Evaluation of Interactions Between Thyroid Dysfunction in End-Stage Renal Disease Patients: A Cross-Sectional Study

Area of Science:

• Endocrinology and Metabolism
• Nephrology
• Thyroid Disorders

Background:

• Thyroid hormones are critical for metabolism, protein synthesis, and development.
• Kidneys play a key role in thyroid hormone metabolism, converting thyroxine (T4) to triiodothyronine (T3).
• Chronic renal failure (CRF) is frequently associated with abnormal thyroid function.

Purpose of the Study:

• To assess thyroid function in patients with chronic renal failure.
• To investigate the correlation between thyroid dysfunction and the severity of chronic kidney disease (CKD).

Main Methods:

• A study involving 192 patients with CRF.
• Thyroid function tests including serum T3, T4, and thyroid-stimulating hormone (TSH) measured via chemiluminescent immunoassay (CLIA).
• Assessment of kidney function using serum creatinine (Jaffe's method) and calculation of estimated glomerular filtration rate (eGFR).

Main Results:

• Significant reductions in serum T3 and T4 levels, along with elevated TSH, were observed in both male and female patients.
• Reduced T3 was found in 38.54%, reduced T4 in 34.37%, subclinical hypothyroidism (SCH) in 16.7%, and overt hypothyroidism in 7.29% of patients.
• Thyroid hypofunction severity was noted to increase with a progressive decrease in eGFR.

Conclusions:

• Chronic renal failure is characterized by thyroid hypofunction.
• A notable prevalence of subclinical and clinical hypothyroidism exists in CKD patients.
• The severity of thyroid hypofunction in CKD patients correlates with declining eGFR, suggesting mechanisms beyond anti-thyroid antibodies.