Effect of preparation method for radioactive iodine therapy on serum electrolytes
Purpose Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation me...
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| Veröffentlicht in: | Japanese journal of radiology 2023-11, Vol.41 (11), p.1247-1254 |
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| container_title | Japanese journal of radiology |
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| creator | Takata, Noriko Miyagawa, Masao Okada, Tomohisa Kawaguchi, Naoto Fujimoto, Yutaka Kouchi, Yoshihiro Tsuruoka, Shintaro Uwatsu, Kotaro Kido, Teruhito |
| description | Purpose
Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation methods have not been compared in the literature. The purpose of this study was to reveal whether THW and rhTSH as preparation methods for RIT affect serum electrolytes differently. We also evaluated clinical factors influencing the onset of hyponatremia and hyperkalemia during RIT.
Materials and methods
From April 2005 to December 2020, we analyzed 278 patients with thyroid cancer who received RIT. The patients were classified into two groups based on the preparation method, and renal function and serum electrolytes were compared between the groups. We also evaluated clinical factors that may affect overt hyponatremia (serum sodium level |
| doi_str_mv | 10.1007/s11604-023-01444-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10613591</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2813885081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c492t-a2e6f70bce8beec17dd049ff48be27d0b4a04848deaf2269250b765f0e64f7803</originalsourceid><addsrcrecordid>eNp9kU1LHTEUhkOpVGv9A12UQDfdTHvycSeZlYjYDxCKoNBdyMyceCMzkzHJCPffG3v1trpwlYTznCfn8BLykcFXBqC-JcZqkBVwUQGTUlbNG3LAdK0qBvrP291dsX3yPqUbgFoKKd-RfaGYlprpA3Jx5hx2mQZH54izjTb7MNER8zr01IVIo-19sF32d0h96P2ENK8x2nlDC5gwLiPFoThiGDYZ0wey5-yQ8OjxPCRX388uT39W579__Do9Oa862fBcWY61U9B2qFvEjqm-B9k4J8uTqx5aaUGWIXu0jvO64StoVb1ygLV0SoM4JMdb77y0I_YdTjnawczRjzZuTLDePK9Mfm2uw51hUDOxalgxfHk0xHC7YMpm9KnDYbAThiUZrpnQegX6Af38Ar0JS5zKfoVqQIhGKVkovqW6GFKK6HbTMDAPkZltZKZEZv5GZprS9On_PXYtTxkVQGyBVErTNcZ_f7-ivQe66KNs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2890339774</pqid></control><display><type>article</type><title>Effect of preparation method for radioactive iodine therapy on serum electrolytes</title><source>SpringerLink Journals</source><creator>Takata, Noriko ; Miyagawa, Masao ; Okada, Tomohisa ; Kawaguchi, Naoto ; Fujimoto, Yutaka ; Kouchi, Yoshihiro ; Tsuruoka, Shintaro ; Uwatsu, Kotaro ; Kido, Teruhito</creator><creatorcontrib>Takata, Noriko ; Miyagawa, Masao ; Okada, Tomohisa ; Kawaguchi, Naoto ; Fujimoto, Yutaka ; Kouchi, Yoshihiro ; Tsuruoka, Shintaro ; Uwatsu, Kotaro ; Kido, Teruhito</creatorcontrib><description>Purpose
Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation methods have not been compared in the literature. The purpose of this study was to reveal whether THW and rhTSH as preparation methods for RIT affect serum electrolytes differently. We also evaluated clinical factors influencing the onset of hyponatremia and hyperkalemia during RIT.
Materials and methods
From April 2005 to December 2020, we analyzed 278 patients with thyroid cancer who received RIT. The patients were classified into two groups based on the preparation method, and renal function and serum electrolytes were compared between the groups. We also evaluated clinical factors that may affect overt hyponatremia (serum sodium level < 134 mmol/L) and hyperkalemia (serum potassium level ≥ 5.0 mmol/L).
Results
Serum sodium and chloride levels in the THW group were significantly lower than those in the rhTSH group (p < 0.001 and p = 0.002, respectively). In contrast, the serum potassium level in the THW group was significantly higher than that in the rhTSH group (p = 0.008). As for clinical factors that may influence hyponatremia, age and estimated glomerular filtration rate (eGFR) were significantly associated with serum sodium level in the univariate analysis (p = 0.033 and p = 0.006, respectively). In the multivariate analysis, only age was significantly associated with serum sodium level (p = 0.030). Regarding hyperkalemia, distant metastases, the preparation method and eGFR were significantly associated with the serum potassium level in the univariate analysis (p = 0.005, p = 0.005 and p = 0.001, respectively). In the multivariate analysis, only eGFR was significantly associated with hyperkalemia (p = 0.019).
