DOI: https://dx.doi.org/10.18203/2349-3933.ijam20220433
Published: 2022-02-23

Thyroid and lipid profile in chronic kidney disease in Southern India

Ershad Hussain Galeti, Sandeep Reddy, Jyothi Conjeevaram, Ayesha Galeti

Abstract


Background: The progression of chronic kidney disease (CKD) is linked to a multitude of comorbidities, such as thyroid dysfunction, dyslipidemia, and cardiovascular disease. Objective were to determine the thyroid and serum lipid profile of CKD patients and to establish correlation between severity of renal disease with these 2 metabolic parameters.

Methods: This was a prospective study conducted among the 100 CKD patients over 1 year admitted in the department of urology and nephrology at our hospital.

Results: There were 66 (66%) male patients and 36 (36%) female patients among the 100 patients. There were no patients in grade 1, whereas there were 2, 20, 66, and 12 patients in grades 2-5 CKD, respectively. In each grade of CKD, the mean age, eGFR, urea, creatinine, thyroid profile, and lipid profile were computed individually. The levels of urea, creatinine, and eGFR differed significantly across CKD grades 2-5. The thyroid profile differed significantly across CKD grades 2-5. The lipid profile differed significantly across CKD grades 2-5, with p=0.000, >0.05, 0.000, >0.05, >0.05 for total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) levels, respectively.

Conclusions: The number of patients increases with decreasing T3 and T4 and increasing thyroid stimulating hormone (TSH) proportionate to the severity of the renal failure. In addition, hypothyroidism is becoming more common in people with chronic renal disease. Serum triglycerides, LDL, and VLDL levels rise statistically significantly in CKD grades 3-5 patients.


Keywords


Dyslipidemia, CKD, Hemodialysis, Thyroid function test

Full Text:

PDF

References


Feehally J, Floege J, Johnson RJ. Comprehensive Clinical Nephrology (3rd Edi), Elsevier. 2018.

National Kidney Foundation K-DOQI: Clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Clinical Reviews in Bone and Mineral Metabolism. 2007;5(1):53-67.

Macdonald G. Harrison’s Internal Medicine, 17th edi by Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL et al. Internal Med J. 2018;38(12):932.

Shah BV, Nair S, Sirsat RA. The outcome of end-stage renal disease. J of Nephrology New Series. 1992;2;151-3.

Sumathi ME, Tembad MM, Jayaprakash Murthy DS, Preethi BP. Study of lipid profile and oxidative stress in chronic renal failure. Biomed Res. 2010;21:451-6.

Lim VS, Fang VS, Katz AL. Thyroid dysfunction in chronic renal failure-A study of pituitary thyroid axis and peripheral turn over kinetics of thyroxine and triiodothyronines. J Clinic Investig. 1977;60(3):522-34.

Lim VS, Zavala DC, Flanigan MJ, Freeman RM. Blunted peripheral tissue responsiveness to thyroid hormone in uremic patients. Kidney Inter. 1987;31(3):808-14.

Ramirez G, Jubiz W, Gutch CF, Bloomer HA, Siegler R, Kolff WJ. Thyroid abnormalities in renal failure. A study of 53 patients on chronic dialysis. Ann Intern Med. 1973;79:500-4.

Kayima JK, Otieno LS, Gitau W, Mwai S. Thyroid hormones profile in patients with chronic renal failure on conservative management and regular hemodialysis. East Afr Med J. 1992;69:333-6.

Spector DA, Davis PJ, Helderman JH, Bell B, Utiger RD. Thyroid function and metabolic rate in chronic renal failure. Ann Intern Med. 1976;85:724-30.

Dudani RA, Desai KB, Mehta MN, Mani LS, Acharya VS. Thyroid dysfunction in Ureaemia J Assoc Physicians India. 1981;29:1037-40.

Karunanidhi A, Kanagasabapathy AS, Shastry JS, Koshy TS. Thyroid function in patients with chronic renal failure. Indian J Med Res. 1979;69:792-7.

Kaptein E, Quion-Verde H, Chooljian CJ, Tang WW, Friedman PE, Rodriquez HJ et al. The Thyroid in end stage renal diseases. Medicine. 1988;187-9.

Hegedus L, Andersen JR, Poulsen. Thyroid gland volume and serum concentrations of thyroid hormones in chronic renal failure. Nephron. 1985;40:171-4.

Lee DM, Knight-Gibson C, Samuelsson O, Attman PO, Wang CS, Alaupovic P et al. Lipoprotein particle abnormalities and the impaired lipolysis in renal insufficiency. Kidney Int. 2002;61:209-18.

Tsao CW, Vasan RS. Cohort Profile: The Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology. Int J Epidemiol. 2015;44(6):1800-13.

Gupta DK. Hypedipidemia in patents of chronic renal failure. Bombay Hospital J. 1991;33:45-50.

Das BS, Mishra SK, Rao DVP. Serum lipids in chronic renal failure. J Assoc Physicians India. 1984;32:1019-21.

Bagdade J, Casaretto A. Effect of chronic uremia, haemodialysis and renal transplantation on plasma lipids and lipoproteins. J Clin Invest. 1976;87:374.

Chan MK, Varghese Z, Moorhead JF. Lipid abnormalities in uremia. Kidney Int. 1981;19:625.

Rajman I, Harper L, McPake D, Kendall MJ, Wheeler DC. Low-density lipoprotein subfraction profiles in chronic renal failure. Nephrol Dial Transplant. 1998;13:2281-7.

Vaziri ND, Liang K. Downregulation of hepatic LDL receptor expression in experimental nephrosis. Kidney Int. 1996;50:887-93.