ASSOCIATION OF THYROID STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL

Abstract

INTRODUCTION: The concept of subclinical primary hypothyroidism has emerged over the past several decades, as our ability to detect subtle changes in thyroid function tests is progressively improved. Although it is recognized that patients with subclinical primary hypothyroidism may have subtle symptoms of thyroid dysfunction, the denition is purely a biochemical one, dened as elevated serum thyrotropin (TSH) levels but 1 normal free thyroxine (FT4) levels. AIMS AND OBJECTIVES: Proposed topic of research: Prevalence of Subclinical Hypothyroidism In Patients With Chronic Kidney Disease, Objective of Proposed Research: Prevalence of Subclinical Hypothyroidism In Patients With Chronic Kidney Disease, Broad objectives: To estimate TSH and Free T4 levels in Chronic Kidney Disease patients and calculate the eGFR using MDRD formula and classify the patients with CKD into 5 stages METHODOLOGY: This Cross sectional Observational Study was single-centre study, which was take place at NRS Hospital Kolkata total time take April 2017 to March 2018. RESULT AND ANALYSIS: We found 10(10.0%) patients had overt hypothyroidsm. 100(100.0%) patients had >3 month of illness. The mean TSH (mean± s.d.) of patients was 6.5200 ± 4.4210 micro IU/mL. The mean FT4 (mean± s.d.) of patients was 1.0509 ± .3960 ng/dL. The mean urea (mean± s.d.) of patients was 96.8830 ± 31.6749. The mean creatinine (mean± s.d.) of patients was 3.3010 ± 1.2648. The mean eGFR (MDRD) (mean± s.d.) of patients was 24.5080 ± 16.6236 ml/min /1#73m2. Association of age in years vs. subclinical hypothirodism was not statistically signicant (p=0.1486). CONCLUSION: We conclude that the prevalence of subclinical hypothyroidism is high among all the stages of CKD patients. Need for treatment depends on the patient's clinical scenario and decision of the clinician based on the presentation. There is an increasing trend of decreased thyroid functional status along with decrease of estimated GFR (eGFR). Chronic kidney disease impairs thyroid functional status in different ways. Thyroid functional status evaluation is recommended in each and every patient of CKD.