The Egyptian Journal of Internal Medicine (Jan 2019)
Frequency and relation of thyroid dysfunction and inflammation in chronic kidney diseases in the Nephrology Unit, Zagazig University
Abstract
Context Thyroid hormones play an important role in renal development, functioning renal mass, and early renal function. Pituitary–thyroid axis and metabolism of the peripheral thyroid hormones have been affected by chronic kidney disease (CKD). Aims The aim was to evaluate the frequency and relationship between thyroid disorders and high-sensitivity C-reactive protein (Hs-CRP) among CKD patients including hemodialysis (HD). Settings and design In Zagazig University Hospital. Participants and methods A case–control study that included 150 adult participants who were divided into: group I which included 50 patients with an estimated glomerular filtration rate (eGFR) of 41.8±23.6 ml/min/1.73 m2. Group II included 50 patients with an eGFR of 11.3±4.2 ml/min/1.73 m2.Group III included 50 participants with normal eGFR. All participants were evaluated for serum creatinine and albumin, complete blood count, estimation of GFR by modification of diet in renal disease (MDRD) equation, and serum thyroid-stimulating hormone (TSH), free T3, free T4, and Hs-CRP. Statistical analysis Using the Statistical Package for the Social Sciences under windows version 20. Qualitative variables were expressed by frequency and percentage, mean±SD, χ2-test, Student’s t-test, analysis of variance (F-test), and correlation analysis. Results The frequency of subclinical hypothyroidism (46%) and overt hypothyroid (42%) in groups I and II, respectively, has been much higher in CKD patients. There was a strong significant negative correlation of Hs-CRP with eGFR, FT3, FT4 (P<0.001), highly significant positive correlation with serum creatinine, TSH (P<0.001) in non-HD patients, but in HD patients there was high statistically significant negative correlation of Hs-CRP with hemoglobin, albumin, FT3 (P<0.001), FT4, and significant positive correlation with dialysis duration (P<0.001) and TSH. Conclusion the frequency of thyroid disorders mostly subclinical hypothyroid (46%) and overt hypothyroid (42%) is common in CKD patients and is highly correlated with Hs-CRP in these patients. So we recommend a thyroid investigation in chronic kidney patients for early detection and reduction of its morbidity and mortality.
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