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In recent decades, the relationship between thyroid and kidney disease has drawn considerable attention. We aim to assess the prevalence and the determinants of hypothyroidism in hemodialysis patients in Somalia. Materials and Methods: This is a cross-sectional study which was conducted in the hemodialysis unit of Mogadishu Somalia Turkish Training and Research Hospital, between June 1 and July, 31 2022. A total of 301 patients who are routinely going to hemodialysis were included in the study. Demographic data including age, gender, and data regarding hemodialysis were extracted from hospital information system (HIS). All participants had their thyroid function test measured before hemodialysis sessions. Results: A total of 301 patients were examined. Their ages ranged from 40 to 66 years, with the median age being 54 (IQR= 40-66). Males were 167 (55.5%) compared to females 134 (44.5%). Hypertension was the most common comorbidity among the patients with 137 (45.5%). Diabetic kidney disease was the most common cause of renal failure in 138 patients (45.84%) followed by hypertensive kidney disease 100 (33.22%). The prevalence rate of hypothyroidism in hemodialysis patients in our study was 28%. In hypothyroidism patients 57.8% had subclinical hypothyroidism and 42.2% had overt hypothyroidism. 70.8% of our patients were in euthyroid status. Subclinical hypothyroidism was commonly seen in patients with diabetes, hypertension, and heart disease. We found that increasing age, decreased albumin level were related to higher risk of subclinical hypothyroidism. We also found that increasing creatinine levels were associated with lower risk of overt hypothyroidism. Conclusion:The prevalence rate of hypothyroidism in hemodialysis patients was 28%, with 57.8% showing subclinical hypothyroidism and 42.2% overt hypothyroidism. Increased age and low albumin level was associated with the prevalence of subclinical hypothyroidism in hemodialysis patients. Also low creatinine level was observed in overt hypothyroidism patients.

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Nephrotic syndrome (NS) was first characterized in 1827 as the occurrence of proteinuria greater than or equal to 3.5 g/24 hours, hypoalbuminemia (albumin less than or equal to 3.0 g/dl), peripheral edema, hyperlipidemia, lipiduria caused by increased permeability of the renal glomerulus. In the early stage of NS the loss of thyroid hormones rarely leads to hypothyroidism and euthyroid state is expected. However, persistent proteinuria will eventually lead to hypothyroidism. Non-autoimmune hypothyroidism due to NS which presents at an early stage of NS is quite rare and cases reporting it are very scarce in the literature. In the presenting case, we reported a 26-year-old male patient with no known history of chronic disease who presented to the emergency department with a complaint of one-week generalized edema, nausea, fatigue, and generalized ache in the extremities. He was diagnosed with nephrotic syndrome complicated by hypothyroidism and was hospitalized for 3 weeks. After 3 weeks of treatment and close monitoring, the patient’s clinical condition and laboratory investigations were improved and was discharged in good health.

Introduction: Polycythemia vera (PV) is a disease of stem cells characterized by pan hyperplastic, malignant, and neoplastic bone marrow conditions. It is characterized by an increased absolute red blood cell count due to uncontrolled red blood cell synthesis, as well as excessive white blood cell and platelet production. Although the relationship between PV and stroke, especially ischemic stroke, is widely known around the world, no previous cases have been reported from Somalia. Case presentation: In the presenting study, we report a 60-year-old male patient who presented with a right-side weakness for 3 days. After laboratory and brain imaging, he was diagnosed with an acute cerebral infarct affecting the left basal ganglion secondary to PV. Conclusions: PV as the cause of ischemic stroke is a rare condition but can be encountered in clinical practice, and clinicians should be familiar with this combination.