title: Hemodialysis in patients requiring 131I treatment for thyroid carcinoma.
abstract: OBJECTIVE
  Thyroid malignancies can be treated by surgery followed by ablation of the remnant tissue with 131I. As iodide removal from the body occurs by renal extraction, in patients suffering from end-stage renal disease it is necessary to properly evaluate both timing and method of the extracorporeal treatment.
  
  
  METHODS
  We present two patients on regular hemodialysis, admitted in isolation to the Nuclear Medicine Department and treated with 131I for thyroid carcinoma diagnosed during the check-up for transplantation. Both patients underwent two hemodialysis sessions with a portable machine for CRRT (continuous renal replacement therapy), 24 and 48 hours after the administration of 50 mCi of 131I. The nursing staff were monitored with a dosimeter. Radioactivity of the patients, dialysate and urines were measured during hemodialysis.
  
  
  RESULTS
  The greater reduction was obtained with the first dialysis, but in both patients a further, though shorter, hemodialysis at 48 hours was necessary for reaching a patient's radioactivity compatible with discharge. Radioactivity measured in the dialysate demonstrated the almost total removal of radioiodine by dialysis alone. In both patients, follow-up exams revealed a complete ablation of thyroid tissue, without signs of local recurrence. The dose of radioactivity of the dialysis staff was below allowable limits.
  
  
  CONCLUSIONS
  We conclude that a successful reduction of radioactivity, without dispersing its therapeutic efficacy, can be obtained with daily hemodialysis with a CRRT machine in patients in isolation treated with 131I. A therapeutic model is proposed.
authors: Nephrology Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Via di Grottarossa 1035-39, Rome, Italy. claudiafofi2@gmail.it
authors: Claudia
authors: C
authors: Fofi
authors: Francescaromana
authors: F
authors: Festuccia
authors: Simona
authors: S
authors: Barberi
authors: Francesca
authors: F
authors: Apponi
authors: Laura
authors: L
authors: Chiacchiararelli
authors: Francesco
authors: F
authors: Scopinaro
authors: Giorgio
authors: G
authors: Punzo
authors: Paolo
authors: P
authors: Menè
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D006435:Renal Dialysis; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes