Author(s): Mohammed Ali Imtiaz 1 , Sushith 2 , Prathima M. B 3 , S. Reshma 4 , Madangopal 5 , Francis N. P. Monteiro 6
ABSTRACT: BACKGROUND: There is a significant alteration in creatine kinase, creatinine, creatinine clearance and estimated GFR(eGFR) in hypothyroid patients which may be due to renal and muscular damage resulting in renal failure and myopathies. Our study adds to the existing knowledge, the importance of periodic assessment of renal parameters and creatine kinase in hypothyroid patients. AIM: The aims of this study were to compare parameters of serum creatinine, creatinine clearance, eGFR and serum creatine kinase in patient with overt hypothyroidism. MATERIALS AND METHODS: This Case control study included twenty eight diagnosed cases of hypothyroidism in the department of Endocrinology, Medicine and Surgery of A J Institute of Medical Sciences & Research Centre, Mangaluru, of age group 15-75 years. Based on T3,T4, TSH levels, subjects were diagnosed as overt hypothyroids. Results were compared with age and sex matched twenty five euthyroids. Serum T3, T4 and TSH; Serum creatinine; Creatinine clearance; and Serum creatine kinase were estimated and analysed. RESULTS: The results of the present study were obtained from 53 subjects out of whom 25 were controls and 28 were overt hypothyroids. Age distribution of study subjects shows that the mean age was 36.30±8.30 for overt hypothyroids. Sex distribution of study subjects shows that majority of overt hypothyroids (78.6%) were females. Pairwise comparison of T3, T4 and TSH among euthyroids and overt hypothyroid groups showed that the mean difference of 41.388 between controls and overt hypothyroids. Overt hypothyroids had low T3 and T4 levels with high TSH levels. Comparison of mean of creatinine clearance in the study groups shows that the mean in controls, and overt hypothyroids were 96.97±31.90 ml/min/1.73 m2 , and 79.95±25.51 ml/min/1.73 m2 respectively. The mean of creatinine in the study and control groups were respectively 1.00±0.26 mg/dl and 0.86±0.22 mg/dl. The mean of creatine kinase in the study and control groups were 231(486) IU/L and 94(±22.5) IU/L respectively. The mean of eGFR in the study and control subjects were 70.14±22.55 ml/min/1.73 m2 and 85.88±30.24 ml/min/1.73 m2 . CONCLUSION: our study shows that patients with hypothyroidism can gradually end up with renal dysfunction and myopathies. This can be prevented by monitoring thyroid hormones levels along with periodic assessment of renal parameters(creatinine and creatinine clearance) and creatine kinase in hypothyroid patients. This may beneficial in reducing the morbidity of patients.