Management of Thyroid Papillary Carcinoma With Radioiodine in a Patient With End Stage Renal Disease on Hemodialysis

Management of 131I therapy for thyroid cancer: cumulative dose from in-patients, discharge planning and personnel requirements

“…For patients on dialysis, the data obtained here are in good agreement with the literature [10][11][12]. The longer T 1/2bio reflects the way in which different physiological conditions influence the iodine clearance with respect to normal patients.…”

Radioiodine Treatment of Thyroid Carcinoma in Patients on Maintenance Hemodialysis

“…The area under the normalized curve when dialysis was carried out 24 h after radioiodine administration was 3.9 times larger than in nondialysis subjects. (6) used normal standard activity. To clarify this issue, we followed six radioiodine treatments, that is a total of 18 dialysis sessions, in three patients who underwent total thyroidectomy for papillary carcinoma and were under maintenance hemodialysis for end-stage renal disease.…”

“…In euthyroid subjects, it seems to be in the range of 12 to 24 h (7). In hyperthyroid patients, the maximal uptake is obtained after 10 h (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). According to Perry et al (15), the thyroid of patients with renal disease is characterized by a slow uptake that begins to level off after 48 h. On the other hand, the situation of iodine depletion induced prior to radioiodine treatment results into uptake within a few hours (7).…”

“…As iodine is mainly excreted by the kidney, radioiodine treatment of patients undergoing chronic hemodialysis requires an adjustment of the dose and timing of administration of the isotope. There is obvious concern regarding the appropriate dose of radioiodine and radiation safety measures to avoid excessive radiation exposure to the patients (3)(4)(5)(6). Despite this, no optimal strategy for such an adjustment has been defined.…”

Radiation Safety Procedures For Non-Radiation Workers in Case of Application Radionuclide Therapy in the Dialysis Patients

“…Tedavi için gerekli olan radyonüklit aktivite miktarı azaltılır. Özellikle anürik diyaliz hastalarında azalan I-131 klirensi nedeniyle, artan radyasyon maruziyetini azaltmak için, diyaliz hastası olmayan hastalara verilen dozun %25-50'sinin verilmesinin uygun olabileceğine dair yayınlar mevcuttur (7,8,9,10,11,12,13). Bu nedenle, en önemli önlemlerden biri tedavi verilecek günün sabahı hastanın diyalize alınması, tedavinin diyaliz seansı arkasından uygulanması ve bir sonraki diyaliz seansının zamanında yapılmasıdır (13).…”