THYROID FUNCTION AND LIPID PROFILE IN NEWLY DIAGNOSED CASES OF CHRONIC KIDNEY DISEASE

Abstract

Introduction:- Chronic kidney disease (CKD) is a clinical syndrome due to irreversible renal dysfunction leading to excretory, metabolic and synthetic failure culminating in the accumulation of non-protein nitrogenous substances and present with various clinical manifestations. The thyroid hormones are essential for kidney growth and development and maintaining electrolytes and water homeostasis.  The kidney plays an important role in thyroid hormone metabolism, degradation and excretion. CKD is associated with a higher prevalence of overt and subclinical primary hypothyroidism. Patients with CKD have elevated levels of triglycerides level because of reduction in the activity of lipoprotein lipase and the direct inhibitory effect of various uremic toxins on the enzymes involved in lipid metabolism. Thyroid dysfunction and dyslipidemia in CKD increase risk of CVD which further leads to increased mortality and morbidity

.Material and methods:- We have conducted a hospital-based prospective study on 127 newly diagnosed patients of CKD, admitted to MBGH, RNT Medical College Udaipur. Patients are selected as per the standard definition of CKD. We have performed thyroid profiles, lipid profiles, and other routine investigations in these patients. EGFR is calculated using the MDRD equation.

Results :- In this study out of 127 patients, 70 patients had normal TSH values, while 57 patients had elevated TSH values. The prevalence of low T3 was 87.4 % and for low T4 was 47.24 %. Out of 70 patients who had normal TSH values 62 patients have low T3 which is 88.57 % and 33 patients have low T4 which is 47.14 %. The most common thyroid abnormality was subclinical hypothyroidism which is found in 35.43 % of patients and 9.45 patients had overt hypothyroidism. Thyroid dysfunction was more in females than in males. The most common lipid abnormality was low HDL in 66 patients which is 51.97 %, the second most common was elevated TG values in 41.73 % of patients. Total cholesterol was elevated in 18.9 % of patients while LDL was elevated in 26.77% of patients.

Conclusion:- The most common thyroid dysfunction found was subclinical hypothyroidism in 35.43 % of patients and overt hypothyroidism in 9.45 % of patients. The Most common lipid abnormality was low HDL followed by elevated TG values. There was an increased incidence of thyroid dysfunction and lipid abnormality in patients with CKD