iodine in the thyroid gland and tissues leads to a disruption in the synthesis and peripheral metabolism of thyroid hormones. In hypothyroidism, there is a disruption of sodium and water reabsorption in the proximal tubule, the volume of the filtrate increases, the volume of the tubular apparatus overloads, and the eGFR decreases.THЕAIM:to study the occurrence of hypothyroidism in patients with different stages of CKD, to evaluate the parameters of thyroid status and antithyroid antibodies in patients with CKD.PATIENTS AND METHODS.953 patients from I.P. Pavlov SPbSMU clinics (screening group) were examined. TSH, free T4, serum creatinine were defined and eGFR was calculated using the formula CKD-EPI in all patients. A group of patients with hypothyroidism accounted for 466 patients. Patients with a normal TSH of 0.4-2.5 mIU / L (comparison group) were selected from the screening group.RESULTS.eGFR in the screening group and in the group of hypothyroid patients correlated with age. Hypothyroidism was associated with female sex and older age. In the group of patients with advanced stage CKD (3B-5), the incidence of subclinical and manifest hypothyroidism was 3 times higher than in the group with normal GFR (GFR> 90 ml / min, p = 0.007). In the group of patients with hypothyroidism, the frequency of advanced stages of CKD (3B-5) was 2 times higher than in the comparison group (p = 0.02). In patients with CKD, a direct correlation was found between GFR and free T3 (r = 0.34, p = 0.02). Thyroid peroxidase antibodies were revealed in 64% of patients with CKD with hypothyroidism.CONCLUSION.Hypothyroidism is associated with chronic kidney disease. For patients with CKD, there is a syndrome of euthyroid pathology ("low T3" syndrome). Hypothyroidism in patients with CKD is not always the outcome of autoimmune thyroiditis.

scholarly journals Thyroid dysfunction in patients of chronic kidney disease

2017 ◽  
Vol 4 (5) ◽  
pp. 1333
Author(s):  
Abhishek Gupta ◽  
Kuldeep K. ◽  
S. K. Virmani ◽  
Mayank Arora
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Past History ◽  
Additional Risk Factor ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
History Of

Background: Thyroid hormones play a very important role in regulating metabolism, development, protein synthesis, and influencing other hormone functions. CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. We aimed to study the thyroid dysfunction in patients of chronic kidney disease for the prevalence of subclinical hypothyroidism.Methods: This cross-sectional study was conducted at Chhatrapati Shivaji Subharti Hospital and Medical College, Meerut, Uttar Pradesh, India, over a 2 year period. The study group comprised 100 patients with Chronic kidney disease. Free thyroxine (fT3, fT4) and thyroid-stimulating hormone (TSH) were measured. Patients with family history of thyroid disorder or past history of any medication for thyroid disease or history of any surgery or any radiological intervention to thyroid gland were excluded from the study.Results: Of 100 CKD patients, 25 were found to have subclinical hypothyroidism (SCH) and 75 were euthyroid. The mean age in patients with SCH was 47.72±10.09 and in euthyroid patients was 46.11±14.332. 12 males (48%) and 13 females (52%) patients were found to have subclinical hypothyroidism and 49 male (65%), 26 female (35%) patients were euthyroid. Prevalence of SCH was 25% with a mean TSH level of 8.68± 1.84.Conclusions: We observed a high prevalence of SCH in our CKD patients. SCH is an additional risk factor in CKD patients and the present study finds thyroid dysfunction being SCH to be very common in CKD patients and reveals significant association between CKD progression and thyroid dysfunction.

scholarly journals Thyroid Disorders and Chronic Kidney Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mohamed Mohamedali ◽  
Srikanth Reddy Maddika ◽  
Anix Vyas ◽  
Viswanathan Iyer ◽  
Pramil Cheriyath
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Laboratory Finding ◽  
Thyroid Disorders ◽  
Low T3 ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Peripheral Metabolism

Thyroid hormones play a very important role regulating metabolism, development, protein synthesis, and influencing other hormone functions. The two main hormones produced by the thyroid are triiodothyronine (T3) and thyroxine (T4). These hormones can also have significant impact on kidney disease so it is important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD). CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Low T3 levels are the most common laboratory finding followed by subclinical hypothyroidism in CKD patients. Hyperthyroidism is usually not associated with CKD but has been known to accelerate it. One of the most important links between thyroid disorders and CKD is uremia. Patients who are appropriately treated for thyroid disease have a less chance of developing renal dysfunction. Clinicians need to be very careful in treating patients with low T3 levels who also have an elevation in TSH, as this can lead to a negative nitrogen balance. Thus, clinicians should be well educated on the role of thyroid hormones in relation to CKD so that proper treatment can be delivered to the patient.

scholarly journals Occurrence of subclinical and overt hypothyroidism among chronic kidney disease patients

2020 ◽  
Vol 8 (9) ◽  
pp. 3284
Author(s):  
Dilip Kumar Jha ◽  
Gregory Minj ◽  
Umesh Prasad ◽  
Yuvraj Lahre ◽  
Diljeet Bodra
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Overt Hypothyroidism ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Serum T3

Background: Chronic kidney disease (CKD) is one of the vital health problems worldwide leading to increased global morbidity and mortality. Thyroid dysfunction including hypothyroidism, hyperthyroidism and non-thyroidal illness has been reported in CKD patients. This study was conducted to determine the prevalence of subclinical and overt hypothyroidism among chronic kidney disease patients. This study also tried to correlate thyroid function abnormalities with severity of renal failure.Method: In this observational and cross sectional study, 100 patients of CKD who were admitted in Department of Medicine, Rajendra institute of medical sciences, Ranchi were studied for thyroid function abnormalities. Result: This study found that glomerular filtration rate (GFR) is positively correlated with serum T3 and T4 level (i.e. with decreasing renal function both T3 and T4 levels decreased). Serum creatinine levels were negatively correlated with serum T3 and T4 level.Conclusions: From this study it was established that CKD is associated with thyroid dysfunction characterized by low serum fT3 and fT4 with high TSH in some cases.

scholarly journals An Overview on the sign of the interaction between thyroid and kidney disease

2019 ◽  
Vol 2 (02) ◽  
Author(s):  
Monika Semwal ◽  
Asheesh Kumar Gupta
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Low T3 Syndrome ◽  
Nonthyroidal Illness ◽  
Low T3

Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. Hypothyroidism is associated with reduced Glomerular filtration rate and hyperthyroidism results in increased GFR as well as increased renin angiotensin aldosterone activation. Chronic Kidney disease (CKD) is characterized by a low T3 syndrome which is now considered a part of an atypical nonthyroidal illness. This review studies probable mechanistic relations between thyroid and kidney disease.

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