Endocrine Abstracts

Objectives: This study was undertaken to ascertain the prevalence of thyroid dysfunction(TD) in patients with Acute Kidney Injury(AKI) and assess the prognostic implications of TD in AKI patients.

Materials and methods: Consecutive adult patients (>18 years) admitted with AKI to the departments of Nephrology & Medicine were recruited if they met AKIN classification criteria for AKI after 48 h of admission (1). Patients were screened for thyroid dysfunction with serum sampling of Thyroid stimulating hormone, Free T3 and Free T4 after taking informed consent. Prognosis of TD in AKI patients was assessed in terms of: 1) Duration of hospital stay, 2) Need for Renal Replacement Therapy (RRT), 3) In-hospital mortality.

Results: 147 patients with AKI (93M:54F) with a mean age of 57.8 years were recruited and TD was noted in 114 patients(77.5%). Of these, 74(64.91%) patients had Non-thyroidal illness (NTI), 10(8.77%) had primary hypothyroidism, 17(14.91%) had subclinical hypothyroidism, 4(3.51%) had primary hyperthyroidism, 7(6.14%) had subclinical hyperthyroidism and 2(1.75%) had central hyperthyroidism. A trend to longer duration of hospitalisation for AKI patients (>7 days) was seen in 65(75.58%) patients with TD compared to 17(62.96%) patients without TD (P=0.09). RRT requirements (56.36 vs 59.38%) (P=0.84) and in-hospital mortality (31.58 vs 33.33%) (P=0.84)of AKI patients with and without TD were similar. However, a trend of increasing mortality was seen in AKI patients with NTI (P=0.059).

Conclusions: Four out of five patients with AKI had some form of thyroid dysfunction, of which majority of them had NTI. However, presence of TD did not significantly affect prognosis of these patients.

Reference

(1) Lopes JA, Jorge S. The RIFLE and AKIN classification for acute kidney injury: a critical and comprehensive review. Clin Kidney J 2013 6 8–14.