STUDY OF THYROID DISTURBANCE IN DIABETIC AND NON-DIABETIC CHRONIC KIDNEY DISEASE PATIENTS
DOI:
https://doi.org/10.24297/jab.v9i1.4228Keywords:
Thyroid disturbance, chronic kidney disease (CKD), diabetic nephropathyAbstract
Objective: study the prevelance of thyroid disturbance in diabetic chronic kidney disease (CKD) patients and non-diabetic CKD patients. Background: CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Hyperthyroidism and hypothyroidism have been associated with insulin resistance which has been reported to be the major cause of impaired glucose metabolism in type 2 diabetes mellitus (T2DM). Methods: This study included (120) CKD patients aged from 25 years to 70 years from Menofia university hospitals during the period from May 2015 to October 2015. They were classified into two groups: (I) (64 patients) (Diabetic group), (II) (56 patients) (Non-diabetic group). Each group was subdivided into 2 subgroups (A,B) according to creatinine clearance (CrCl): (A) (CrCl>45ml/min), (B) (CrCl<45ml/min). Members of the study were subjected to thorough history taking, complete physical examination and to kidney function testing (serum creatinine (Scr), blood urea nitrogen (BUN)), hemoglobin A1c (HbA1c), thyroid function tests (TSH, free T3, free T4), thyroglobulin, serum albumin (SA). Results: The mean age in diabetic patients (group I) was 53.7 years while in non-diabetic patients (group II) was 46 years. The mean TSH for subgroup IA was 5.4 μIU/ml while subgroup IB was 1.4 μIU/ml and for subgroup IIA was 1.6 μIU/ml while for subgroup IIB was 2.1 μIU/ml. There was highly significant difference between subgroup IA and IB (p value=<0.001) and between subgroup IA and IIA (p value=<0.001). There was no significant difference between subgroup IIA and IIB (p value=0.658) and between subgroup IB and IIB (p value=0.467). Conclusion: This study shows that thyroid disturbance is more common in diabetic CKD patients than non-diabetic CKD patients and that hypothyroidism is more common in diabetic patients with early CKD stages than late CKD stages.Downloads
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References
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29. Swamy R, Kumar N, Srinivas K, et al. Evaluation of hypothyroidism as a complication of type 2 diabetes mellitus. Biomedical Research. 2012; 23(2): 170–72.
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31. Nakamura S, Sakata S, Kojima N, Komaki T, Matsuda M, Miura K.Serum thyroglobulin concentration in patients with diabetes mellitus.EndocrinolJpn. 1987; 34(4): 473-8.
2. Mariani L and Berns J. The renal manifestations of thyroid disease. American Society of Nephrology J. 2012; 23(1): 22-26.
3. Wang C. The relationship between type 2 Diabetes mellitus and related thyroid diseases. J Diabetes Research. 2013; ID 390534: 9 pages.
4. McFarlane P, Gilbert R, MacCallum L, Senior P. Chronic kidney disease in diabetes. Canadian J Diabetes. 2013; 37(1): 129-136.
5. Miulescu R, Neamtu M, Margina D, Poiana C, Paun D. Associations between thyroid dysfunction and chronic kidney disease. Rom J Diabetes NutrMetab Dis. 2014; 21(1): 37-42.
6. Rajeev G, Rayappa W, Vijayalakshmi R, Swathi M, Kumar S. Evaluation of thyroid hormone levels in chronic kidney disease patients. Saudi J Kidney Dis and transplantation. 2015; 26(1): 90-93.
7. Rai S, Ashok J, Prajna K, et al. Thyroid function in type 2 diabetes mellitus and in diabetic nephropathy. J Clin Diagn Res. 2013; 7(8): 1583–1585.
8. Pasupathi P, Bakthavathsalam G, Saravanan G, Sundaramoorthi R. Screening for Thyroid Dysfunction in the Diabetic/Non-Diabetic Population. Thyroid Science. 2008; 3(8): 1-6.
9. Taksali R, Bindu S and MulayS.Evaluation of Thyroid Dysfunction in Type II Diabetes Mellitus: A Case Control Study. IJCMAAS. 2013; 1(1): 16-20.
10. Bajaj S, Gupta A, Gupta P, Srivastava A, Purwar N. Prevalence of hypothyroidism in diabetic and non-diabetic chronic kidney disease and effect of treatment on GFR. Nephrol Dial Transplant. 2015; 30(3): 503-504.
11. Stojceva-Taneva O, Selim G, Stojkovski L, Ivanovski N. Hypertension and progression of nephropathy in diabetic and non-diabetic chronic kindney disease patients. Hippokratia. 2007; 11(2): 72–76.
