Prevalence of Hypothyroidism in Patients with Chronic Kidney Disease

Lee, Da Hyen; Jeon, Young Deok; Lee, Seung Hun; Mun, Ga Seul; Na, Su Sie; Cha, Huk Hwan

Abstract

BACKGROUND/AIMS
Primary thyroid disease is prevalent in chronic renal disease, especially in patients requiring chronic dialysis. However, the relationship between kidney function and the prevalence of primary thyroid disease has not been studied in Korea, a nation where the dietary iodine intake is excessive.
METHODS
Retrospective data from 2201 consecutive adult patients who visited a health promotion center over the last 5 years were analyzed; specifically, 54 patients with chronic kidney disease not requiring hemodialysis and 64 adults treated with hemodialysis. The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease equation. Multivariable logistic regression was used to evaluate the independent association between the prevalence of primary hypothyroidism and estimated GFR.
RESULTS
The prevalence of overt hypothyroidism increased from 0.5% at an estimated GFR > 90 mL/min/1.73 m2 to 6.3% in end-stage renal disease requiring chronic dialysis (p < 0.001 for trend). Compared with participants with an estimated GFR > 60 mL/min/1.73 m2, those with an estimated GFR < 60 mL/min per 1.73 m2 had an increased odds of overt hypothyroidism after adjusting for age, gender, fasting blood glucose (FBS), and the total cholesterol (TC) and triglyceride (TG) concentrations.
CONCLUSIONS
These findings suggest that overt primary hypothyroidism is relatively common (6.3%) among persons with chronic kidney disease requiring chronic dialysis, and it is independently associated with a progressively lower estimated GFR.