期刊论文详细信息
BMC Endocrine Disorders
Thyroid dysfunction and dyslipidemia in chronic kidney disease patients
Nirmal Baral2  Madhab Lamsal2  Sharad Gautam2  Rajendra KC2  Saroj Khatiwada1 
[1] Department of Pharmacy, Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu 44600, Nepal;Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
关键词: Thyroid dysfunction;    Subclinical hypothyroidism;    Nepal;    Dyslipidemia;    Chronic kidney disease;   
Others  :  1230189
DOI  :  10.1186/s12902-015-0063-9
 received in 2015-07-22, accepted in 2015-10-23,  发布年份 2015
PDF
【 摘 要 】

Background

Chronic kidney disease (CKD) is becoming a serious health problem; the number of people with impaired renal function is rapidly rising. Progression of CKD is associated with having a number of complications, including thyroid dysfunction, dyslipidemia and cardiovascular diseases. This study was conducted to investigate thyroid function and lipid profile in CKD patients.

Methods

A cross-sectional study was conducted among 360 chronic kidney disease patients at B P Koirala Institute of Health Sciences, Dharan, Nepal. Demographic features (age and sex) and medical history of diabetes mellitus, hypertension and cardiovascular diseases of each patient were noted, and blood samples (5 ml) were analyzed for serum urea, creatinine, glucose, free triiodothyronine (T3), free thyroxine (T4), thyroid stimulating hormone (TSH), total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and triglyceride.

Results

Thyroid dysfunction was found in 38.6 % CKD patients, the most common being subclinical hypothyroidism (27.2 %), followed by overt hypothyroidism (8.1 %) and subclinical hyperthyroidism (3.3 %). Hypercholesterolemia, low HDL cholesterol, undesirable LDL cholesterol and hypertriglyceridemia were observed in 34.4, 34.1, 35 and 36.6 % patients respectively. Stage 4 and 5 CKD patients had significantly higher risk of having thyroid dysfunction as compared to stage 3 patients. Significant risk factors for cardiovascular disease in CKD patients included presence of diabetes mellitus, hypercholesterolemia, undesirable LDL cholesterol and being in stage 4 and 5 (as compared to stage 3).

Conclusions

Thyroid dysfunction, hypercholesterolemia, low HDL cholesterol, undesirable LDL cholesterol and hypertriglyceridemia are common in CKD patients. Progression of CKD is accompanied by rise in hypothyroidism and cardiovascular disease.

