Radioiodine Therapy in Patient with Differentiated Thyroid Cancer and End-Stage Renal Disease on Maintenance Hemodialysis: Case Report with Review of Literature

Abstract

Surgical resection followed by radioactive iodine ( 131 I) therapy constitutes a standard treatment for differentiated thyroid cancer. 131 I is normally excreted through the kidneys, and treatment of patients with end-stage renal disease on hemodialysis requires special attention to the dose of 131 I, the timing of dialysis, and radiation safety. We present a case of end-stage renal disease in a postthyroidectomy patient on hemodialysis who required radioactive iodine ablation, and we review the literature.

Management of radioiodine ablation therapy in haemodialysis patients with thyroid cancer: a case series of two patients

“…In the treatment of DTC in ESKD patients requiring HD, the timing of the rst HD session after 131 I administration and, to a lesser extent, the interval between subsequent sessions is critical in maximizing treatment e cacy and minimizing bone marrow toxicity. Previous studies have utilized a range of intervals to the rst HD session, varying from 15-hours to 42-hours (4). The interval to subsequent HD sessions has also varied widely in these studies, ranging from 12-hours to 45-hours(4).…”

“…There is limited published guidance in the setup of the treatment protocol for radioablation of thyroid remnants in ESKD patients (2,3) and literature is mainly limited to case reports and case series that feature a wide range of protocols and approaches (4). The paucity of literature in treating these patients contributes to the lack of consensus in the optimal treatment schedule to ensure treatment e cacy while limiting risks of myelotoxicity (5).…”