Holst Jennifer P, Burman Kenneth D, Atkins Frank, Umans Jason G, Jonklaas Jacqueline
Georgetown University/Washington Hospital Center, Washington, DC, USA.
Thyroid. 2005 Dec;15(12):1321-31. doi: 10.1089/thy.2005.15.1321.
Treatment with radioactive iodine ((131)I) may be necessary for thyroid cancer or for hyperthyroidism in patients with end-stage renal disease who require hemodialysis. Because (131)I is cleared mainly by the kidneys in patients with normal renal function, many issues arise in patients who require (131)I treatment but who are on hemodialysis. This paper presents a case report of a patient on dialysis who required treatment with (131)I for thyroid cancer. We describe a mathematical model, which suggests that the treatment dose of (131)I for a patient with thyroid cancer on hemodialysis would be approximately 13%-28% of a typical empiric dose of (131)I for a patient with normal renal function. Also, we present a comprehensive review and discussion of the literature on patients who are receiving hemodialysis who were treated with (131)I for either thyroid cancer or hyperthyroidism. Using a multidisciplinary approach and special precautions, (131)I therapy can be administered safely and effectively for patients with thyroid cancer or hyperthyroidism who are receiving hemodialysis.
对于甲状腺癌或需要血液透析的终末期肾病患者的甲状腺功能亢进症，可能需要用放射性碘（¹³¹I）进行治疗。由于在肾功能正常的患者中，¹³¹I主要通过肾脏清除，因此对于需要¹³¹I治疗但正在接受血液透析的患者会出现许多问题。本文介绍了一例接受透析的患者因甲状腺癌需要¹³¹I治疗的病例报告。我们描述了一个数学模型，该模型表明，接受血液透析的甲状腺癌患者的¹³¹I治疗剂量约为肾功能正常患者典型经验性¹³¹I剂量的13% - 28%。此外，我们对接受血液透析且因甲状腺癌或甲状腺功能亢进症接受¹³¹I治疗的患者的文献进行了全面综述和讨论。采用多学科方法并采取特殊预防措施，可以为接受血液透析的甲状腺癌或甲状腺功能亢进症患者安全有效地实施¹³¹I治疗。
