Thyroid Function Status in Nephrotic Syndrome in Paediatric Age Group: A Hospital-based Cross-sectional Study

Abstract

Introduction: Nephrotic syndrome, being one of the common glomerular diseases in the paediatric population, is characterised by massive proteinuria and has a negative impact on thyroid function, necessitating investigation. Aim: To assess the status of thyroid function in nephrotic syndrome in the paediatric age group. Materials and Methods: This descriptive cross-sectional study was carried out at Bankura Sammilani Medical College and Hospital (BSMCH) in Bankura, West Bengal, India. The study included 100 children of both sexes aged one to eightyear-old who had nephrotic syndrome, either newly diagnosed or relapsed, and who were either hospitalised to the paediatric department or visited an outpatient department between April 2020 and September 2021. Thyroid hormone profiles, as well as other relevant investigations, were estimated in all children. Data was analysed using the Epi-Info (version 3.5.1) software. Results: Out of 100 children, 64% were males and the rest, 36%, were females. The mean age of presentation was 4.31±1.90 years. A 62% of them had a higher serum level of Thyroid Stimulating Hormone (TSH). Low levels of thyroxine (T4) and triiodothyronine (T3) were observed in 56% and 54% of cases, respectively. The serum albumin and serum TSH levels showed a significant negative correlation (r=-0.249, p=0.013). While T3 had a significant positive correlation (r=0.221, p=0.027), serum levels of T4 had a positive correlation (r=0.187) but turned out to be statistically insignificant (p=0.063). Conclusion: It was found that 62% of the children having nephrotic syndrome also had increased levels of TSH. Serum T4 and T3 levels were low in 54% and 56% of the study population, respectively, necessitating further investigation.

Hypothyroidism among Children with Nephrotic Syndrome Admitted to a Tertiary Care Centre

“…The prevalence was 41.16%, 62%, and 70.8% in a study done in Korean, Indian and Egyptian populations respectively. 1 , 6 , 8 A case-control study from Iran found elevated TSH levels in 34.2% of nephrotic children compared to controls (10.8%). 9 …”