scholarly journals Thyroid Function Test in Patients with Chronic Kidney Disease

Author(s):  
V. Abhinaya ◽  
S. Magesh Kumar

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.

2018 ◽  
Vol 22 (4) ◽  
pp. 40-49 ◽  
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
B. G. Lukichev ◽  
S. V. Dora ◽  
O. V. Galkina

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.


2014 ◽  
Vol 21 (1) ◽  
pp. 37-42
Author(s):  
Rucsandra Dănciulescu Miulescu ◽  
Marius Cristian Neamţu ◽  
Denisa Margină ◽  
Cătălina Poiană ◽  
Diana Loreta Păun

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.


2021 ◽  
Vol 31 (03) ◽  
pp. 142-145
Author(s):  
Adil Mehmood ◽  
Roshina Anjum ◽  
Muhammad Shahbaz ◽  
Rizwan Hafeez ◽  
Zahra Fatima ◽  
...  

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.


2017 ◽  
Vol 4 (5) ◽  
pp. 1333
Author(s):  
Abhishek Gupta ◽  
Kuldeep K. ◽  
S. K. Virmani ◽  
Mayank Arora

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.


Author(s):  
Dilip Kumar Jha ◽  
Gregory Minj ◽  
Umesh Prasad ◽  
Yuvraj Lahre ◽  
Diljeet Bodra

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.


2021 ◽  
Vol 8 (32) ◽  
pp. 2980-2987
Author(s):  
Navjot Kaur Layal ◽  
Tejinder Sikri ◽  
Jaskiran Kaur ◽  
Jasmine Kaur ◽  
Hardeep Singh Deep

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


Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.


2021 ◽  
Author(s):  
Yanli Li ◽  
Min Yi ◽  
Xiaoyi Deng ◽  
Wangen Li ◽  
Yimei Chen ◽  
...  

Abstract Background Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The coexistence of TD could adversely influence metabolic control and even increase the long-term mortality in patients with DM. The objective of the present study was to investigate the thyroid status and the relationship between thyroid hormones, diabetic complications and metabolic parameters in patients with newly diagnosed type 2 DM (T2DM). Methods This is an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched nondiabetic subjects. Clinical characteristics were collected and laboratory measurements were conducted. Results Levels of free T3 (FT3), free T4 (FT4) and TSH were significantly lower in patients with T2DM as compared to nondiabetic subjects. The prevalence of TD was 21.2% in patients with diabetes, higher than that of controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications (diabetic nephropathy (DN), diabetic ketosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, P < 0.001) for DN. Conclusions TD is not rarely seen in patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to TD. Decreased FT3 is strongly correlated with the presence of DN.


2010 ◽  
Vol 128 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Rodrigo Diaz-Olmos ◽  
Antônio-Carlos Nogueira ◽  
Daniele Queirós Fucciolo Penalva ◽  
Paulo Andrade Lotufo ◽  
Isabela Martins Benseñor

CONTEXT AND OBJECTIVE: Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them. DESIGN AND SETTING: Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP). METHODS: All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, high-sensitivity C-reactive protein, thyroid-stimulating hormone (TSH), free thyroxine (free-T4) and anti-thyroperoxidase antibodies (anti-TPO). RESULTS: The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01). There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism. Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l) did not change the results. CONCLUSION: In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace.


2019 ◽  
Vol 44 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Binbin Pan ◽  
Xin Du ◽  
Hao Zhang ◽  
Xi Hua ◽  
Xin Wan ◽  
...  

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.


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