Background: Chronic kidney disease (CKD) represents a major and growing health concern in both global and Indian populations. In addition to progressive renal dysfunction, CKD is frequently accompanied by metabolic and endocrine disturbances that may affect disease progression and patient outcomes. Alterations in thyroid hormone and serum amylase levels are frequently encountered in CKD patients, even in the absence of overt thyroid or pancreatic disease, and may hold important diagnostic and prognostic relevance. Aim: The aim of this study was to evaluate thyroid function parameters (free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH)) and serum amylase levels in patients with CKD, and to assess their association with disease severity. Methods: This hospital-based cross-sectional observational study was conducted at a tertiary care centre in India. Adult patients with CKD were classified into stages G1-G5 based on estimated glomerular filtration rate (eGFR). Thyroid function tests were measured using chemiluminescent immunoassay, while serum amylase was estimated by enzymatic colorimetric methods. Statistical analyses were performed to compare biochemical parameters across CKD stages and to evaluate correlations with renal function. Results: Significant differences were observed in FT3 and FT4 levels across CKD stages (p=0.010 and p=0.003, respectively), with lower values in advanced stages. TSH levels showed a significant increasing trend across stages (p=0.029). Serum amylase levels demonstrated a rising trend in advanced CKD; however, the difference did not reach statistical significance (p=0.12). Conclusion: Thyroid dysfunction and alterations in serum amylase levels are common findings in patients with CKD and show meaningful associations with disease severity. Incorporating endocrine and enzymatic evaluation alongside conventional renal markers may provide additional clinical insight in the evaluation of patients with CKD.
Sharma et al. (Tue,) studied this question.