Title: Correlation of Serum T3, T4, TSH with Chronic Kidney Disease
Authors: Dr Nirali Salgiya, Dr Nilesh Kumar Patira, Dr Deepak Agrawal
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.71
Abstract
Aims and Objectives: Correlation of serum T3, T4, TSH with Chronic kidney disease patients.
Material and Methods: The present study was undertaken at Maharana Bhupal Govt. Hospital, attached to R.N.T. Medical College Udaipur (Raj.).
· Patients admitted with sign and symptoms due to deranged renal functions were stratified into stages of CKD according to guidelines of the National Kidney Foundation [Kidney Dialysis Outcomes Quality Initiative (KDOQI)]
· Methods of measurement of GFR: Cockroft-Gault formula was used.
· Clinical history was recorded including age, sex, weight, height, primary renal diagnosis, and Blood pressure, history of diabetes and smoking.
· Blood samples were collected in the non-fasting state.
· Descriptive statistical analysis was carried out in this study.
Observation and Conclusion: In this study population, 100 patients of various stages of CKD (II to V) were included. They were non-diabetic, and were not on dialysis.
Serum T3 differed between chronic kidney disease stages, being more commonly decreased in more advanced chronic kidney disease. Serum T4 differed between chronic kidney disease stages, being more commonly decreased in more advanced chronic kidney disease. Serum TSH differed between chronic kidney disease stages, being more commonly increased in more advanced chronic kidney disease. Prevalence of hypothyroidism with chronic kidney disease was 31% .31 out of 100 patients had hypothyroidism. Out of which 29 had subclinical hypothyroidism (0% in stage II, 16% in stage III, 40% in stage IV, and 60% in stage V) and 2 had overt hypothyroidism (8% in stage V).
According to this study all CKD patients should undergo for thyroid function evaluation as these patients are definitely associated with development of hypothyroidism.
1. 1. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: evaluation, classification and stratification. Am J Kidney Dis 2002; 39 (2 suppl 1):S1-S266.
2. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16:31-41
3. Kalz IA, Emmanovel DS, Lindheimer MD. Thyroid hormone and the kidney. Nephron 1975: 15; 223-49.
4. Yashpal et al. Thyroid function in uremia. Ind J Nephrol (New Series) 1991: 1;2 vol. 1, no. 2. April June, 1991.
5. Spector DA, Davis PJ, Helderman JH et al. Thyroid function and metabolic statein chronic renal failure. Ann Int Med 1976: 85; 724-30.
6. G Avasthi, S Malhotra, APS Narang, S Sengupta. Study of thyroid function onpatients of chronic renal failure. Indian J Nephro, 2001: 11; 165-169.
7. K Neuhaus, G Baumann, A Walter and H Tholen Serum thyroxine and thyroidbinding proteins chronic renal failure. J of Clinical endocrinology andmetabolism, 1975: 41; 395-398.
8. Nephrology division. Dept of Internal Medicine, University Lowa, Iowa city,IA, USA. Thyroid function in patients with chronic renal failure. Am JKidney Dis, Oct2001: 38,4 (supp 1): 580-4 links.
9. Lim VS, Fang VS, Katz AL, Refetoffs. Thyroid dysfunction in chronic renalfailure. J Clin Invest. Sept, 1977: 66(3); 522-534.
10. Kohli HJ, Mahajan SK Karla OP. Malhotra KC. Thyroid status in chronic renalfailure. Indian J Nephrology1993; 3(2); 32-36.
11. Mehta HJ et al. Total free thyroid hormone levels in chronic renal failure.Journal Postgraduate Medicine 1991; 37(2):79-83.
12. Kaptein EM et al. The thyroid in end stage renal disease.Medicine, 1988: 67; 187.
13. Ramirez G, O Neill WM, Jubiz w, Bloomer HA. Thyroid dysfunction in uremia: Evidence with thyroid and hypophyseal abnormalities. Ann Int Med 1976: 84;672.
14. Spector DA, Davis PJ, Helderman JH et al: Thyroid dysfunction and metabolicstate in chronic renal failure. Ann Int. Med 1976: 85; 724.
15. Desanto NG, Fine RN, Carela C et al: Thyroid function in uremic children.Kidney Int 1985: 28; 5166.
16. Lo JC, Chertow GM, Go AS and Hsu CY. Increased prevalence of subclinicaland clinical hypothyroidism in persons with chronic kidney disease. Kidney International 2005: 67; 1047-52.
17. Lim VS .Thyroid functions in patients with chronic renal failure. AmericanJournal of Kidney Disease 2001: 38; 580-84.
18. Lim VS, Fang VS, S Refetoff, AI Katz 1974, T3 hypothyroidism in uremia. ProcAm SocNephrol.7; 52.
