Thyroid Profile in Chronic Kidney Disease Patients: A Cross-Sectional Study

Abstract

Introduction: Thyroid dysfunction is common in chronic kidney disease (CKD) and may exacerbate morbidity. This study assessed the prevalence of thyroid abnormalities and their association with renal function in CKD patients. Methods: A cross‑sectional study with 100 adults CKD stages 2–5 patients conducted at a tertiary care hospital in Ahmedabad, India (August 2019–September 2021). Thyroid function tests (free T3, free T4, TSH) and serum creatinine levels were measured. The estimated glomerular filtration rate (eGFR) was calculated using creatinine clearance. The prevalence of low T3 syndrome and subclinical hypothyroidism was determined. One-way ANOVA, Pearson's correlation, and Tukey post-hoc tests were used to analyse the relationship between thyroid parameters and eGFR. Results: In present study, mean age was 51.8 ± 10.6 years and 74% were male. Low free T3 occurred in 46%, low free T4 in 8%, and elevated TSH in 8% of patients. The prevalence of low T3 increased with CKD severity (stage 3: 4%; stage 4: 35%; stage 5: 57%; p=.007). Free T4 was significantly lower in stages 4 and 5 compared to stage 3 (p=.003). Creatinine clearance is positively correlated with both free T3 (r = 0.262, p=.008) and free T4 (r = 0.306, p =.002). Conclusions: Subclinical hypothyroidism and low T3 syndrome are common in chronic kidney disease (CKD) and are associated with deteriorating renal function. Routine thyroid function screening, including free T3 measurement, is recommended to facilitate timely diagnosis and management, potentially improving clinical outcomes.