Prevalence and Associated Risk Factors of Developing Thyroid Hormone Dysfunction in Children With Idiopathic Nephrotic Syndrome Followed Up at Kenyatta National Hospital

Abstract

Background: Evidence from publications done globally show that a significant percentage of children diagnosed with idiopathic nephrotic syndrome complicate with deranged thyroid hormone levels despite being in remission, and this affects the outcome of treatment and disease progression. Thyroid hormone derangements in children with idiopathic nephrotic syndrome have not been studied in Kenya. Objectives: The broad objective of this study was to determine the prevalence of thyroid hormone imbalances in children undergoing nephrotic syndrome follow-up at the Kenyatta National Hospital paediatric renal clinic. Methodology: This study used a prospective cross-sectional study in the outpatient paediatric renal clinic of Kenyatta National Hospital on approximately 65 children between ages 1-17years who have been diagnosed with idiopathic nephrotic syndrome. The study ran a course of five months and included participants who matched the inclusion criteria. Data collected was filled in a data collection tool designed. The information was using SPSS version 21. Categorical data was analyzed and presented as frequencies and proportions, continuous data was summarized and presented as means and standard deviations. Results: The study participants were aged 4-17 years old with a median age of 11.0.38 out of 65 had less than 2 relapses per year. Most of the participants were in remission. 71% of the children had albumin levels in the normal range. 94% of the study participants were using immunosuppressive agents. In this study, 51% were euthyroid whereas 49% had hypothyroidism. Of the study participants with hypothyroidism, 47% had subclinical hypothyroidism, 31% had low T3 syndrome and 22% had overt hypothyroidism. Both albumin level and proteinuria were significantly associated with derangement of thyroid hormones at 5% significance level, p values 0.01 and 0.02, respectively. Conclusion: The prevalence of thyroid hormone derangements among children on follow up for idiopathic nephrotic syndrome in this study is 49%. Proteinuria and albuminemia showed increase in the odds of developing deranged thyroid hormone levels among children on follow up for idiopathic nephrotic syndrome in this study despite being tagged as in remission