Thyroid hormones have a very important role in regulating metabolism, development, protein synthesis, and influencing other hormone functions. The two main hormones produced by the thyroid are triiodothyronine (T3) and thyroxine (T4) and these hormones can also have significant impact on kidney diseases, soitis important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD).CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Low T3 levels or nonthyroid illness are the most common laboratory finding followed by sub-clinical hypothyroidism in CKD patients. Hyperthyroidism is usually not associated with CKD but has been known to accelerate it. One of the most important links between thyroid disorders and CKD is elevated urea levels/uremia. Patients who are appropriately treated for thyroid disease have a less chance of developing renal dysfunction. Clinicians need to be very careful in treating patients with low T3 levels who also have an elevation in TSH, as this can lead to a negative enitrogen balance.Thus, clinicians should be well educated on the role of thyroidhormonesin relationto CKD so that proper treatment can be delivered to the patient.
