Prevalence and Determinants of Hypothyroidism in Patients on Routine Hemodialysis in Somalia: A Cross-Sectional Study

Figures & data

Table 1 Descriptive Statistics for Clinical Characteristics of Patients

Variables	Frequency (%)
Comorbidity
No known comorbid	16 (5.3)
Diabetes	101(33.6)
Hypertension	137(45.5)
Heart disease	43(14.2)
Smoker	4(1.3)
Causes of renal failure
Diabetic kidney disease	138(45.84)
Hypertensive kidney disease	100(33.22)
Glomerulonephritis	28(9.3)
Polycystic kidney disease	7(2.3)
Obstructive kidney disease	13(4.3)
No known cause	15(5)

Table 2 Comparison of Patients’ Feature Among Those Who Had Euthyroid and Hypothyroid (n=296)

Variables	Euthyroid n(%)	Sub Clinical Hypothyroid n(%)	Overt Hypothyroidism n(%)	p-value
Age (in years)^#	52(36.5–65)	59.5(48–70.75)	60(42–72)	0.039*
Gender
Male	117(70.9)	28(17)	20(12.1)	0.898
Female	96(73.3)	20(15.3)	15(11.5)
Causes of failure
Diabetic kidney disease	92(67.6)	24(17.6)	20(14.7)	0.294^Ɨ
Hypertensive kidney disease	77(77.8)	12(12.1)	10(10.1)
Glomerulonephritis	22(84.6)	2(7.7)	2(7.7)
Polycystic kidney disease	6(85.7)	1(14.3)	0(0)
Obstructive kidney disease	7(53.8)	4(30.8)	2(15.4)
No known cause	9(60)	5(33.3)	1(6.7)
Comorbidity
Diabetes	75(76.5)	12(12.2)	11(11.2)	0.388
Hypertension	93(68.9)	25(18.5)	17(12.6)	0.532
Heart diseases	28(65.1)	8(18.6)	7(16.3)	0.509
Smoker	3(75)	1(25)	0(0)	0.734^Ɨ
FT4^# (ng/mL)	0.7(0.6–0.9)	0.6(0.6–0.8)	0.2(0.2–0.3)	<0.001**
BUN^# (mg/dL)	123(93–152)	114.5(99.25–148)	119(81–148)	0.372
Creatinine^# (mg/dL)	7.1(5.3–9.5)	7.75(5.25–9.925)	5.6(3.8–7.7)	0.003*
Hemoglobin^# (g/dL)	8.9(8.4–9.9)	8.8(8.1–9.6)	9.3(8.4–10)	0.216
Calcium^# (mg/dL)	8.6(8.3–9.2)	8.75(7.75–9.375)	8.6(7.8–9.2)	0.894
Albumin^# (g/dL)	3.7(3.5–4.2)	3.5(3.125–3.9)	3.7(3.3–4)	0.007**
PTH^# (pg/mL)	258(178–389)	244.5(160.75–392)	251(149–301)	0.190
Potassium^# (mEq/L)	4.4(3.85–5.15)	4.7(3.825–5.2)	4.5(3.6–5.2)	0.503
Sodium^# (mEq/L)	138(135–140)	137.5(135–140)	137(135–139)	0.248
Phosphorous^# (mg/dL)	4.2(3.2–5.2)	4.45(3.2–5.275)	4.2(3.1–5.2)	0.489
Ferritin^# (ng/mL)	425(300–625)	529.5(250–628)	515(326–620)	0.831

Notes: ^#Non-normal continuous data is reported as median (inter-quartile range), ^ƗFisher-exact test is reported, *Significant at p<0.05, **Significant at p<0.01.

Abbreviations: FT4, free T4; n, Number of patients; PTH, Parathyroid hormone.

Table 3 Post-Hoc Analysis Among Three Groups of Thyroid Status

Comparison Between Three Groups	Age	FT4	Creatinine	Albumin
Between euthyroid and overt hypothyroid	NS	**	**	NS
Between euthyroid and subclinical hypothyroid	**	**	NS	**
Between subclinical and overt hypothyroid	NS	**	**	NS

Note: **Significant at p<0.01.

Abbreviations: FT4, free T4; NS, non-significant.

