ABSTRACT
Hypertension poses a challenge to public health as well as to the medical science. Final metabolite of purine in humans is uric acid, increased serum level of which is associated with cardio-renal risk, although serum uric acid (SUA) level appears to have different effects on blood pressure (BP), depending on level and how long subjects were exposed. We wanted to study the association between hyperuricemia and hypertension, in various aspects, in the context of new 2017 ACC/ AHA High Blood Pressure Clinical Practice Guidelines.METHODSThe study was conducted in a tertiary care hospital, Agartala, Tripura. It is a case control study. SUA estimation was in 160 hypertensive patients and 160 normotensive controls, by using uricase method. SPSS version 24 was used for data entry and analysis. Chi square test and unpaired t test were used, wherever applicable.RESULTSOut of 320 subjects, who were included in the study, 160 subjects were hypertensive and 160 subjects were normotensive. There was strong association between hypertension and hyperuricemia. Hyperuricemia is more common in males and in patients with stage II hypertension.CONCLUSIONSThe association between hyperuricemia and hypertension, has long been recognized. It remains unresolved whether the association of high uric acid level with high blood pressure is solely because of the underlying renal and metabolic abnormalities. Association of hyperuricemia and hypertension indicated that, hyperuricemia might be a target for the proposed therapeutic evaluation for the prevention of hypertension and provided impetus for the future design research work including interventional studies.
ABSTRACT
Chronic Kidney failures are progressive diseases and are divided into stages 1 to 5 based on the severity. Glomerular filtration rate (GFR) falls as the severity of kidney failure increases. Hypothyroidism was found to be present along with chronic renal failure and a presence of Low T3 was associated with increased chance of mortality due to cardiovascular complications. Significant association was known to exist in between thyroid dysfunction and chronic kidney disease progression. Aims & objectives: To study the pattern of thyroid dysfunction in chronic kidney disease population (who are not dialyses dependent) admitted at a tertiary care hospital of Tripura & to evaluate the correlation existing in between severity of kidney failure and thyroid dysfunction. Methods: 260 chronic kidney disease patients were included in the study. Diagnosis of chronic kidney failure was performed as per criteria laid down by Kidney Disease Outcome Quality Initiative. Blood was drawn for estimation of serum creatinine, GFR and thyroid profile. Data collected were analysed statistically and P≤0.05 was considered statistically significant. The statistical software namely SPSS 15.0 were used for statistical data analysis. Results: Among 260 individuals 138 were male and 122 female with age ranging from 20 to 82 years with mean age of 60.08±11.35 years. Calculation of GFR showed a mean GFR of 35.37±26.20 & mean serum creatinine level of 2.74±1.61mg/dl. Of the 260 patients, 68(26.1%), 74(28.5%), 74(28.5%), 31(11.9%) & 13(5%) patients belonged to CKD Stages 5,4,3,2 & 1 respectively. Low T3 is the most common thyroid dysfunction & the earliest abnormality noticed in CKD patients. The prevalence of low T3 syndrome in this study was 41.5 %( n=108). Increasing trend for Low T3 prevalence with increasing severity of CKD was noticed in this study and was statistically significant(P<O.001). The prevalence seen for LowT3 was CKD1-7.7%; CKD2-16.1%; CKD3-29.7%; CKD4-50% & CKD5- 63.2%. Statistically significant correlation was also seen with increasing prevalence of hypothyroidism & fall in GFR as the severity of kidney dysfunction increased (P<0.001). Conclusion: The present study was done to study the correlation of thyroid dysfunctions and chronic kidney diseases. It was observed that hypothyroidism both subclinical and overt exist with CKD and the most early and common dysfunction was lowT3 syndrome. The prevalence of thyroid dysfunction increase significantly as kidney failure progress .Low T3 is associated with increased chance of mortality due to cardiovascular complications and serves as a prognostic indicator in CKD individuals.