Thyroid Dysfunction and Dyslipidemia in Patients With Chronic Kidney Diseases

Chronic kidney disease[CKD] is becoming a serious health problem.The number of people with impaired renal function is rapidly rising, especially in industrialized countries. It is increasing rapidly worldwide at an annual growth rate of 8%. Chronic kidney disease [CKD] is defined as kidney disease that has been present for months to years. Chronic kidney disease [CKD] is a complex disease impacting more than twenty million individuals. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia and metabolic bone disease .CKD patients should be assessed for the presence of these complications and receive optimal treatment to reduce their morbidity and mortality .

CKD affects thyroid function in many ways, including low thyroid circulating hormone levels, altered peripheral hormone metabolism, insufficient binding to carrier proteins, reduced tissue thyroid hormone content and altered iodine storage in the thyroid gland.Thus,inCKD,thyroid hormone metabolism is impaired. . Hypothyroidism in patients with renal failure causes many metabolic and clinical problems, and both these diseases can mutually exacerbate their disturbances.. Chronic kidney disease has been known to affect thyroid hormones metabolism .Low serum level of T3 and T4 are most remarkable laboratorial finding. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end stage renal failure[ESRF]. CKD is often associated with dyslipidemia. Several factors contribute to these changes. Patient with CKD have a reduction in the activity of lipoprotein lipase and hepatic triglyceride lipase. This interferes with uptake of triglyceride rich Apo lipoprotein B containing lipoprotein by the liver and in peripheral tissue, yielding increased circulation of these atherogenic lipoproteins. Early diagnosis of thyroid and lipid disorders by regular screening, and treatment of such disorders in CKD patients may be highly beneficial to slow progression of CKD.