DOI: 10.36347/sjams.2016.v04i02.014

Pages: 358-365

Forty two patients with chronic renal insufficiency underwent clinical evaluation & studies of thyroid function. The results were compared with age & sex-matched controls. Two patients had clinical hypothyroidism with low serum T3, T4, FT4 & high serum TSH. The remaining patients did not have goitre & they were clinically euthyroid. A linear decline in TT3 levels was seen when linear correlation was tested between GFR and TT3 levels. There was no significant decline in TT3 and FT3 levels in mild CKD. Thus, TT3 and FT3 levels tend to fall at GFR levels below 60ml/min. When controls were compared with mild CKD cases, no significant decline in TT4 levels was found but when compared with moderate and severe CKD cases there was a tendency of fall of TT4 as CKD progressed. However, a linear correlation between TT4 levels and GFR was not found. A significant reduced level of TT4 as compared to TT3 and FT3 was found in severe CKD thus, TT4 can be used as a specific indicator of severe CKD. Contrary to FT3, levels of FT4 remained normal through all the stages of CKD. TSH levels remained normal throughout the course of CKD. There was an increased incidence of signs and symptoms simulating hypothyroid state in pts of severe CKD but this does not signify that they had primary hypothyroidism. However, Incidence of hypothyroidism in CKD patients is increased. Only TSH and FT4 levels can be relied upon to diagnose and treat primary hypothyroidism. There was no incidence of goiter, hyperthyroidism or thyroid nodules in CKD pts. To conclude thyroid dysfunction occurs both clinically & biochemically in patients with chronic renal insufficiency.