Assessment of Thyroid Hormone Status Among Patients With Chronic Kidney Disease in a Tertiary Care Center: A Cross-Sectional Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Chronic kidney disease (CKD) is a progressive condition characterized by an irreversible decline in renal function. Thyroid dysfunction is frequently observed in individuals with CKD due to impaired hormone metabolism, altered peripheral conversion, and reduced renal clearance. These changes may influence disease progression and overall clinical outcomes, making thyroid evaluation clinically relevant in CKD populations. AIM: To assess the level of thyroid dysfunction in individuals with chronic kidney disease and to correlate these findings with the different stages of CKD. METHODS: This 18-month descriptive cross-sectional study included 90 patients with CKD attending the Dialysis Unit and Medicine Outpatient Department at SMIMS, Kulasekharam. A detailed clinical evaluation and laboratory investigations were performed for all participants. Serum urea, creatinine, electrolytes, albumin, lipid profile, and thyroid function tests, including thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4), were measured using an electrochemiluminescence immunoassay (ECLIA). CKD staging was defined using KDIGO 2021 eGFR criteria. Statistical analysis included one-way ANOVA, chi-square test, Fisher's exact test, and Student's t-test as appropriate, with p < 0.05 considered statistically significant. RESULTS: Of the 90 participants, 24 (27%) had normal thyroid function, whereas 66 (73%) exhibited thyroid dysfunction. Among these, 35 (48%) had overt hypothyroidism, 17 (19%) had low T3 syndrome, and 14 (15.6%) had subclinical hypothyroidism; no cases of hyperthyroidism were identified. Thyroid abnormalities were more frequent in advanced CKD. Mean TSH levels increased significantly from Stage 3 (3.8 ± 1.2 µIU/mL) to Stage 5 (5.9 ± 1.8 µIU/mL) (p = 0.001), while mean fT4 and fT3 values declined progressively across stages (p = 0.003 and p < 0.001, respectively). Low HDL was common, affecting 66.67% of patients. CONCLUSION: Thyroid dysfunction, particularly overt hypothyroidism, low T3 syndrome, and subclinical hypothyroidism, was highly prevalent among CKD patients and demonstrated a significant association with advancing CKD stages. These findings highlight the importance of routine thyroid evaluation in CKD to support early detection and improved clinical management.
Source: Cureus
DOI: 10.7759/cureus.99501
Institution: SRM Medical College Hospital and Research Centre
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417448047