Association Between Thyroid Dysfunction and Serum Biochemical Abnormalities in Children with CKD at a Tertiary Care Center

Abstract

Background: Chronic kidney disease (CKD) in children is associated with multiple systemic complications including endocrine abnormalities such as thyroid dysfunction, which often remain underdiagnosed due to non-specific clinical manifestations. Thyroid hormones regulate calcium and phosphate metabolism, bone turnover, and protein synthesis, and their dysfunction can exacerbate biochemical derangements in CKD.

Aim of the study: The aim of this study was to assess the association between thyroid dysfunction and serum biochemical abnormalities in children with CKD.

Methods: This cross-sectional analytic study was conducted at the Department of Pediatric Nephrology, Bangladesh Medical University (BMU), which was formerly known as Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from February 2017 to January 2018. Total 60 children aged 2–18 years with CKD were included in this study.

Result: The mean age was 12 years (range 2–18) and 63.3% were male. Serum creatinine was highest in subclinical hypothyroidism (7.05 mg/dl) and lowest in hyperthyroidism (4.15 mg/dl). Biochemical parameters varied by thyroid dysfunction and CKD stage. Serum creatinine ranged from 4.15 ± 0.07 mg/dl (hyperthyroidism) to 7.05 ± 4.11 mg/dl (subclinical hypothyroidism). Calcium was lowest in hyperthyroidism (5.90 ± 0.28 mg/dl) and highest in euthyroid (8.35 ± 1.45 mg/dl). CKD stage-V showed highest creatinine (7.85 ± 4.84 mg/dl) and lowest TCO₂ (17.24 ± 6.02 mmol/L). Phosphate increased and calcium decreased significantly with CKD stage. Electrolytes varied minimally; all p-values >0.05 except for CKD trends.

Conclusion: This study found that while thyroid dysfunction showed non-significant variations in biochemical markers, CKD progression significantly affected creatinine, calcium, and phosphate levels. Electrolyte changes across CKD stages were minimal.