Thyroid dysfunction in patients with chronic kidney disease.

Abstract

Objective: To determine the frequency of thyroid dysfunction among patients with chronic kidney disease (CKD). Study Design: Cross-sectional study. Setting: Department of Medicine, Ayub Teaching Hospital's. Period: September 2019 to August 2020. Methods: The study included adult patients with CKD who were at least 18 years old, regardless of gender. Patients with acute kidney injury, pregnant and lactating females, patients with history of goiter, thyroid surgery or radioactive iodine treatment, familial diseases of thyroid disorders, history of medication for thyroid disorders, and known cases of thyroid disorders were not included. Likewise, patients who were on concurrent medications which could affect thyroid function like amiodarone, lithium, iodine, glucocorticoids and interferon were also excluded. Results: A total of 165 patients of CKD were enrolled. The mean age of the patients was 38 ± 14 years, there were 71 (43%) males and 94 (57%) females. The mean TSH, T3 and free T4 were 3.73257 ± 16.52632 mIU/L, 1.5869 ± 0.76796nmol/L, and 1.4480 ± 0.57540 ng/L respectively. Thirty-nine (23.6%) patients had thyroid dysfunction while 126 (76.4%) were euthyroid. Regarding thyroid status of the patients, twenty-two (13.3%) patients of CKD had subclinical hypothyroidism, eight (4.8%) had hypothyroidism, six (3.6%) had subclinical hyperthyroidism, three (1.8%) had hyperthyroidism 126 (76.4%) were euthyroid. Conclusion: Thyroid dysfunction is common among patients with CKD. Subclinical hypothyroidism is the most prevalent anomaly, followed by hypothyroidism. In view of the increased CVD and mortality in these patients, it is imperative to regularly screen CKD patients for thyroid dysfunction and to appropriately treat them.