Published: 2019-09-23

Thyroid status in patients undergoing maintenance haemodialysis: a South Indian cohort study

Bhaskaran S., Sakthidasan S., Lalitha Shanmugam, Suthakaran C.


Background: Hypothyroidism is common throughout the world and the prevalence of hypothyroidism is high in India. Ailment of thyroid function has been documented to occur at a higher rate in patients with chronic kidney disease (CKD), including those undergoing dialysis than in general population.

Methods: A prospective cross-sectional observational clinical study in real time was carried out to assess the thyroid status in eighty-nine adult patients undergoing a 4 h three times weekly haemodialysis schedule in a rural tertiary referral hospital in South India. The status of the thyroid was monitored via Free T3 Free T4 and Thyroid Stimulating Hormone levels.

Results: Subclinical hypothyroidism was common in patients undergoing haemodialysis. Although there was a negative correlation between the levels of thyroid hormones and other variables, it was clinically insignificant.

Conclusions: The present study showed that abnormalities in thyroid function are high in patients undergoing haemodialysis and that there were no clinically significant correlation between the levels of thyroid hormones and clinical or biochemical characteristics.


Haemodialysis, Observational study, Subclinical hypothyroidism, Thyroid status

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Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM. et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018;14(5):301-16.

Bagcchi S. Hypothyroidism in India: more to be done. Lancet Diabetes Endocrinol. 2014;2(10):778.

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocr Metab 2011;15(2);S2:78-81.

Rhee CM, You AS, Nguyen DV, Brunelli SM, Budoff MJ, Streja E, et al. Thyroid Status and Mortality in a Prospective Hemodialysis Cohort. J Clin Endocrinol Metab. 2017;102(5):1568-77.

Chandra A. Prevalence of hypothyroidism in patients with chronic kidney disease: a cross-sectional study from North India. Kidney Res Clin Pract. 2016;35(3):165-8.

Fragidis S, Sombolos K, Thodis E, Panagoutsos S, Mourvati E, Pikilidou M, et al. Low T3 syndrome and long-term mortality in chronic haemodialysis patients. World J Nephrol 2015;4(3):415-22.

Chávez Valencia V, Mejía Rodríguez O, Viveros Sandoval ME, Abraham Bermúdez J, Gutiérrez Castellanos S, Orizaga de la Cruz C, et al. Prevalence of malnutrition-inflammation complex syndrome and its correlation with thyroid hormones in chronic haemodialysis patients. Nefrologia. 2018;38(1):57-63.

Rhee CM, Kalantar-Zadeh K, Streja E, Carrero JJ, Ma JZ, Lu JL, et al. The relationship between thyroid function and estimated glomerular filtration rate in patients with chronic kidney disease. Nephrol Dial Transplant. 2015;30(2):282-7.

Rhee CM, Kim S, Gillen DL, Oztan T, Wang J, Mehrotra R, et al. Association of thyroid functional disease with mortality in a national cohort of incident hemodialysis patients. J Clin Endocrinol Metab. 2015;100(4):1386-95.

Zoccali C, Benedetto F, Mallamaci F, Tripepi G, Cutrupi S, Pizzini P, et al. Low triiodothyronine and cardiomyopathy in patients with end-stage renal disease. J Hypertens. 2006;24(10):2039-46.

Enia G, Panuccio V, Cutrupi S, Pizzini P, Tripepi G, Mallamaci F, et al. Subclinical hypothyroidism is linked to micro-inflammation and predicts death in continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant. 2007;22(2):538-44.

Carrero JJ, Qureshi AR, Axelsson J, Yilmaz MI, Rehnmark S, Witt MR, et al. Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med. 2007;262(6):690-701.

Rotondi M, Netti GS, Rosati A, Mazzinghi B, Magri F, Ronconi E, et al. Pretransplant serum FT3 levels in kidney graft recipients are useful for identifying patients with higher risk for graft failure. Clin Endocrinol (Oxf). 2008;68(2):220-5.