STUDY OF THYROID PROFILE IN CHILDREN WITH CHRONIC KIDNEY DISEASE AT TRIBHUVAN UNIVERSITY TEACHING HOSPITAL

Nivedita  Mishra; Laxman  Shrestha; Luna  Bajracharya

doi:10.51168/sjhrafrica.v5i12.1503

Authors

Nivedita Mishra MBBS, MD (Paediatrics), Divisional Medical Officer at Northeast Frontier Railways Divisional Railway Hospital, Katihar, Bihar, India.
Laxman Shrestha Professor & HOD, Department of Child Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Luna Bajracharya Assistant Professor, Department of Child Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1503

Keywords:

Children, Chronic kidney disease, Nepal, Thyroid dysfunction, TUTH

Abstract

Background: The kidney and thyroid are interconnected, with thyroid hormones affecting renal growth and development. Disturbances in thyroid function can worsen pre-existing kidney disorders. Kidney plays a crucial role in thyroid hormone metabolism, degradation, and excretion, leading to hyper or hypothyroidism. The main objective of the study was to find the association between stages of CKD based on glomerular filtration rate (GFR) and thyroid dysfunction in children.

Methods: This prospective observational study was carried out from October 2019 to October 2020 at a Nepalese tertiary care hospital. Children with CKD ages 1–16 were enrolled. Their medical history, clinical observations, and biochemical tests, including thyroid and renal function tests, were documented on a pre-made proforma. Spearman correlation, the Kruskal-Wallis test, the Fisher exact test, and chi-square were used to examine the data.

Results: Glomerulonephritis was the most prevalent cause of CKD among the 36 children with the disease, accounting for 30.5% of cases. 27 (75%) of the children were between the ages of 11 and 16. The majority of children (28, or 77.78%) were in stage 5 of CKD. Most of the cases (61.11%) had normal thyroid function. Of the children, 14 (38.89%) had hypothyroidism. Low T3 syndrome was the most prevalent type of hypothyroidism, occurring in 5 children (13.9%), and subclinical hypothyroidism occurred in 4 children (11.11%). 2 (5.56%) children had low T4 syndrome, which was the most common thyroid function anomaly.Perhaps as a result of the small sample size, thyroid dysfunction did not correlate with age, gender, length of illness, or declining GFR.

Conclusion:

This study found that children with CKD had subclinical hypothyroidism and low T3 syndrome. Therefore, in order to diagnose and treat thyroid dysfunction early on, a thyroid function test should be conducted on all children with chronic kidney disease.

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