Table 4 Univariate Predictor of Hypothyroidism (n=296)

Variables	Subclinical Hypothyroidism	p-value	Overt Hypothyroidism	p-value
	OR (95% CI)		OR (95% CI)
Age (in years)	1.02 (1–1.04)	0.040*	1.02 (0.99–1.04)	0.107
Gender
Male	1.15 (0.61–2.17)	0.668	1.09 (0.53–2.25)	0.807
Female	Ref		Ref
Comorbid
Diabetes	0.61 (0.30–1.24)	0.178	0.84 (0.39–1.81)	0.663
Hypertension	1.40 (0.74–2.62)	0.291	1.22 (0.59–2.49)	0.588
Heart diseases	1.32 (0.56–3.11)	0.524	1.65 (0.66–4.14)	0.284
BUN^# (mg/dL)	0.99 (0.99–1.07)	0.867	0.99 (0.98–1)	0.122
Creatinine^# (mg/dL)	0.99 (0.99–1.01)	0.878	0.76 (0.65–0.90)	0.001**
Hemoglobin^# (g/dL)	0.87 (0.66–1.14)	0.305	1.27 (0.93–1.73)	0.134
Calcium^# (mg/dL)	0.90 (0.64–1.28)	0.573	0.87 (0.58–1.29)	0.490
Albumin^# (g/dL)	0.39 (0.22–0.70)	0.002**	0.56 (0.28–1.12)	0.100
PTH^# (pg/mL)	1 (0.99–1)	0.844	1 (0.99–1)	0.090
Potassium^# (mEq/L)	1.27 (0.87–1.84)	0.215	0.99 (0.65–1.53)	0.981
Sodium^# (mEq/L)	0.97 (0.90–1.04)	0.380	0.94 (0.86–1.02)	0.143
Phosphorous^# (mg/dL)	1.22 (0.99–1.51)	0.068	1.16 (0.91–1.48)	0.238
Ferritin^# (ng/mL)	1 (0.99–1)	0.901	1 (0.99–1)	0.757

Notes: ^#Non-normal continuous data is reported as median (inter-quartile range), *p-value significant at level of 0.05, **p-value significant at level of 0.01.

Abbreviations: BUN, blood urea nitrogen; CI, confidence interval; OR, odds ratio; Ref, Reference category; PTH, parathyroid hormone.

Table 5 Multivariable Predictor of Hypothyroidism (n=296)

Variables	Subclinical Hypothyroidism	p-value	Overt Hypothyroidism	p-value
	OR (95% CI)		OR (95% CI)
Age (in years)	1.03 (1.01–1.05)	0.014*	1.01 (0.99–1.04)	0.260
Gender
Male	–	–	–	–
Female	–		–
Comorbid
Diabetes	0.27 (0.29–1.25)	0.586	0.87 (0.38–1.97)	0.746
Hypertension	–	–	–	–
Heart diseases	–	–	–	–
BUN^# (mg/dL)	0.99 (0.99–1)	0.349	0.99 (0.98–1.01)	0.693
Creatinine^# (mg/dL)	1 (0.99–1.01)	0.748	0.78 (0.64–0.96)	0.016**
Hemoglobin^# (g/dL)	0.85 (0.64–1.14)	0.286	1.25 (0.88–1.77)	0.216
Calcium^# (mg/dL)	–	–	–	–
Albumin^# (g/dL)	0.33 (0.17–0.64)	0.001**	0.61 (0.29–1.30)	0.203
PTH^# (pg/mL)	1 (0.99–1)	0.688	0.99 (0.99–1)	0.243
Potassium^# (mEq/L)	1.28 (0.86–1.94)	0.226	1.37 (0.82–2.30)	0.228
Sodium^# (mEq/L)	0.99 (0.92–1.08)	0.919	0.98 (0.89–1.07)	0.644
Phosphorous^# (mg/dL)	1.20 (0.96–1.51)	0.115	1.19 (0.92–1.55)	0.182
Ferritin^# (ng/mL)	–	–	–	–

Notes: ^#Non-normal continuous data is reported as median (inter-quartile range), *p-value significant at level of 0.05, **p-value significant at level of 0.01.

Abbreviations: BUN, blood urea nitrogen; CI, confidence interval; OR, odds ratio; PTH, parathyroid hormone; Ref, Reference category.