AIMS OF THE STUDY:
To estimate Serum T3, T4TSH in patients of Chronic Renal failure with special reference to (a) Biochemcial abnormalities of thyroid functions in CRF(b) To correlate between severity of CRF and alteration of thyroid indices (c) Effect of conservative management vs haemodialysis on thyroid indices.

MATERIALS AND METHODS:
Twenty cases of CRF patients admitted to Department of Medicine and Nephrology, V.S.S. Medical College Hospital Burla from January 2003-December 2003 were taken for the study. CRF was diagnosed by the criteria given by “Harrison’s Principles of Internal Medicine, Edn 15th. Individuals with known thyroid disease and those on antithyroid drugs, iodine intake were not included in the study. Serum T3, T4, TSH and free T3, T4 was done in all patients on admission and repeated at 3rd , 6th and 12th months during follow up and results were compared. Severity of renal failure was grouped according to GFR and the value of T3, T4, TSH was compared between groups.

OBSERVATION:
Out of 20 CRF patients in this study, male (80%) commonest presenting features anorexia (80%), puffiness on face (70%), oliguria (50%). All patients were anaemic , 70% had hypertension. Commonest vause of CRF was diabetes (50%), hypertension (20%), chronic glomerulonephritis (10%), chronic pylonephritis (5%). No cause found in 15%. TSH was normal in 17 cases. Only 3 cases had increased TSH. 16 cases had low T3, 13 cases normal T4, only 7 cases had increased T4. No significant improvement in T3, T4, TSH was seen in aptietns receiving conservative management. However haemodialysis reverted the abnormality partially. Severity of renal failure and thyroid dysfunction with respect to T3 was found to be significant.

CONCLUSION:
From the study it can be presumed that, there occurs a state of biochemical hypothyroidism in patients of CRF and extent of thyroid dysfunction depends upon the severity of renal failure. The low T3 is not due to increased T3 degradation or decreased T3 secretion, but as a result of impaired extrathyroidal T4 to T3 conversion. The reduction in T4 s due to presence of circulating inhibitors which impair binding of T4 to thyroxin binding globulin. Conservative management does not improve thyroid status through haemodilysis partially reverts back the abnormality.