Radioiodine Therapy for Thyroid Cancer and Hyperthyroidism in Patients with End-Stage Renal Disease on Hemodialysis

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.