Shakya Shobhit, Kumar Satish, Verma Virendra, Gupta Harish, Sonkar Satyendra Kumar, Atam Virendra
General Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.
Medicine, King George Medical University, Lucknow, IND.
Cureus. 2023 Feb 16;15(2):e35088. doi: 10.7759/cureus.35088. eCollection 2023 Feb.
Thyroid hormones have a very crucial role in the regulation of metabolism, synthesis of proteins, development, and influencing functions of various other hormones in the human body. While both kidneys play an essential role in the metabolism of thyroid hormone by conversion of thyroxine (T4) to triiodothyronine (T3). In patients with chronic renal failure, frequent abnormal thyroid functions are observed.
To evaluate thyroid function in patients of chronic renal failure and to find out their correlation with the severity of the disease.
A total of 192 patients were selected for the study after applying inclusion and exclusion criteria. A thyroid function test was done in all enrolled subjects. Serum estimation of T3, T4, and thyroid stimulating hormone (TSH) was done by the chemiluminescent immunoassay (CLIA) method, urea was estimated by the diacetyl monoxide method (DAM, Method), and serum creatinine by Jaffe's method. The results were evaluated for age, sex, and estimated glomerular filtration rate (eGFR) of the patients in view of thyroid dysfunction.
Of all 192 patients enrolled in the study, 124 (64.58%) were male and 68 (35.41%) were females. The observed male-to-female ratio was 1.93:1.18. The mean age of the study group (mean +/- standard deviation, SD) in males was 42+/-18 and in females 38+/-11 years (p value = 0.258). Significant reductions of serum T3, T4, and elevation of TSH were noted in both sexes. A reduced level of T3 was observed in 38.54% (42 males and 32 females) patients, reduced T4 in 34.37% (42 males and 22 females) patients, and subclinical hypothyroidism (SCH) in 16.7% (12 males and 20 females) patients. Biochemical overt hypothyroidism was noted in 7.29% (six males and eight females) of patients.
Chronic renal failure is a condition of thyroid hypofunction. A higher prevalence of SCH and clinical hypothyroidism is reported here in chronic kidney disease (CKD) patients. The severity of thyroid hypofunction increases with a progressive reduction in eGFR. Hypothyroidism in CKD patients may be due to different onset mechanisms other than anti-thyroid antibodies.
甲状腺激素在调节人体新陈代谢、蛋白质合成、发育以及影响其他各种激素的功能方面发挥着至关重要的作用。而双侧肾脏在将甲状腺素（T4）转化为三碘甲状腺原氨酸（T3）的过程中，对甲状腺激素的代谢起着重要作用。在慢性肾衰竭患者中，经常观察到甲状腺功能异常。
评估慢性肾衰竭患者的甲状腺功能，并找出其与疾病严重程度的相关性。
应用纳入和排除标准后，共选取192例患者进行研究。对所有纳入研究的对象进行甲状腺功能测试。采用化学发光免疫分析法（CLIA）测定血清T3、T4和促甲状腺激素（TSH），采用二乙酰一肟法（DAM法）测定尿素，采用Jaffe法测定血清肌酐。从甲状腺功能障碍的角度，对患者的年龄、性别和估计肾小球滤过率（eGFR）进行结果评估。
在所有纳入研究的192例患者中，男性124例（64.58%），女性68例（35.41%）。观察到的男女比例为1.93:1.18。研究组男性的平均年龄（平均值±标准差，SD）为42±18岁，女性为38±11岁（p值 = 0.258）。男女两性均出现血清T3、T4显著降低以及TSH升高的情况。38.54%（42例男性和32例女性）的患者观察到T3水平降低，34.37%（42例男性和22例女性）的患者T4水平降低，16.7%（12例男性和20例女性）的患者出现亚临床甲状腺功能减退（SCH）。7.29%（6例男性和8例女性）的患者出现生化显性甲状腺功能减退。
慢性肾衰竭是一种甲状腺功能减退的病症。本研究报告慢性肾脏病（CKD）患者中亚临床甲状腺功能减退和临床甲状腺功能减退的患病率较高。甲状腺功能减退的严重程度随着eGFR的逐渐降低而增加。CKD患者的甲状腺功能减退可能是由于除抗甲状腺抗体以外的不同发病机制所致。
