Correlation of thyroid hormones and serum electrolytes with kidney function in chronic kidney disease: a cross-sectional observational study

Authors

  • Susmita Sarkar Post Graduate Resident, Department of Biochemistry, GRMC, Gwalior, MP, India
  • Sanjeev Kumar Singh Professor and Head, Department of Biochemistry, GRMC, Gwalior, MP, India
  • Manish Kumar Kain Demonstrator, Department of Biochemistry, GRMC, Gwalior, MP, India
  • Shivam Yadav Professor and Head, Department of Nephrology, GRMC, Gwalior, MP, India

DOI:

https://doi.org/10.51168/7t02ge98

Keywords:

Chronic kidney disease, Thyroid hormones, Electrolytes, eGFR, FT3, TSH

Abstract

Objective

To evaluate the association of thyroid hormones and serum electrolytes with kidney function in patients with chronic kidney disease.

Methods

This cross-sectional observational study was conducted over six months (June–November 2025) in the Departments of Biochemistry and Nephrology at a tertiary care hospital. A total of 250 adults with chronic kidney disease were recruited using purposive sampling. Patients with acute kidney injury, known thyroid disease, medications affecting thyroid function or electrolytes, critical illness, or pregnancy were excluded. Serum free triiodothyronine, free thyroxine, thyroid-stimulating hormone, electrolytes, creatinine, urea, and uric acid were measured using standard laboratory methods. Estimated glomerular filtration rate was calculated using the four-variable Modification of Diet in Renal Disease equation. Correlations were assessed using Pearson's or Spearman's correlation coefficient, as appropriate.

Results

The mean age was 56.4 ± 12.8 years, with 148 (59.2%) males. The mean estimated glomerular filtration rate was 28 ± 17 mL/min/1.73 m². Reduced free triiodothyronine was observed in 69% of patients, reduced free thyroxine in 25.6%, and elevated thyroid-stimulating hormone in 20%. Free triiodothyronine showed a strong positive correlation with estimated glomerular filtration rate (r = 0.62, p < 0.001), while thyroid-stimulating hormone showed a negative correlation (r = −0.41, p < 0.01). Potassium, magnesium, and phosphorus were negatively correlated, whereas calcium showed a positive correlation (p < 0.001).

Conclusion

Thyroid hormone and electrolyte abnormalities were common and associated with declining kidney function.

Recommendations

Regular monitoring of thyroid function and serum electrolytes should be considered in patients with advanced chronic kidney disease.

Author Biographies

  • Susmita Sarkar, Post Graduate Resident, Department of Biochemistry, GRMC, Gwalior, MP, India

    is a Postgraduate Resident in the Department of Biochemistry, Gajra Raja Medical College (GRMC), Gwalior, Madhya Pradesh, India. Her academic interests include clinical biochemistry, thyroid function, renal biomarkers, and metabolic abnormalities associated with chronic kidney disease.

  • Sanjeev Kumar Singh, Professor and Head, Department of Biochemistry, GRMC, Gwalior, MP, India

    is Professor and Head, Department of Biochemistry, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. His academic interests include clinical biochemistry, metabolic disorders, and laboratory medicine.

  • Manish Kumar Kain, Demonstrator, Department of Biochemistry, GRMC, Gwalior, MP, India

    is a Demonstrator in the Department of Biochemistry, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. His academic interests include clinical biochemistry and laboratory investigations.

  • Shivam Yadav, Professor and Head, Department of Nephrology, GRMC, Gwalior, MP, India

    is Professor and Head, Department of Nephrology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. His clinical and academic interests include chronic kidney disease and nephrology.

References

1. Chandra A. Prevalence of hypothyroidism in patients with chronic kidney disease: a cross-sectional study from North India. Kidney Res Clin Pract. 2016;35(3):165-168. https://doi.org/10.1016/j.krcp.2016.06.003

2. Singh S, Verma A, Aryal G, Thapa S, Khakurel S, Shrestha K. Thyroid hormone profile in patients with chronic kidney disease: a single centre study. J Nepal Health Res Counc. 2016;14(34):197-201.

3. Behera BP. Comparative study of serum electrolytes Na+, K+, Ca++ in patients of chronic kidney disease in relation to its severity. Int J Res Med Sci. 2020;8(5):1766-1773. https://doi.org/10.18203/2320-6012.ijrms20201924

4. Gupta A, Kuldeep K, Virmani SK, Arora M. Thyroid dysfunction in patients of chronic kidney disease. Int J Adv Med. 2017;4(4):1052-1056. https://doi.org/10.18203/2349-3933.ijam20174189

5. Malik AS. Evaluation of thyroid function in patients with chronic kidney disease. Iraqi J Med Sci. 2011;9(2). [Use only if the original article's publication year/issue is confirmed from the journal record.]

6. Rhee CM, Brent GA, Kovesdy CP, Soldin OP, Nguyen D, Budoff MJ, et al. Thyroid functional disease: an under-recognized cardiovascular risk factor in kidney disease patients. Nephrol Dial Transplant. 2015;30(5):724-733. https://doi.org/10.1093/ndt/gfu269

7. Rhee CM, Alexander EK, Bhan I, Brunelli SM. Hypothyroidism and mortality among dialysis patients. Clin J Am Soc Nephrol. 2013;8(4):593-601. https://doi.org/10.2215/CJN.06920712

8. Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005;67(3):1047-1052. https://doi.org/10.1111/j.1523-1755.2005.00169.x

9. Chaker L, Cappola AR, Mooijaart SP, Peeters RP. Clinical aspects of thyroid function during ageing. Lancet Diabetes Endocrinol. 2018;6(9):733-742. https://doi.org/10.1016/S2213-8587(18)30028-7

10. Carrero JJ, Qureshi AR, Axelsson J, Yilmaz MI, Rehnmark S, Witt MR, et al. Clinical and biochemical implications of low thyroid function in patients with chronic kidney disease stages 3 and 4. Clin J Am Soc Nephrol. 2007;2(4):714-720. https://doi.org/10.2215/CJN.04071206

11. Molla K, et al. Assessment of serum electrolytes and kidney function test for screening of chronic kidney disease among Ethiopian Public Health Institute staff members, Addis Ababa, Ethiopia. BMC Nephrol. 2020;21:494. https://doi.org/10.1186/s12882-020-02166-0

12. Korgaonkar S, Tilea A, Gillespie BW, Kiser M, Eisele G, Finkelstein F, et al. Serum potassium and outcomes in CKD: insights from the RRI-CKD cohort study. Clin J Am Soc Nephrol. 2010;5(5):762-769. https://doi.org/10.2215/CJN.05860809

13. Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol. 2010;5(Suppl 1):S23-S30. https://doi.org/10.2215/CJN.05910809

14. Kovesdy CP. Management of hyperkalemia in chronic kidney disease. Nat Rev Nephrol. 2014;10(11):653-662. https://doi.org/10.1038/nrneph.2014.168

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Published

2026-06-30

Issue

Vol. 7 No. 2 (2026): June 2026 issue

Section

Section of Microbiology Research

License

Copyright (c) 2026 Susmita Sarkar, Sanjeev Kumar Singh, Manish Kumar Kain, Shivam Yadav

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite

Susmita Sarkar, Sanjeev Kumar Singh, Manish Kumar Kain, & Shivam Yadav. (2026). Correlation of thyroid hormones and serum electrolytes with kidney function in chronic kidney disease: a cross-sectional observational study. Student’s Journal of Health Research Africa, 7(2), 8. https://doi.org/10.51168/7t02ge98