Study of Thyroid dysfunction and Insulin Resistance in Hemodialysis patients

End stage renal disease (ESRD) is one of the common causes of non-thyroid illness. Hyperinsulinemia is a dominant feature in patients with chronic kidney disease. The objective of the current work is to study the relation between thyroid hormones and insulin resistance in hemodialysis patients. Thirty patients with ESRD under regular hemodialysis and thirty normal control subjects were included. They underwent complete history taking and clinical examination. After overnight fasting, blood samples were collected for biochemical, hematological tests, thyroid profile and insulin estimation. Insulin resistance was calculated using homeostasis model assessment. Free T3 and free T4 showed statistically significant decrease in hemodialysis patients and TSH was significantly increased in these patients. Fasting blood glucose and insulin levels were higher in ESRD patients and hence insulin resistance was significantly elevated. BMI, Hemoglobin and hematocrit were significantly lower in the patients compared to normal subjects. There exists a significant negative correlation between free T3, free T4 with HOMA-IR and a positive correlation between TSH and HOMA-IR. The higher prevalence of thyroid dysfunction in ESRD necessitates the regular screening of thyroid function in these cases. We established a close relation between insulin resistance and thyroid hormones which needs to be explored further to establish the causal association and to determine the optimal thyroid hormone levels to decrease insulin resistance and its related complications.