Title: Study of Thyroid hormone (T3, T4, TSH) level in dialyzed Chronic Kidney Disease (CKD) Patients
Authors: Dr Nitesh Singhal, Dr Ajay Kumar Bhargava, Dr Sushma Pandey
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.53
Abstract
Objective: This study was undertaken to investigate the effect of renal function, on the thyroid hormone (T3, T4 and TSH) level in dialyzed chronic kidney disease (CKD) patients in both sex and different age group.
Background: Present study designed to analyze the thyroid hormone level in dialyzed CKD patients. Chronic kidney disease (CKD) is associated with a higher prevalence of primary hypothyroidism. The prevalence of chronic kidney disease in India is 17.2% and its association with hypothyroidism. Chronic kidney disease causes uremia which affects peripheral metabolism and hypothalamus-pituitary-thyroid axis. Due to this effect there is disturbance in synthesis and secretion of adequate amount of T3 and T4.
Methods: Thyroid hormone was estimated and levels of thyroid hormone were studied in 50 chronic kidney disease patients verses 50 healthy controls. Serum T3, T4 and TSH was done by chemiluminiscence immunoassay technique (CLIA) on fully auto analyzer (Maglumi1000).
Results: We found both T3 and T4 were significantly reduced (p<0.0001) whereas TSH (p<0.0001) were significantly higher in patient group compared to healthy subjects.
Conclusion: In present study, we demonstrate that renal impairment may lead to thyroid hormone dysfunction. Thyroid function test is important in diagnosis, prognosis and medical management of Chronic Kidney Disease (CKD).
Keywords: Chronic kidney disease (CKD), Thyroid profile (T3, T4, TSH).
References
- Brenner and Rectors’s. The Kidney. In: Robert. A. Fenton, Jeppe Praetorius, Anatomy of Kidney.10th Ed, Vol 1. 2016: 42-82.
- Sarita Gaikwad and Rajendra Huparikar et al. Chronic Renal Failure. Ayurveda e-journal Rasamruta. 2016; 8:23.
- Ilangovan Veerappan and Georgi Abraham. Chapter 130, Chronic Kidney disease: Current status, Challenges and Management in India. 2012:593.
- Ajay K Singh et al. Epidemiology and risk factors of chronic kidney disease in India-results from the SEEK (screening and early evaluation of kidney disease) study. BMC nephrology.2013; 14:114.
- Kaptein EM, Quion-Verde H, Massry S.G. et al. Hemodynamic effects of thyroid hormone. Contributions to Nephrology.1984; 41: 151-59.
- Balaji Rajagopalan et al. Renal function markers and thyroid hormone status in un-dialyzed chronic kidney disease. Al Ameen Journal Medical Science.2013; 6 (1): 70-7 4.
- Gopal Basu et al. Interactions between thyroid disorders and kidney disease. Indian Journal of Endocrinology and Metabolism. 2012; 16(2):204-13.
- Iglesias et al. Thyroid dysfunction and kidney disease. European Journal of Endocrinology. 2009;160:503-15.
- Fauci B, Kasper, Braunwald, Hauser, Longo. Harrison’s Principles of Internal Medicine. In: Joanne M. Bargman, Karl Skorecki’s, chronic kidney disease.17edition, volume 2.2008:1761-71.
- Hegedus L, Andersen J.R, Poulsen L.R, Perrild H, Holm B, JM. GEH. Thyroid gland volume and serum concentrations of thyroid hormones in chronic renal failure. Nephron.1985; 40(2):171–74.
- Lim V.S et al. Thyroid functions in patients with chronic renal failure. American journal of kidney disease. 2001; 38: s80-s84.
- Mohamedali M, Reddy Maddika S, Vyas A, Iyer V , Cheriyath P. Thyroid disorders and chronic kidney disease. Internal Journal Nephrol.2014; 5:202-81.
- Laura H. Mariani, Jeffrey S. Berns. The renal manifestations of Thyroid disease.JASN.2012; 23(1):22-26.
- Khalidah S. Merzah et al. The Biochemical changes in patients with chronic renal failure. International journal of pharma medicine and biological sciences.2015; 4(1):75-79.
- Avasthi et al. Study of thyroid function in patients of chronic Renal failure. Indian Journal Nephrol.2001; 11: 165-69.
- Rotondi M, Netti GS, Rosati A, Mazzinghi B,Magri F, Ronconi E, Becherucci F, Pradella F,Salvadori M, Serio M, Romagnani P, Chiovato L. Pretransplant serum FT3 levels in kidney graft recipients are useful for identifying patients with higher risk for graft failure. Clinical Endocrinology.2008; 68: 220–225.