A Cross-Sectional Study of Thyroid Dysfunction in Chronic Kidney Disease Patients Attending DSP Main Hospital, Durgapur

Abstract

Background: Numerous metabolic and endocrine disorders are linked to CKD (Chronic Kidney Disease), a chronic illness marked by permanent loss of renal function. Thyroid hormone metabolism, breakdown, and excretion are all significantly influenced by the kidneys. Therefore, aberrant thyroid hormone levels may result from impaired renal function. Thyroid dysfunction, particularly hypothyroidism and low T3 syndrome, is frequently observed in CKD patients and may worsen disease progression and clinical outcomes. The goal of the current investigation was to evaluate thyroid function abnormalities in individuals with CKD and ascertain the correlation between thyroid dysfunction and the severity of CKD.

Methods: This hospital-based cross-sectional study was conducted in the Department of Medicine at DSP Main Hospital, Durgapur. A total of 90 patients with CKD stage III and above, aged above 18 years, were included over a period of two years using purposive consecutive sampling. Patients with known thyroid disorders, pregnancy, or those taking drugs affecting thyroid function were excluded. Blood samples were analysed for T3, T4, and TSH levels using ECLIA (Electrochemiluminescence Immunoassay). Renal function was measured using serum creatinine and eGFR (estimated Glomerular Filtration Rate) computed using the Cockcroft-Gault algorithm. SPSS software version 21 was used for the statistical analysis, and p < 0.05 was deemed significant.

Results: The mean age of the study population was 61.31 ± 14.4 years, with males constituting 53.3% of the subjects. Most patients were in CKD stage III (66.7%), followed by stage IV (22.2%) and stage V (11.1%). Thyroid dysfunction was observed in 35.6% of CKD patients. Among these, low T3 syndrome (16.7%) was the most common abnormality, followed by subclinical hypothyroidism (15.6%) and overt hypothyroidism (3.3%). The prevalence of thyroid dysfunction increased with CKD severity, affecting 25% of stage III, 50% of stage IV, and 70% of stage V patients. A significant negative correlation was found between TSH and eGFR, while T3 and T4 showed a positive correlation with eGFR.

Conclusion: Thyroid dysfunction is common among CKD patients and its prevalence increases with disease severity. Low T3 syndrome and subclinical hypothyroidism are the most frequent abnormalities. Routine assessment of thyroid function in CKD patients may aid in early detection and better management of endocrine complications associated with renal disease.