Thyroid dysfunction and iodine status in children with non-dialysis-dependent chronic kidney disease.

Document Type : Original Article


1 Department of Pediatrics, Faculty of Medicine, Assiut University, Assuit, Egypt.

2 Department of clinical pathology, Faculty of Medicine, Assiut University, Assuit, , Egypt.

3 Pediatric department, Assuit University Children Hospital, Assuit University, Assuit, Egypt


Introduction: Thyroid dysfunction in chronic kidney disease (CKD) has been an emerging issue in the last few years. Many literatures demonstrate the relationship between chronic kidney disease and hypothyroidism in adult patients while data in Pediatric cases are scares.
Aim of the study: This cross-sectional study was done to detect the abnormalities of thyroid function and iodine status in children with non-dialysis-dependent CKD.
Methods: The study included 60 patients aged 2.9–16 years fulfilling the diagnostic criteria of CKD. They were subjected to full clinical assessment, estimation of glomerular filtration rate (eGFR), and thyroid function. Serum and urinary iodine levels were estimated in patients and comparable controls.
Results:  Showed that 18.2% of the cases had hypothyroidism (3.3 % had primary hypothyroidism, 3.3% had secondary hypothyroidism, 11.6% had subclinical hypothyroidism and 10% of the cases had a nonthyroidal illness (low FT3 and normal TSH levels)). There were significantly higher levels of serum iodine and a significantly lower level of urinary iodine in cases with CKD compared with controls. No significant correlation between either serum or urinary levels of iodine and eGFR or TSH, FT4, or FT3 levels was found. Patients with eGFR < 60 mL/min/1.73m2 have significantly lower levels of FT3 and FT4 levels than those with GFR ≥ 60 mL/min/1.73m2. A significant positive correlation between TSH level and creatinine level and a negative correlation between FT3 and creatinine level had been found.
Conclusion:  This study confirms the occurrence of changes in thyroid function in pediatric patients with predialysis CKD nearly as that occurs in adult CKD patients.


Main Subjects