Original Research Article
Year: 2018 | Month: October | Volume: 5 | Issue: 10 | Pages: 1-7
Study on Effect of Levothyroxine Replacement Therapy on Some Biochemical Markers of Renal Function in Hypothyroid Patients in Tertiary Care Centre of Kumaon Region
Seema Gupta1*, Paramjeet Singh2**, Sangeeta Singh3*, Basant Joshi4*
1Assistant Professor, 2,3Associate Professor, 4Tutor
*Department of Biochemistry, **Department of Medicine
Government Medical College, Haldwani, Uttarakhand, India
Corresponding Author: Seema Gupta
ABSTRACT
Introduction- Thyroid hormones are essential for energy metabolism, growth and development of various body organs including kidneys. The literature concerning the association between renal function changes with the severity of hypothyroidism and the effects of levothyroxine replacement therapy is unclear.
Aims and objectives- This study was therefore conducted with aim to assess the derangements in biomarkers of renal function in hypothyroid patients as well as to observe the effects of thyroxine treatment in these subjects.
Materials and methods- 215 subjects were enrolled in the study. 135 newly diagnosed cases of hypothyroidism were divided into 2 groups; subclinical hypothyroids (GII; n=75) and overt hypothyroid (GIII; n=60). The results were compared with 80 euthyroid controls (GI; n=80).
83 selected subjects; 38 of subclinical hypothyroidism and 45 overt hypothyroid cases were followed up with repeat of renal and thyroid function tests after 3 months of thyroxine replacement therapy (L-T4 therapy).
Serum sample for TSH, T3 and T4 was analysed on autoanalyser e411 of Roche diagnostics. Serum urea, creatinine and uric acid estimation was done on cobas 501c of Roche diagnostics.
Results- Mean levels of serum creatinine and uric acids were raised in overt hypothyroid & subclinical cases as compared to controls. The levels of serum creatinine (p<0.001) & uric acid (p<0.05) were significantly elevated in OH cases when compared with SH cases. No significant change was observed in serum urea levels in SCH and OH cases in comparison to euthyroid controls. There was a significant reduction in levels of Serum creatinine, uric acid levels in SCH and OH cases after 3 months of levothyroxine replacement therapy, while there was no change in serum urea levels.
A significant positive correlation of creatinine (p<0.0242) and uric acid (p<0.0281) with TSH and negative correlation of urea and T4 was observed in hypothyroid group as whole before therapy.
Conclusions - This study concludes that there is deterioration in renal function with progression of hypothyroidism and the derangements are reversible with restoration of thyroid hormone levels by levothyroxine replacement therapy. Thus, clinicians can advise the renal function tests while screening and treating hypothyroid patients.
Key words: Subclinical hypothyroidism), Overt Hypothyroidism, Creatinine, Uric Acid, Levo- thyroxine therapy
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