A STUDY OF THYROID PROFILE AND FASTING LIPID PROFILE IN CHRONIC KIDNEY DISEASE

Background: Chronic kidney disease [CKD] is associated with specific abnormalities in the thyroid and lipoprotein metabolism both in the early and in the advanced stages of chronic renal failure. Regardless of age, heart disease is a major cause of morbidity and mortality among patients with renal failure.Our study aimed at to estimate thyroid profile and dyslipidemia in CKD patients on conservative management,on haemodialysisand to compare with healthy controls.

Methods: This was a prospective study conducted among the 100 CKD patients and controls over 18 months admitted in the department of general medicine at our hospital.

Results: Hundred CKD cases with 70 male and 30 female in a M: F ratio of 2.3:1 were found to be in different stages CKD (12, 29 and 59 in stage-3 to stage-5 respectively). In 59 cases of stage-5 CKD, 32 were on HD and 27 on conservative management. 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 3-5.The thyroid profile differed significantly across CKD grades 3-5. The lipid profile differed significantly across CKD grades 3-5, 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 TSH proportionate to the severity of the renal failure, hypothyroidism is becoming more common in people with chronic renal disease.All lipid abnormalities found in CKD on HD have reduced HDL levels in serum along with significant rise in serum triglyceride, serum cholesterol serum LDL level and serum VLDL level.Dyslipidemia in CKD worsened as patientsprogresssed to severe stages with significant increase in TG, TC, VLDLc and TC/HDLc confirming presence of atherogenic lipid profile needing early intervention to prevent cardiovascular complications.