title: Evaluation of thyroid disease in kidney transplantation candidates: management and follow-up.
abstract: BACKGROUND
  Diagnosis of thyroid disease is fundamental in the evaluation of patients awaiting kidney transplantation. We analyzed the incidence of thyroid disease in patients with end-stage renal disease (ESRD) and evaluated its evolution before and after kidney transplantation.
  
  
  METHODS
  Between January 2000 and May 2008, we evaluated 323 candidates for kidney transplantation. In all patients, serum concentrations of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were determined and a ultrasonography of the neck was performed. Patients with thyroid cancer were considered eligible for kidney transplantation after at least 2 years since treatment.
  
  
  RESULTS
  One-hundred-four patients with ESRD (44%) had functional or morphologic changes in the thyroid gland. Forty-one patients (17.4%) underwent fine-needle aspiration cytology; 3 demonstrated showed papillary carcinoma; 3, follicular adenomas; 8, uncertain cytologic lesions; and 27, a nodular goiter. Seventeen patients underwent surgery. Six of 11 patients with thyroid cancer underwent transplantation: two patients underwent laterocervical lymph node dissection because of local recurrence within 2 years after successful transplantation; the other 4 patients are alive with a functioning graft. Of the 184 transplant recipients, 10 underwent surgery to treat thyroid disease: 8 with multinodular goiter, 1 with micropapillary carcinoma, and 1 with follicular adenoma. All 10 patients are alive with a well-functioning graft and no signs of disease recurrence.
  
  
  CONCLUSIONS
  Thyroid diseases are common in patients with ESRD. Early diagnosis and treatment significantly decreased morbidity and mortality in patients awaiting transplantation.
authors.affiliation: Department of Surgery, Organ Transplant Unit, University Hospital of Catania, Catania, Italy. veroux@unict.it
authors.forename: M
authors.initials: M
authors.lastname: Veroux
authors.forename: G
authors.initials: G
authors.lastname: Giuffrida
authors.forename: M
authors.initials: M
authors.lastname: Gagliano
authors.forename: A
authors.initials: A
authors.lastname: Giaquinta
authors.forename: T
authors.initials: T
authors.lastname: Tallarita
authors.forename: M
authors.initials: M
authors.lastname: Sorbello
authors.forename: D
authors.initials: D
authors.lastname: Corona
authors.forename: D
authors.initials: D
authors.lastname: Zerbo
authors.forename: D
authors.initials: D
authors.lastname: Vizcarra
authors.forename: V
authors.initials: V
authors.lastname: Scriffignano
authors.forename: M A
authors.initials: MA
authors.lastname: Cannizzaro
authors.forename: P
authors.initials: P
authors.lastname: Veroux
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications / Q000453:epidemiology*