Assessment of renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia: a cross sectional study

Abstract

IntroductionStudies demonstrated that abnormal thyroid functions may result in decreased or increased kidney size, kidney weight, and affect renal functions. In this regard, studies on the association of abnormal thyroid functions and renal function tests are scarcely found in Ethiopia.ObjectiveTo assess renal function and electrolytes in patients with thyroid dysfunction, in Addis Ababa, Ethiopia.MethodsCross sectional study was conducted from March 21/2015-May 27/2015 at Arsho Advanced Medical Laboratory. During the study period, 71 patients with thyroid dysfunction were eligible, and socio demographic data collected by structured questionnaire. Then blood sample was collected for thyroid function tests, renal function and blood electrolyte analysis. The collected data was analyzed by SPSS version 20. ANOVA and binary logistic regression were employed to evaluate the mean deference and associations of thyroid hormone with renal function and electrolyte balances.ResultsAmong the renal function tests, serum uric acid, and creatinine mean values were significantly decreased in hyperthyroid patients; whereas, eGFR mean value was significantly increased in hyperthyroid study patients (P<0.05). Meanwhile, from the electrolyte measurements made, only the mean serum sodium value was significantly increased in hyperthyroid study participants. Binary logistic regression analysis on the association of thyroid dysfunction with electrolyte balance and renal function tests indicated that serum sodium, creatinine, eGFR values and hyperthyroidism have a statistical significant association at AOR 95% CI of 0.141(0.033-0.593, P=0.008); 16.236(3.481-75.739, P=0.001), and 13.797(3.261-58.67, P=0.001) respectively.ConclusionThe current study reveals, thyroid abnormalities may lead to renal function alterations and also may disturb electrolyte balance. Knowledge of this significant association has worthwhile value for clinicians, to manage their patients' optimally.

Hemato-biochemical alterations and antioxidant status during drug-induced thyroid dysfunction in Wister rats

“…Besides, the impaired water excretion in the setting of hypothyroidism is likely to be related to a reduction in renal perfusion secondary to the systemic effects of thyroid hormone deficiency on cardiac output and peripheral vascular resistance. Otherwise, sodium levels were significantly increased in hyperthyroidism group which agreed with the results recorded by Abebe et al (2016), who attributed hypernatremia to the effect of hyperthyroidism that can result in or accelerate chronic kidney disease (CKD) by the mechanisms of intra-glomerular hypotension (increased filtration pressure) and consequent hyper-filtration. Investigation of calcium levels showed significant increases in hypothyroidism which may be attributed to metabolic derangement induced by thyroid hormone deficiency such as altered calcium homeostasis.…”

Hypothyroidism and Kidney Function: A Mendelian Randomization Study

“…P rimary hypothyroidism is characterized by a high concentration of thyrotropin (TSH) concomitant with concentrations of thyroid hormones being low (overt) or within the reference range (subclinical). In conventional nongenetic observational studies, both overt and subclinical hypothyroidism are associated with increased plasma creatinine, decreased estimated glomerular filtration rate (eGFR), chronic kidney disease (CKD), and increased urinary albumin/creatinine ratio (UACR) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Overt hypothyroidism is most often an autoimmune disease in adults, (13) affecting predominantly middle-aged and older women.…”

“…Thyroid hormones within the reference range may also affect kidney function through direct effects on glomerular and tubular functions and indirect prerenal effects on cardiovascular hemodynamics and renal blood flow (14). Increased TSH within the reference range is associated with reduced eGFR (1,(15)(16)(17)(18)(19)(20)(21)(22), but whether related triiodothyronine and thyroxine are also associated with kidney function is debated (3,4,15,17,(21)(22)(23). Diagnosis of kidney disorders may also be related to thyroid dysfunction due to the depletion of TSH, free thyroxine (fT4), and relevant binding proteins from the circulation through leakage into the urine or alternatively to nonthyroidal illness (14,(24)(25)(26)(27).…”

Correlation of Serum Electrolytes in Patients With Thyroid Dysfunction

“…However, the present study is in contrast to the study done by Abebe et al and Alkazaz et al which showed that hyperthyroidism leads to hypokalemia. 22,23 This significant increment of sodium ions in the case of hyperthyroidism could possibly be due to availability of increased thyroid hormones, the Na-H exchanger and Na-Picotransporter activity will also increase first in proximal tubules then almost all segments of nephron. Another possibility for the increment of serum sodium value might be of the direct relation of hyperthyroidism with plasma rennin activity, and plasma level of angiotensinogen, angiotensin II and aldosterone.…”