Thyroid Dysfunction in Patients With End-Stage Renal Disease: A Single-Centered Experience From Pakistan

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Introduction The global prevalence of chronic kidney disease (CKD) is increasing due to diabetes and hypertension, with a substantial number of patients progressing to end-stage renal disease (ESRD) requiring maintenance dialysis. Thyroid dysfunction, particularly hypothyroidism, is common in CKD and ESRD patients but is often underdiagnosed due to symptom overlap with uremia. This study aimed to determine the prevalence of thyroid dysfunction in hemodialysis patients at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Methods A prospective cross-sectional study was conducted, enrolling 131 patients on maintenance hemodialysis for at least three months. Participants' demographic and clinical data were collected, and blood samples were taken for thyroid function testing using an Access hypersensitive thyroid-stimulating hormone (hTSH) immunoassay system. Statistical analyses were performed using SPSS version 22.0 (IBM Corp., Armonk, NY), with a significance threshold of p < 0.05. Results The total population included in the study was 131. Out of them, 74 (56.5%) were males. The study population had a mean age of 56.4 years. Hypertension and diabetes were the most common comorbidities noticed in 73 (55.7%) and 14 (10.7%) patients, respectively. Hypothyroidism was observed in 27 (20.6%) patients, with 18 (66.7%) of them having overt hypothyroidism. Hyperthyroidism was observed in four (3.1%) patients, all subclinical. Significant risk factors for hypothyroidism included female gender, longer duration on hemodialysis, decreased total leukocyte and platelet counts, and increased serum urea and creatinine levels. Conclusion The study underscores the significant burden of thyroid dysfunction in ESRD patients on hemodialysis, emphasizing the need for regular screening and management to mitigate associated cardiovascular risks and improve patient outcomes. Future studies should explore the long-term benefits of routine thyroid screening and the impact of different dialysis modalities on thyroid function.

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