Evaluation Of Thyroid Dysfunction In Children Of Different Stages Of CKD In A Tertiary Care Hospital

Abstract

Background: Thyroid dysfunction is a common yet often overlooked complication in children with chronic kidney disease (CKD). This study aimed to evaluate the pattern of thyroid abnormalities across different stages of CKD in pediatric patients at a tertiary care hospital. Methods: This cross-sectional analytic study was conducted in the Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from February 2017 to January 2018. In this study, we included 60 pediatric patients with CKD, either newly diagnosed or previously diagnosed, who were admitted to the inpatient department or attended the outpatient department. Results: The mean age of participants was 12.02 ± 4.21 years, with a male predominance (63.3%). Most patients (78.3%) were from rural areas. The most common thyroid dysfunction was Low T3 Syndrome (58.3%), especially in Stage V (62.5%). Subclinical hypothyroidism was found in 8.3% of cases, all in Stage V, while hyperthyroidism was rare (1.7%). Euthyroidism was observed in 15% of patients. TSH levels were significantly higher in advanced CKD stages (p = 0.031), and a significant positive
correlation was found between TSH and CKD stage (r = +0.258, p = 0.046). Conversely, T3 showed a significant negative correlation with CKD stage (r = –0.254, p = 0.041). T4 levels also decreased with disease progression, though not significantly (r = –0.082, p = 0.533). Anemia, respiratory distress, and edema were the most frequent clinical features. Conclusion: Thyroid dysfunction, particularly Low T3 Syndrome and subclinical hypothyroidism, is common in pediatric CKD, especially in advanced stages. Routine screening for thyroid function in children with CKD may enable early detection and management.