12. Banaga A, Mohammed E, Siddig R, et al. Causes of end stage renal failureamong haemodialysis patients in Khartoum State/Sudan. BMC Res Notes.2015; 8:502-508.
13. Graham U, Magee G, Hunter S, Atkinson A.Diabetic nephropathy and chronic kidney disease at a busy diabetes clinic: A study of Outpatient Care and suggestions for improved care pathways at a subspecialty specialist diabetic renal clinic. Ulster Med J. 2010; 79(2): 57-61.
14. Kamenov Z, Parapunova R and Georgieva R.Earlier development of diabetic neuropathy in men than in women with type 2 diabetes mellitus. Gend Med. 2010; 7(6): 600-615.
15. Lorenzo V, Saracho R, Zamora J, Rufino M, Torres A. Similar renal decline in diabetic and non-diabetic patients with comparable levels of albuminuria. Nephrol Dial Transplant.2010; 25: 835–841.
16. Satchell S and Tooke J.What is the mechanism of microalbuminuria in diabetes: a role for the glomerular endothelium?Diabetologia. 2008; 51(5): 714–725.
17. Biesenbach G, Raml A, Schmekal B, Eichbauer-Sturm G.Decreased insulin requirement in relation to GFR in nephropathic Type 1 and insulin-treated Type 2 diabetic patients. Diabet Med. 2003; 20(8): 642-5.
18. Kulozik F and Hasslacher C. Insulin requirements in patients with diabetes and declining kidney function: differences between insulin analogues and human insulin? Ther Adv Endocrinol Metab. 2013; 4(4): 113–121.
19. Joly D, Choukroun G, Combe C, at al. Glycemic control according to glomerular filtration rate in patients with type 2 diabetes and overt nephropathy: a prospective observational study. Diabetes Res Clin Pract. 2015; 108(1): 120-7.
20. Menon V, Wang X, Greene T, et al. Relationship between c-reactive protein, albumin, and cardiovascular disease in patients with chronic kidney disease. American Journal of Kidney Diseases. 2003; 42(1): 44-52.
21. Gomi I, Fukushima H, Shiraki M, et al. Relationship between serum albumin level and aging in community-dwelling self-supported elderly population. J NutrSciVitaminol. 2007; 53: 37-42.
22. Hermans M, Henry R, Dekker J, et al. Estimated Glomerular Filtration Rate and Urinary Albumin Excretion Are Independently Associated with Greater Arterial Stiffness: The Hoorn Study. J Am Soc Nephrol. 2007; 18: 1942–1952.
23. Imai E, Horio M, Yamagata K, et al. Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study. Hypertens Res. 2008; 31: 433–441.
24. Iseki K, Ikemiya Y, Iseki C, Takishita S. Proteinuria and the risk of developing end-stage renal disease. Kidney Int. 2003; 63: 1468–1474.
25. Halbesma N, Kuiken D, Brantsma A, et al. Macroalbuminuria is a better risk marker than low estimated GFR to identify individuals at risk for accelerated GFR loss in population screening. J Am Soc Nephrol. 2006; 17: 2582–2590.
26. Olivero J, Frommer J and Gonzalez J. Medical nephrectomy: The last resort for intractable complications of the nephrotic syndrome. Am J Kidney Dis. 1993; 21: 260-263.
27. Rhee C, Kalantar-Zadeh K, Streja E, et al. The relationship between thyroid function and estimated glomerular filtration rate in patients with chronic kidney disease. Nephrol Dial Transplant. 2014; 0: 1–6.
28. Islam S, Yesmine S, Khan A, Alam N. A comparative study of thyroid hormone levels in diabetic and nondiabetic patients. South East Asian J Trop Med Public Health.2008; 39(5): 913–916.
29. Swamy R, Kumar N, Srinivas K, et al. Evaluation of hypothyroidism as a complication of type 2 diabetes mellitus. Biomedical Research. 2012; 23(2): 170–72.
30. Venturi S, Donati F, Venturi A, Venturi M. Environmental iodine deficiency: A challenge to the evolution of terrestrial life? Thyroid. 2000; 10 (8): 727–9.
31. Nakamura S, Sakata S, Kojima N, Komaki T, Matsuda M, Miura K.Serum thyroglobulin concentration in patients with diabetes mellitus.EndocrinolJpn. 1987; 34(4): 473-8.
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Published
2016-02-23
How to Cite
El-Najjar, M., & Emara, M. (2016). STUDY OF THYROID DISTURBANCE IN DIABETIC AND NON-DIABETIC CHRONIC KIDNEY DISEASE PATIENTS. JOURNAL OF ADVANCES IN BIOLOGY, 9(1), 1740–1749. https://doi.org/10.24297/jab.v9i1.4228
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