CHRONIC RENAL FAILURE;

STUDY OF THYROID HORMONE LEVELS IN UN-DIALYZED PATIENTS

Abstract

Objectives: To compare thyroid hormone levels in apparently healthy individuals
and un-dialyzed chronic renal failure patients in local population. Study Design: Crosssectional,
descriptive, observational study. Setting: OPD patients in BMSI Biomedical Science
Institute of Medical Jinnah Medical Karachi. Period: June 2010 to December 2010 in BMSI
JPMC, Karachi. Methods: Ninety individuals including 30 healthy control and 60 patients of
chronic renal failure were included in this study. Individuals were grouped based on severity of
diseases (stages) as healthy (control) group and the diseased group. Patients with un-dialyzed
CRF on conservative management, GFR < 60 ml/mint/1.73m2, age between 20 to 60 years in
both sexes were included in this study. Patients already taking thyroxine or antithyroid drugs,
history of thyroid surgery and neck radiation and patients on maintenance haemodialysis were
excluded. Measurement of thyroid hormone levels were done through Radio Imune Assay (RIA)
method and GFR by Cock Craft Gualt formula. Results: Serum FT3 significantly low in patients
with CRF of stage III 1.27±0.12, stage IV 1.04±0.09 vs 2.80±0.09 in controls, p=0.001. TSH
was significantly high in patients of CRF as compared to control 4.41±0.87 and 3.3±0.34 vs
1.97±0.16, P=0.001. No significant difference was seen in serum FT4 levels. Conclusion: In
local population thyroid hormone level of FT3 declines with the severity of Glomerular Filtration
Rate as compare to healthy individuals. However, TSH level increases with this severity as also
reported in other countries. Additionally, FT3 level is helpful for early detection and prevention
of complications. Local population need awareness to prevent CRF by reporting to hospital
before stage 3.