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Hypothyroidism in Children with Chronic Kidney Disease Attending a Tertiary Care Center
Garima Yadav1, Aashima Dabas1, Mukta Mantan1
1Department of Pediatrics and Department of Biochemistry, New Delhi, India.
Insights
Hypothyroidism affects over a quarter of children with chronic kidney disease (CKD), with higher prevalence in advanced stages. This thyroid dysfunction is linked to significant growth failure in pediatric CKD patients.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Thyroidology
Background:
- Primary hypothyroidism is common in adult chronic kidney disease (CKD) patients.
- Data on hypothyroidism in pediatric CKD populations is limited.
- Thyroid dysfunction can significantly impact growth and development in children.
Purpose of the Study:
- To determine the prevalence of hypothyroidism in children (aged 1-18 years) with CKD.
- To assess the relationship between CKD stage and hypothyroidism.
- To investigate the association between thyroid dysfunction and growth parameters in pediatric CKD.
Main Methods:
- A cross-sectional study involving clinical examination and biochemical thyroid profile assessment.
- Enrollment of 65 children (aged 1-18 years) diagnosed with CKD.
- Categorization of CKD based on disease stages (1-5).
Main Results:
- Overall, 26.2% of pediatric CKD patients exhibited thyroid dysfunction.
- Hypothyroidism prevalence was higher in advanced CKD stages (40.9% in Stages 4-5 vs. 20.9% in Stages 1-3).
- Children with hypothyroidism, particularly overt hypothyroidism, showed significantly lower height standard deviation scores, indicating more profound growth failure.
Conclusions:
- A significant proportion of children with CKD experience hypothyroidism.
- Thyroid dysfunction is associated with impaired growth in pediatric CKD.
- Routine screening for thyroid dysfunction in children with CKD is recommended.
Abstract:
Primary hypothyroidism is observed in adult patients with chronic kidney disease (CKD) though described scantily in the pediatric population. The primary objective of this study was to detect the prevalence of hypothyroidism in children (1-18 years) with CKD as assessed by thyroid profile. This cross-sectional study was conducted in the department of pediatrics of a tertiary care teaching hospital between January 2016 and January 2017. Clinical examination and biochemical investigations were performed for children with CKD aged 1 -18 years. Sixty-five children (51 boys, 43 CKD Stages 1-3) with a mean [standard deviation (SD)] age of 7.9 (3.2) years were enrolled. Overall, 17 (26.2%) had thyroid dysfunction; nine (13.8%) had subclinical hypothyroidism, three (4.6%) overt hypothyroidism, and five (7.7%) had isolated low T3 levels. The prevalence of hypothyroidism increased from 20.9% in CKD Stages 1-3 to 40.9% in Stages 4-5 of CKD; P = 0.09. The mean (SD) height SD scores were lower in those with hypothyroidism than with normal thyroid function [-1.02 (1.69) and -1.89 (1.12), P = 0.003, respectively], lowest at -2.79 (0.65) in overt hypothyroidism. A significant proportion of children with CKD manifest with hypothyroidism who have more profound growth failure. It may be prudent to screen CKD patients for thyroid dysfunction.
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