Relationship Between Chronic Kidney Disease And Thyroid Hormone Level And Its Clinical Significance

1 ObjectiveChronic kidney diseases(CKD)is one of the most common chronic diseases in the world.At present,the main treatment of CKD is to delay the process of renal insufficiency and renal replacement therapy.Studies at home and abroad have shown that abnormal thyroid hormone levels are prevalent in CKD patients,mostly manifested as low T3 syndrome.Low levels of thyroid hormone can promote the occurrence of cardiovascular disease(CVD),thus affecting the progression and prognosis of CKD patients.At present,the domestic research on the correlation between the two and its clinical significance is still immature.This study mainly explores the incidence of abnormal thyroid hormone levels in non-dialysis patients with CKD at different stages,and its correlation with the staging of CKD,anemia,lipid metabolism,microinflammation and other aspects,and its clinical significance.It provides a new idea for the early prevention and treatment of CKD.2 MethodThe study collected 100 patients with CKD in the first Affiliated Hospital of the First Affiliated Hospital of Bengbu Medical College from September 2017 to November2018,while the healthy physical examination population of 20 patients with CKD and thyroid-related diseases in the health examination center was collected as the healthy control group.The collection of the medical history of all the subjects and the early morning fasting venous blood were taken to the laboratory of our hospital and the laboratory of the endocrinology department.The main test items included serum myoglobin(Scr),triglyceride(TG)and total cholesterol(TC).Hypersensitivity C-reactive protein(CRP)and anemia index hemoglobin(HB)and thyroid function,including serum free and combined triiodothyronine(FT3,TT3),free and bound thyroxine(FT4,TT4)and thyroid stimulating hormone(TSH).According to the stage of CKD,all patients were divided into 5 groups,and the healthy control group was one group,and the incidence of thyroid hormone levels and thyroid hormone levels in each group were analyzed,and the relationship between the level of thyroid hormone and theindicators of renal function,anemia,lipid metabolism,and microinflammation.3 Results1.There was no significant difference in the basic data between each group and normal control group in each period of CKD(P>0.05),but there was comparability among the groups.2.The incidence of abnormal thyroid hormone levels in CKD patients was significantly higher than that in healthy controls(P<0.05),and the main manifestations were the decrease of FT3,TT3 levels,and the incidence increased gradually with the progress of CKD stages.3.The levels of hemoglobin,blood lipid and microinflammation in patients with CKD: the level of Hb in CKD1-5 stage was lower than that in healthy control group(P< 0.05),and decreased with the decrease of eGFR(P< 0.001).The levels of serum TC in patients with CKD1-5 were significantly higher than those in controls(P < 0.05).There was no significant difference in serum levels of);TG in patients with CKD1-5(P > 0.05);CRP)in CKD1-5 patients(P < 0.001).4.There was a significant positive correlation between FT3 and Hb(r=0.275,p=0.006).There was a significant negative correlation with CRP(r=-0.374,p<0.001).It was negatively correlated with TG(r=-0.317,p<0.001)and had no significant correlation with TC.TT3 was positively correlated with Hb(r=0.261,p=0.004),negatively correlated with CRP(r=-0.230,p=0.021),and not significantly correlated with TC and TG.4 Conclusion1.The level of thyroid hormone is abnormal in patients with chronic kidney diseases,and the incidence increases gradually with the decrease of renal function.The main manifestation is the decrease of FT3,TT3.2.The FT3 level in CKD patients was positively correlated with Hb and negatively correlated with CRP and TG.TT3 was negatively correlated with CRP and positively correlated with Hb.Low TT3 and FT3 may accelerate the progression of renal disease by affecting Hb,CRP and lipid metabolism in CKD patients.