Division of Nephrology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL.
Division of Nephrology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
Am J Kidney Dis. 2020 Dec;76(6):889-892. doi: 10.1053/j.ajkd.2020.02.448. Epub 2020 May 26.
Children who receive peritoneal dialysis (PD) are at increased risk for thyroid dysfunction. A rarely appreciated cause is iodine overload. We report 4 children who developed iodine overload and secondary hypothyroidism. All had kidney failure treated by PD. Each previously had normal thyroid function screening test results. At the time hypothyroidism was detected, the duration of PD ranged from 1 week to 27 months (median, 6 months). Three children had high thyrotropin values and all had high serum iodine levels. The sole source of iodine exposure in each child was a povidone-iodine-impregnated gauze in the sterile transfer set cap associated with PD. Iodine overload is a poorly appreciated problem associated with the provision of PD in infants and small children and can lead to thyroid dysfunction. Increased awareness among pediatric nephrologists should lead to the development of optimal monitoring and prevention recommendations.
接受腹膜透析（peritoneal dialysis，PD）的儿童发生甲状腺功能障碍的风险增加。一个很少被认识到的原因是碘过载。我们报告了 4 例发生碘过载和继发性甲状腺功能减退的儿童。这些儿童均因肾衰竭接受 PD 治疗。他们之前都有正常的甲状腺功能筛查结果。在发现甲状腺功能减退时，PD 的持续时间从 1 周至 27 个月不等（中位数为 6 个月）。3 名儿童促甲状腺素值较高，所有儿童的血清碘水平均较高。每个儿童碘暴露的唯一来源是与 PD 相关的无菌转移套件盖中的聚维酮碘浸渍纱布。碘过载是一种与婴儿和幼儿 PD 相关的认识不足的问题，可导致甲状腺功能障碍。儿科肾病医生的认识提高应导致制定最佳监测和预防建议。