Conclusion
THW and rhTSH affect serum sodium and potassium levels differently. Renal function may be risk factors for hyperkalemia, whereas older age may be a risk factor for hyponatremia.</description><identifier>ISSN: 1867-1071</identifier><identifier>EISSN: 1867-108X</identifier><identifier>DOI: 10.1007/s11604-023-01444-9</identifier><identifier>PMID: 37184818</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Age ; Electrolytes ; Epidermal growth factor receptors ; Glomerular filtration rate ; Hyperkalemia ; Hyponatremia ; Hypothyroidism ; Imaging ; Iodine ; Iodine radioisotopes ; Medicine ; Medicine & Public Health ; Metastases ; Multivariate analysis ; Nuclear Medicine ; Original ; Original Article ; Potassium ; Radiology ; Radiotherapy ; Renal function ; Risk factors ; Sodium ; Thyroid ; Thyroid cancer ; Thyroid gland ; Thyroid-stimulating hormone</subject><ispartof>Japanese journal of radiology, 2023-11, Vol.41 (11), p.1247-1254</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c492t-a2e6f70bce8beec17dd049ff48be27d0b4a04848deaf2269250b765f0e64f7803</cites><orcidid>0000-0001-8582-3134</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11604-023-01444-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11604-023-01444-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37184818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takata, Noriko</creatorcontrib><creatorcontrib>Miyagawa, Masao</creatorcontrib><creatorcontrib>Okada, Tomohisa</creatorcontrib><creatorcontrib>Kawaguchi, Naoto</creatorcontrib><creatorcontrib>Fujimoto, Yutaka</creatorcontrib><creatorcontrib>Kouchi, Yoshihiro</creatorcontrib><creatorcontrib>Tsuruoka, Shintaro</creatorcontrib><creatorcontrib>Uwatsu, Kotaro</creatorcontrib><creatorcontrib>Kido, Teruhito</creatorcontrib><title>Effect of preparation method for radioactive iodine therapy on serum electrolytes</title><title>Japanese journal of radiology</title><addtitle>Jpn J Radiol</addtitle><addtitle>Jpn J Radiol</addtitle><description>Purpose
Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation methods have not been compared in the literature. The purpose of this study was to reveal whether THW and rhTSH as preparation methods for RIT affect serum electrolytes differently. We also evaluated clinical factors influencing the onset of hyponatremia and hyperkalemia during RIT.
Materials and methods
From April 2005 to December 2020, we analyzed 278 patients with thyroid cancer who received RIT. The patients were classified into two groups based on the preparation method, and renal function and serum electrolytes were compared between the groups. We also evaluated clinical factors that may affect overt hyponatremia (serum sodium level < 134 mmol/L) and hyperkalemia (serum potassium level ≥ 5.0 mmol/L).
Results
Serum sodium and chloride levels in the THW group were significantly lower than those in the rhTSH group (p < 0.001 and p = 0.002, respectively). In contrast, the serum potassium level in the THW group was significantly higher than that in the rhTSH group (p = 0.008). As for clinical factors that may influence hyponatremia, age and estimated glomerular filtration rate (eGFR) were significantly associated with serum sodium level in the univariate analysis (p = 0.033 and p = 0.006, respectively). In the multivariate analysis, only age was significantly associated with serum sodium level (p = 0.030). Regarding hyperkalemia, distant metastases, the preparation method and eGFR were significantly associated with the serum potassium level in the univariate analysis (p = 0.005, p = 0.005 and p = 0.001, respectively). In the multivariate analysis, only eGFR was significantly associated with hyperkalemia (p = 0.019).