【 授权许可】

   
2015 Khatiwada et al.

【 预 览 】
附件列表
Files Size Format View
20151104012244252.pdf 392KB PDF download
【 参考文献 】
  • [1]Olechnowicz-Tietz S, Gluba A, Paradowska A, Banach M, Rysz J. The risk of atherosclerosis in patients with chronic kidney disease. Int Urol Nephrol. 2013; 45(6):1605-12.
  • [2]Tsukamoto Y, Wang H, Becker G, Chen HC, Han DS, Harris D et al.. Report of the Asian Forum of Chronic Kidney Disease Initiative (AFCKDI) 2007. “Current status and perspective of CKD in Asia”: Diversity and specificity among Asian countries. Clin Exp Nephrol. 2009; 13(3):249-56.
  • [3]Trivedi H. Cost implications of caring for chronic kidney disease: are interventions cost-effective? Adv Chronic Kidney Dis. 2010; 17(3):265-70.
  • [4]Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim Care. 2008; 35(2):329-44.
  • [5]Malyszko J, Malyszko J, Wolczynski S, Mysliwiec M. Adiponectin, leptin and thyroid hormones in patients with chronic renal failure and on renal replacement therapy: are they related? Nephrol Dial Transplant. 2006;21(1):145-52.
  • [6]Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005; 67(3):1047-52.
  • [7]Collaboration PS, Lewington S, Whitlock G, Clarke R, Sherlinker P, Emberson J, Halsey J et al.. Blood cholesterol and vascular mortality by age, sex and blood pressure a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007; 370(9602):1829-39.
  • [8]Attman PO, Samuelsson O, Alaupovic P. The effect of decreasing renal function on lipoprotein profiles. Nephrol Dial Transplant. 2011; 26(8):2572-5.
  • [9]Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL et al.. Kidney disease as a risk factor for development of cardiovascular disease a statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation. 2003; 108(17):2154-69.
  • [10]Chen SC, Hung CC, Kuo MC, Lee JJ, Chiu YW et al.. Association of dyslipidemia with renal outcomes in chronic kidney disease. PLoS One. 2013; 8(2):e55643.
  • [11]Sharma SK, Dhakal S, Thapa L, Ghimire A, Tamrakar R, Chaudhary S et al.. Community-based screening for chronic kidney disease, hypertension and diabetes in Dharan. J Nepal Med Assoc. 2013; 52(189):205-12.
  • [12]Poudel B, Yadav BK, Jha B, Raut KB. Dyslipidaemia in chronic kidney disease in Nepalese population. Mymensingh Med J. 2013; 22(1):157-63.
  • [13]Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA et al.. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014; 63(5):713-35.
  • [14]Paudel K. Prevalence and clinical characteristics of hypothyroidism in a population undergoing maintenance hemodialysis. J Clin Diagn Res. 2014; 8(4):MC01-4.
  • [15]Shantha GPS, Kumar AA, Bhise V, Khanna R, Sivagnanam K, Subramanian KK. Prevalence of subclinical hypothyroidism in patients with end-stage renal disease and the role of serum albumin: a cross-sectional study from South India. Cardiorenal Med. 2011; 1(4):255-60.
  • [16]Ng YY, Wu SC, Lin HD, Hu FH, Hou CC, Chou YY et al.. Prevalence of clinical and subclinical thyroid disease in a peritoneal dialysis population. Perit Dial Int. 2012; 32(1):86-93.
  • [17]Jeena EJ, Malathi M, Sudeep K. A hospital-based study of anti-TPO titer in patients with thyroid disease. Muller J Med Sci Res. 2013; 4(2):74-7.
  • [18]Khatiwada S, Gelal B, Shakya PR, Lamsal M, Baral N. Urinary iodine excretion among Nepalese school children in Terai Region. Indian J Pediatr. 2015.
  • [19]Song SH, Kwak IS, Lee DW, Kang YH, Seong EY, Park JS. The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone. Nephrol Dial Transplant. 2009; 24(5):1534-8.
  • [20]Rajeev G, Chickballapur Rayappa WD, Vijayalakshmi R, Swathi M, Kumar S. Evaluation of thyroid hormone levels in chronic kidney disease patients. Saudi J Kidney Dis Transpl. 2015; 26(1):90-3.
  • [21]Rajagopalan B, Dolia PB, Arumalla VK. Renal function markers and thyroid hormone status in undialyzed chronic kidney disease. Al Ameen J Med Sci. 2013; 6(1):70-4.
  • [22]Chonchol M, Lippi G, Salvagno G, Zoppini G, Muggeo M, Targher G. Prevalence of subclinical hypothyroidism in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2008; 3(5):1296-300.
  • [23]Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP et al.. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. J Am Med Assoc. 2010; 304(12):1365-74.
  • [24]Ashizawa K, Imaizumi M, Usa T, Tominaga T, Sera N, Hida A et al.. Metabolic cardiovascular disease risk factors and their clustering in subclinical hypothyroidism. Clin Endocrinol (Oxf). 2010; 72(5):689-95.
  • [25]Basu G, Mohapatra A. Interactions between thyroid disorders and kidney disease. Indian J Endocrinol Metab. 2012; 16(2):204-13.
  • [26]Tsimihodimos V, Mitrogianni Z, Elisaf M. Dyslipidemia associated with chronic kidney disease. Open Cardiovasc Med J. 2011; 5:41-8.
  • [27]Raju DSSK, Lalitha DL, Kiranmayi P. A study of lipid profile and lipid peroxidation in chronic kidney disease with special reference to hemodialysis. J Clinic Res Bioeth. 2013; 4(1):1000143.
  • [28]Mehdi U, Toto RD. Anemia, diabetes, and chronic kidney disease. Diabetes Care. 2009; 32(7):1320-6.
  • [29]Mohamedali M, Maddika SR, Vyas A, Iyer V, Cheriyath P. Thyroid disorders and chronic kidney disease. Int J Nephrol. 2014; 2014:520281.
  • [30]Afsar B. Dyslipidemias in chronic kidney disease: current guidelines and future perspectives. OA Nephrology. 2013; 1(1):2.
  文献评价指标  
  下载次数:3次 浏览次数:7次