Study of Clinical and Biochemical profile of Thyroid Abnormalities in chronic kidney Disease with Reduced Glomerular Filtration Rate - A one year cross Sectional Study at KLE University, Belgaum

Abstract

Background and objectives ABSTRACT Chronic kidney disease ( CKD ) is increasingly recognized as a major public health problem. The kidney normally plays an important role in the metabolism, degradation, and excretion of several thyroid hormones. It is not surprising therefore that impairment in kidney function leads to disturbed thyroid physiology. The present study was undertaken to assess the clinical and biochemical profile of thyroid abnormalities in chronic kidney disease. Methodology The present cross-sectional study was carried in Department of Medicine /Nephrology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. A total of 91 patients with chronic kidney disease were included in the study based on the definition of The Kidney Disease Outcomes Quality Initiative ( K/DOQI ) of the National Kidney Foundation. Results Out of 91 patients, 59 ( 64.84% ) were males and 32 patients ( 35.16% ) were females, accounting a male to female ratio of 1.84:1. Majority of patients 58( 63.74% ) were in the age group of 46 to 60 years. The commonest cause of chronic kidney disease in our study was diabetic nephropathy 46 ( 50.55% ) . Majority of patients were in stage IV CKD 42 ( 46.158% ) . In all the 91 ( 100% ) patients the commonest symptom was tiredness and weakness. The next common symptom was dry skin in 78 ( 85.71% ) . In the present study, the commonest sign of thyroid dysfunction was coarse skin ( 62.64% ) . Raised TSH was noted in 14 IV ( 15.38% ) patients, 5 ( 5.49% ) had below normal FT4 and 6 ( 6.59% ) had below normal FT3. Conclusion and interpretation Based on the Zulewski’s score for the assessment of hypothyroidism considering clinical signs and symptoms 7.69% patients were diagnosed to have clinical hypothyroidism. Of the 91 patients with chronic kidney disease the biochemical profile considering FT3, FT4 and TSH levels 14 ( 15.38% ) patients had thyroid abnormalities of which, 7 ( 7.69% ) each had hypothyroidism and subclinical hypothyroidism.