Thyroid dysfunction and serum creatinine variations: A tertiary care study from northern Kerala

  • Revathy B.R Department of Biochemistry, Malabar Medical College Hospital and Research Centre Calicut 673315, Kerala India
  • Shivraj Gowda Department of Biochemistry, Malabar Medical College Hospital and Research Centre Calicut 673315, Kerala India
  • Sneha Henry Department of Biochemistry, Malabar Medical College Hospital and Research Centre Calicut 673315, Kerala India
Keywords: creatinine, glomerular filtration rate, hyperthyroidism, hypothyroidism, thyroid dysfunction

Abstract

Background: Thyroid hormones regulate renal hemodynamics and glomerular filtration rate (GFR), influencing serum creatinine levels. Understanding this relationship is crucial to avoid misclassification of renal function.

Objective: To determine the association between thyroid dysfunction and serum creatinine variations in patients attending a tertiary care center.

Methods: This retrospective cross-sectional study included 84 thyroid patients (66 females, 18 males) from a tertiary care center in Calicut, Kerala. Participants were classified as hypothyroid or hyperthyroid based on thyroid function tests (TSH, FT3, FT4). Serum creatinine levels were categorized as reduced or elevated using sex-specific reference ranges. Statistical analysis employed chi-square and Fisher's exact tests.

Results: Hypothyroid patients exhibited elevated creatinine in 85-100% of cases, while hyperthyroid patients demonstrated reduced creatinine in 92-100% of cases across subgroups. Highly significant inverse associations were observed across all thyroid markers (p<0.001 for all comparisons). The strongest concordance occurred in women younger than 45 years (100% concordance), with modest attenuation in older women (≥45 years), although associations remained highly significant.

Conclusion: Thyroid dysfunction profoundly affects serum creatinine through GFR modulation. Clinicians should systematically evaluate thyroid status before diagnosing chronic kidney disease based on creatinine abnormalities to prevent misclassification.

References

Iddah MA, Macharia BN (2013) Autoimmune thyroid disorders. ISRN Endocrinology 2013: 509764. https://doi.org/10.1155/2013/509764

Jaiswal N, Nirwan DS (2018) Study of serum creatinine level in hypothyroidism. Journal of Mahatma Gandhi University of Medical Sciences and Technology 3(3): 79-81.

Siriwardhane T, Krishna K, Ranganathan V, Jayaraman V, Wang T, Bei K, Ashman S, Rajasekaran K, Rajasekaran JJ, Krishnamurthy H (2019) Significance of anti-TPO as an early predictive marker in thyroid disease. Autoimmune Diseases 2019: 1684074. https://doi.org/10.1155/2019/1684074

Anandpara GK, Panchal MA, Rawal YP, Chokshi S (2020) Study of evaluation of renal function in subclinical hypothyroid patients. International Journal of Clinical Biochemistry and Research 7(2): 185-190. https://doi.org/10.18231/j.ijcbr.2020.040

Basu G, Mohapatra A (2012) Interactions between thyroid disorders and kidney disease. Indian Journal of Endocrinology and Metabolism 16(2): 204-213. https://doi.org/10.4103/2230-8210.93737

Yuen NK, Ananthakrishnan S, Campbell MJ (2016) Hyperparathyroidism of renal disease. The Permanente Journal 20(3): 15-127. https://doi.org/10.7812/TPP/15-127

Sönmez E, Bulur O, Ertugrul DT, Sahin K, Beyan E, Dal K (2019) Hyperthyroidism influences renal function. Endocrine 65(1): 144-148. https://doi.org/10.1007/s12020-019-01903-2

Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, Okosieme OE (2018) Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology 14(5): 301-316. https://doi.org/10.1038/nrendo.2018.18

Vanderpump MP (2011) The epidemiology of thyroid disease. British Medical Bulletin 99(1): 39-51. https://doi.org/10.1093/bmb/ldr030

Chaker L, Bianco AC, Jonklaas J, Peeters RP (2017) Hypothyroidism. The Lancet 390(10101): 1550-1562. https://doi.org/10.1016/S0140-6736(17)30703-1

Narasaki Y, Sohn P, Rhee CM (2021) The interplay between thyroid dysfunction and kidney disease. Seminars in Nephrology 41(2): 133-143. https://doi.org/10.1016/j.semnephrol.2021.03.008

Iglesias P, Bajo MA, Selgas R, Díez JJ (2017) Thyroid dysfunction and kidney disease: An update. Reviews in Endocrine and Metabolic Disorders 18(1): 131-144. https://doi.org/10.1007/s11154-016-9395-7

Naguib R, Elkemary E (2023) Thyroid dysfunction and renal function: A crucial relationship to recognize. Cureus 15(2): e35242. https://doi.org/10.7759/cureus.35242

Okamura M, Konishi M, Butler J, Kalantar-Zadeh K, von Haehling S, Anker SD (2023) Kidney function in cachexia and sarcopenia: Facts and numbers. Journal of Cachexia, Sarcopenia and Muscle 14(4): 1589-1595. https://doi.org/10.1002/jcsm.13260

Li S, Cao H, Gao Z, Liang Y, Ma Y, Liu S, Wang L, Wei W (2025) Association between chronic kidney disease and sarcopenia and emerging treatment strategies. Frontiers in Nutrition 12: 1699218. https://doi.org/10.3389/fnut.2025.1699218

Ma HY, Chen S, Du Y (2021) Estrogen and estrogen receptors in kidney diseases. Renal Failure 43(1): 619-642. https://doi.org/10.1080/0886022X.2021.1901739

Liu X, Zhao Y, Feng Y, Wang S, Zhang J (2025) Ovarian aging: Mechanisms, age-related disorders, and therapeutic interventions. MedComm 6(12): e70481. https://doi.org/10.1002/mco2.70481

Published
2026-02-08
How to Cite
Revathy B.R, Gowda, S., & Henry, S. (2026). Thyroid dysfunction and serum creatinine variations: A tertiary care study from northern Kerala. Acta Biochimica Indonesiana, 9(1), 229. https://doi.org/10.32889/actabioina.229