Title: Prevalence of Hypothyroidism in Patients with Chronic Kidney Disease in a Tertiary Hospital in South India

Authors: Dr Kaveri Kannan, Dr Preethi Shahila, Dr K.R. Jegan, Dr Parvathy.S

 DOI: https://dx.doi.org/10.18535/jmscr/v8i12.41

Abstract

Background: Thyroid hormones have significant impact on kidney disease so it is important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD). CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Low T3 levels are the most common laboratory finding followed by subclinical hypothyroidism in CKD patients.

Aim: To prove the prevalence of hypothyroidism in CKD patients and its relation between cardiovascular disease and mortality in a tertiary care hospital, in South India.

Materials & Methods: A cross-sectional study was performed among 100 CKD patients of a tertiary care hospital in South India from September 2018 to November 2018 to determine the prevalence of hypothyroidism in the both dialysis dependent and non-dialysis dependent CKD population.

Observation & Conclusion: From this study an increased prevalence of hypothyroidism (clinical and subclinical) was observed in patients with reduced glomerular filtration rate and also an increased risk of cardiovascular events in these patients. Patients in the overt hypothyroid group had increased risk of cardiovascular events compared to euthyroid groups

Keywords: Hypothyroidism, CKD, Cardiovascular events.

References

  1. Luo, J. Z. Luo, and I. Jackson, “Tripeptide amide L-pyroglutamyl-histidyl-L prolineamide (L-PHP Thyrotropin- Releasing Hormone, TRH) promotes insulin-producing cell proliferation,” Current Aging Science, vol. 6, no. 1, pp. 8–13, 2013.
  2. W. Szkudlinski, V. Fremont, C. Ronin, and B. D. Weintraub, “Thyroid-stimulating hormone and thyroid-stimulating hormone receptor structure-function relationships,” Physiological Reviews, vol. 82, no. 2, pp. 473–502, 2002.
  3. Basu and A. Mohapatra, “Interactions between thyroid disorders and kidney disease,” Indian Journal of Endocrinology and Metabolism, vol. 16, no. 2, pp. 204–213, 2012.
  4. Chonchol, G. Lippi, G. Salvagno, G. Zoppini, M. Muggeo, and G. Targher, “Prevalence of subclinical hypothyroidism in patients with chronic kidney disease,” Clinical Journal of the American Society of Nephrology, vol. 3, no. 5, pp. 1296–1300, 2008.
  5. I. Feinstein, E. M. Kaptein, J. T. Nicoloff, and S. G. Massry, “Thyroid function in patients with nephrotic syndrome and normal renal function,” American Journal of Nephrology, vol. 2, no. 2, pp. 70–76, 1982.
  6. P. Sarma and G. T. Simmons, “Intraglomerular metastases from papillary carcinoma of the thyroid,” The Journal of the Louisiana State Medical Society, vol. 141, no. 6, pp. 26–28, 1989.
  7. Gamboa-Dominguez and A. Tenorio-Villalvazo, “Metastatic follicular variant of papillary thyroid carcinoma manifested as a primary renal neoplasm,” Endocrine Pathology, vol. 10, no. 3, pp. 265–268, 1999.
  8. Mohamed Mohamedali, Srikanth Reddy Maddika, Anix Vyas, Viswanathan Iyer, Pramil Cheriyath, "Thyroid Disorders and Chronic Kidney Disease", International Journal of Nephrology, vol. 2014, Article ID 520281, 6pages, 2014. https://doi.org/10.1155/2014/520281.

Corresponding Author

Dr Parvathy.S

Post Graduate, Department of General Medicine, Kanyakumari Government Medical College, Asaripallam