Abstract

Background: Abnormal thyroid function tests are frequently observed in patients of
chronic kidney disease. Kidneys plays a significant role in thyroid hormone metabolism
by conversion of T4 to T3 (the active metabolite). Low plasma free T3 in ESRD is a
marker of the inflammation and endothelial activation; and is known to predict all
cause mortality. The present study was done look for the biochemical abnormalities of
thyroid function tests in chronic kidney disease and to correlate the severity of CKD
and alterations of thyroid indices.
Materials and Methods: In a cross sectional study, thyroid function test [TT3, TT4,
FT4, TSH] were estimated by CLIA in 50 patients of chronic kidney disease who were
in various stages. Symptoms of hypothyroidism, thyroid hormone abnormalities and
CKD stage were analyzed using Chi square test and ANOVA tests.
Results: Among the mean age was 48.8 ± 12.2 years of which 33 were male and 17
females. The mean value of TT3 in CKD stage 3, 4, 5 were 1.01±0.39; 1.05± 0.6;
0.95±1.09 μg/mL respectively. (p= 0.02 Significant). The mean value of TT4 in CKD
stage 3, 4, 5 were 6.3± 2.4; 5.5± 1.5; 5.11 ± 1.01 μIU/ml respectively. (p=0.71 Not
significant).
Conclusion: Total T3 and total T4 were found to be progressively decreased as stage of
CKD increased. There was no significant correlation between TT4 and CKD stage.
There was a significant correlation between the prevalence of thyroid dysfunction and
the stage of chronic kidney disease.Higher the degree of renal insufficiency, the higher
was the prevalence of thyroid hormone abnormalities, the levels of thyroid profile i.e
T3, T4 decreases and TSH increases as severity of renal failure increases. Thyroid
hormone abnormalities could represent a risk factor for cardiovascular disease and
might also be implicated in kidney disease progression.