Conclusion
THW and rhTSH affect serum sodium and potassium levels differently. Renal function may be risk factors for hyperkalemia, whereas older age may be a risk factor for hyponatremia.</description><subject>Age</subject><subject>Electrolytes</subject><subject>Epidermal growth factor receptors</subject><subject>Glomerular filtration rate</subject><subject>Hyperkalemia</subject><subject>Hyponatremia</subject><subject>Hypothyroidism</subject><subject>Imaging</subject><subject>Iodine</subject><subject>Iodine radioisotopes</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Multivariate analysis</subject><subject>Nuclear Medicine</subject><subject>Original</subject><subject>Original Article</subject><subject>Potassium</subject><subject>Radiology</subject><subject>Radiotherapy</subject><subject>Renal function</subject><subject>Risk factors</subject><subject>Sodium</subject><subject>Thyroid</subject><subject>Thyroid cancer</subject><subject>Thyroid gland</subject><subject>Thyroid-stimulating 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of preparation method for radioactive iodine therapy on serum electrolytes</title><author>Takata, Noriko ; Miyagawa, Masao ; Okada, Tomohisa ; Kawaguchi, Naoto ; Fujimoto, Yutaka ; Kouchi, Yoshihiro ; Tsuruoka, Shintaro ; Uwatsu, Kotaro ; Kido, Teruhito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-a2e6f70bce8beec17dd049ff48be27d0b4a04848deaf2269250b765f0e64f7803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Electrolytes</topic><topic>Epidermal growth factor receptors</topic><topic>Glomerular filtration rate</topic><topic>Hyperkalemia</topic><topic>Hyponatremia</topic><topic>Hypothyroidism</topic><topic>Imaging</topic><topic>Iodine</topic><topic>Iodine radioisotopes</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Multivariate analysis</topic><topic>Nuclear Medicine</topic><topic>Original</topic><topic>Original Article</topic><topic>Potassium</topic><topic>Radiology</topic><topic>Radiotherapy</topic><topic>Renal function</topic><topic>Risk factors</topic><topic>Sodium</topic><topic>Thyroid</topic><topic>Thyroid cancer</topic><topic>Thyroid gland</topic><topic>Thyroid-stimulating hormone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takata, Noriko</creatorcontrib><creatorcontrib>Miyagawa, Masao</creatorcontrib><creatorcontrib>Okada, Tomohisa</creatorcontrib><creatorcontrib>Kawaguchi, Naoto</creatorcontrib><creatorcontrib>Fujimoto, Yutaka</creatorcontrib><creatorcontrib>Kouchi, Yoshihiro</creatorcontrib><creatorcontrib>Tsuruoka, Shintaro</creatorcontrib><creatorcontrib>Uwatsu, Kotaro</creatorcontrib><creatorcontrib>Kido, Teruhito</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central 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Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Japanese journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takata, Noriko</au><au>Miyagawa, Masao</au><au>Okada, Tomohisa</au><au>Kawaguchi, Naoto</au><au>Fujimoto, Yutaka</au><au>Kouchi, Yoshihiro</au><au>Tsuruoka, Shintaro</au><au>Uwatsu, Kotaro</au><au>Kido, Teruhito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of preparation method for radioactive iodine therapy on serum electrolytes</atitle><jtitle>Japanese journal of radiology</jtitle><stitle>Jpn J Radiol</stitle><addtitle>Jpn J Radiol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>41</volume><issue>11</issue><spage>1247</spage><epage>1254</epage><pages>1247-1254</pages><issn>1867-1071</issn><eissn>1867-108X</eissn><abstract>Purpose
Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation methods have not been compared in the literature. The purpose of this study was to reveal whether THW and rhTSH as preparation methods for RIT affect serum electrolytes differently. We also evaluated clinical factors influencing the onset of hyponatremia and hyperkalemia during RIT.
Materials and methods
From April 2005 to December 2020, we analyzed 278 patients with thyroid cancer who received RIT. The patients were classified into two groups based on the preparation method, and renal function and serum electrolytes were compared between the groups. We also evaluated clinical factors that may affect overt hyponatremia (serum sodium level < 134 mmol/L) and hyperkalemia (serum potassium level ≥ 5.0 mmol/L).
Results
Serum sodium and chloride levels in the THW group were significantly lower than those in the rhTSH group (p < 0.001 and p = 0.002, respectively). In contrast, the serum potassium level in the THW group was significantly higher than that in the rhTSH group (p = 0.008). As for clinical factors that may influence hyponatremia, age and estimated glomerular filtration rate (eGFR) were significantly associated with serum sodium level in the univariate analysis (p = 0.033 and p = 0.006, respectively). In the multivariate analysis, only age was significantly associated with serum sodium level (p = 0.030). Regarding hyperkalemia, distant metastases, the preparation method and eGFR were significantly associated with the serum potassium level in the univariate analysis (p = 0.005, p = 0.005 and p = 0.001, respectively). In the multivariate analysis, only eGFR was significantly associated with hyperkalemia (p = 0.019).
Conclusion
THW and rhTSH affect serum sodium and potassium levels differently. Renal function may be risk factors for hyperkalemia, whereas older age may be a risk factor for hyponatremia.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>37184818</pmid><doi>10.1007/s11604-023-01444-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8582-3134</orcidid><oa>free_for_read</oa></addata></record> |
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| source | SpringerLink Journals |
| subjects | Age Electrolytes Epidermal growth factor receptors Glomerular filtration rate Hyperkalemia Hyponatremia Hypothyroidism Imaging Iodine Iodine radioisotopes Medicine Medicine & Public Health Metastases Multivariate analysis Nuclear Medicine Original Original Article Potassium Radiology Radiotherapy Renal function Risk factors Sodium Thyroid Thyroid cancer Thyroid gland Thyroid-stimulating hormone |
| title | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
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