CORRELATION BETWEEN THYROID DYSFUNCTION AND SEVERITY OF RENAL DISEASES IN CHRONIC KIDNEY DISEASE PATIENTS – A PROSPECTIVE STUDY

Abstract

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. Total number of 100 patients with Chronic Kidney Disease on conservative management were selected in this prospective study. Out of the 100 patients with CKD 55 patients had low T3 syndrome (0.1- 1.8ng/ml, ) which accounts for 55% of the patients, 32 patients had low T4 syndrome which accounts for 32%. Low T3 &T4 were 26 patients. of the patients and 7 patients had primary hypothyroidism TSH >20p,IU/ml. Excluding Primary Hypothyroidism, analysis of serum T3,T4 and TSH in the study subjects shows significance p < 0.005. 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 , . In patients with low T3 syndrome, the mean values of TSH in various stages of renal disease are within normal range and, values of mean TSH did not show any linear correlation with glomerular filtration rate. Number of patients with low T4 syndrome did not correlate with severity of renal disease. Thyroid Dysfunction occurred in 55% 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 patients with low T3 syndrome progressively increase with the renal failure, but there is no linear correlation.