L’hypothyroïdie au cours de l’insuffisance rénale chronique : Prévalence et facteurs de risque

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Dr. GRARI Riad
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Introduction Clinical and subclinical hypothyroidism is common in chronic kidney disease. It seems to be associated with a cardiovascular and progressive risk of chronic renal failure. The aim of the work is to determine the prevalence of clinical and subclinical hypothyroidism during the different stages of the development of chronic renal failure and to identify the risk factors associated with it. Méthodes The study is descriptive transverse. Included are 338 patients, aged 15 to 75, with CKD, stages 1 to 5 (including dialysis and transplant recipients). Clinical hypothyroidism is defined by TSH> 10 IU / ml and low FT4 levels. Subclinical hypothyroidism is defined by TSH ≥ 5IU / ml and normal FT3 / FT4 levels. Low T3 syndrome is defined by an FT3 <1.8 ng / ml and a TSH <5 IU / ml. The data collected was analyzed using SPSS Version 19 software Résultats The average age of the patients is 53.2 years, sex ratio 1.3; they are hypertensive, diabetic and anemic in 69.3%, 28.3% and 48% of the cases respectively. The prevalence of clinical and subclinical hypothyroidism for all groups is 15.4% ; that of clinical hypothyroidism is 5.6% and that of subclinical hypothyroidism is 9.8%. The prevalence of low T3 syndrome is 37%. The prevalence of clinical hypothyroidism is not correlated with stages of CKD ; that of subclinical hypothyroid increases with CKD and reaches 12.9% in PD patients. The low T3 syndrome increases with the drop in eGFR reaching 69.6% in stage 5. We note a linear relationship between T3 and protein mass reflected by LTI, as well as an inverse relationship between T3 and CRP. Conclusions Low T3 syndrome is the most common thyroid disorder in people with chronic kidney disease, associated with malnutrition/inflammation. It therefore constitutes a prognostic marker, in particular a cardiovascular marker