الفهرس 
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Abstract
Thyroid hormones affect renal development and physiology. Hyperthyroidism accelerates several physiologic processes, a fact which is reflected in the decreased systemic vascular resistance, increased cardiac output (CO), increased renal blood flow (RBF). Hypothyroidism has a more negative influence on kidney function. Peripheral vascular resistance is increased with intrarenal vasoconstriction, and CO is decreased, causing decreased RBF.
So, the present study aimed to detect the prevalence of thyroid function abnormalities in patients with chronic renal failure and patients on regular hemodialysis.
This study included (80) CKD patients aged from 20 years to 70 years from Menofia university hospitals & Shebin El-Kom Teaching hospital during the period from May 2017 to October 2017. They were classified into four groups: (1) (26 patient) (CKD patient with GFR <30), (2) (14 patient) (CKD patient with GFR 30-60), (3) (20 patient) (CKD patient with GFR >60),(4) (20 patient) on hemodialysis. Members of the study were subjected to careful history taking, complete physical examination and laboratory investigations including kidney function testing (Scr, BUN), thyroid function tests (TSH, free T3, free T4), ACR, Serum calcium, phosphorus, CBC.
In the present study, the included patients had a mean age of 50.81 ± 11.9. They comprised 39 females and 41 males.
In our study we found significant difference between studied groups as regard TSH and Free T4 so the study revealed that there was association between kidney function decline and high thyroid function.
As regard Albumin creatinine ratio, there was no evidence of interaction between eGFR and albumin -to-creatinine ratio.
Also our study revealed that there was highly significant difference between studied groups regarding Serum Calcium where we found that lower baseline serum calcium, already within the normal reference range, is associated with a subsequent GFR decline in individuals with CKD.
Regarding Serum Phosphorous we found that there was significant relation between Serum Phosphorous and decline in GFR.
Also our study revealed that there was strong association between anemia and chronic kidney disease where all patients in study had low hemoglobin level.
Regarding the correlations between GFR and the various laboratory data, we found that:
GFR<30 significantly correlated with (Serum Calcium , Serum Phosphorous, Albumine/creatinine ratio).
GFR30-60 significantly correlated with (Free T4 and Albumine/creatinine ratio).
GFR>60 significantly correlated with (Serum Calcium , Serum Phosphorous, Hemoglobin).
The patient who had thyroid disturbance start to receive treatment and will be followed by thyroid function (TSH, Free T3, Free T4) and kidney function.