open access

Vol 73, No 3 (2022)
Original paper
Submitted: 2021-12-13
Accepted: 2022-02-21
Early publication date: 2022-06-10
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Effects of high-activity radioactive iodine treatment on renal function in patients with differentiated thyroid carcinoma — retrospective study

Liang Yin12, Weilong Li13, Xiaolan Lv14, Yangyang Lin5, Qiang Jia1, Jian Tan1, Xue Li1, Danyang Sun1, Yan Wang6, Zhaowei Meng1
DOI: 10.5603/EP.a2022.0037
·
Endokrynol Pol 2022;73(3):619-626.
Affiliations
  1. Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
  2. Department of Nuclear Medicine, Pingjin Hospital, Characteristic Medical Centre of Chinese People’s Armed Police Forces, Tianjin, China
  3. Department of Nuclear Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
  4. Department of Ultrasound, Affiliated Hospital of Hebei University, Baoding, China
  5. Department of Dermatology, Tianjin Children’ s Hospital, Tianjin, China
  6. State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China

open access

Vol 73, No 3 (2022)
Original Paper
Submitted: 2021-12-13
Accepted: 2022-02-21
Early publication date: 2022-06-10

Abstract

Introduction: It is not clear whether high-activity radioactive iodine (131I) treatment will affect renal function. This study aimed to investigate the effects of high-activity 131I treatment on the clinical metrics of renal function in patients with differentiated thyroid carcinoma (DTC).

Material and methods: 262 DTC patients with abnormal baseline renal function (group A) and 262 DTC patients with normal baseline renal function (group B) who received 131I therapy were analysed. Each group was further divided into three subgroups based on the cumulative activity of 131I: subgroup 1 if the cumulative activity was less than 11.1 GBq; subgroup 2 if the cumulative activity was between
11.1 GBq and 18.5 GBq; and subgroup 3 if the cumulative activity was more than 18.5 GBq. The clinical metrics of renal function including serum creatinine (SCr), blood urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) were measured and compared before initial 131I treatment and 5 years later.

Result: There was no significant difference of the demographics between the two groups. In group A, SCr and BUN levels were elevated in 186 and 113 patients, respectively, and eGFR was decreased in 108 patients before the initial 131I therapy. SCr and BUN levels were found to be increased in all subgroups 5 years after the initial 131I therapy; furthermore, eGFR was found to be decreased in all subgroups after
131I therapy, and the difference was statistically significant (p < 0.05). A gender bias was not observed in the changing trends of SCr and BUN levels and eGFR. In group B, no significant difference in the mean levels of SCr, BUN, and eGFR was observed in the 3 subgroups (p > 0.05), regardless of gender, before the initial 131I therapy and 5 years later. A total of 5, 2, and 2 patients presented with abnormal renal function after 131I treatment in subgroups 1, 2, and 3, respectively. No statistically significant difference was observed in the incidence of renal dysfunction among the 3 subgroups (p = 0.423).

Conclusion: Our findings suggest that the nephrotoxicity of high-activity 131I therapy, regardless of gender, is very low in patients with DTC with normal renal function; however, high-activity 131I therapy may exacerbate the loss of renal function in those with renal dysfunction.

Abstract

Introduction: It is not clear whether high-activity radioactive iodine (131I) treatment will affect renal function. This study aimed to investigate the effects of high-activity 131I treatment on the clinical metrics of renal function in patients with differentiated thyroid carcinoma (DTC).

Material and methods: 262 DTC patients with abnormal baseline renal function (group A) and 262 DTC patients with normal baseline renal function (group B) who received 131I therapy were analysed. Each group was further divided into three subgroups based on the cumulative activity of 131I: subgroup 1 if the cumulative activity was less than 11.1 GBq; subgroup 2 if the cumulative activity was between
11.1 GBq and 18.5 GBq; and subgroup 3 if the cumulative activity was more than 18.5 GBq. The clinical metrics of renal function including serum creatinine (SCr), blood urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) were measured and compared before initial 131I treatment and 5 years later.

Result: There was no significant difference of the demographics between the two groups. In group A, SCr and BUN levels were elevated in 186 and 113 patients, respectively, and eGFR was decreased in 108 patients before the initial 131I therapy. SCr and BUN levels were found to be increased in all subgroups 5 years after the initial 131I therapy; furthermore, eGFR was found to be decreased in all subgroups after
131I therapy, and the difference was statistically significant (p < 0.05). A gender bias was not observed in the changing trends of SCr and BUN levels and eGFR. In group B, no significant difference in the mean levels of SCr, BUN, and eGFR was observed in the 3 subgroups (p > 0.05), regardless of gender, before the initial 131I therapy and 5 years later. A total of 5, 2, and 2 patients presented with abnormal renal function after 131I treatment in subgroups 1, 2, and 3, respectively. No statistically significant difference was observed in the incidence of renal dysfunction among the 3 subgroups (p = 0.423).

Conclusion: Our findings suggest that the nephrotoxicity of high-activity 131I therapy, regardless of gender, is very low in patients with DTC with normal renal function; however, high-activity 131I therapy may exacerbate the loss of renal function in those with renal dysfunction.

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Keywords

blood urea nitrogen; creatinine; differentiated thyroid carcinoma; estimated glomerular filtrate; radioactive iodine

About this article
Title

Effects of high-activity radioactive iodine treatment on renal function in patients with differentiated thyroid carcinoma — retrospective study

Journal

Endokrynologia Polska

Issue

Vol 73, No 3 (2022)

Article type

Original paper

Pages

619-626

Early publication date

2022-06-10

Page views

449

Article views/downloads

37

DOI

10.5603/EP.a2022.0037

Bibliographic record

Endokrynol Pol 2022;73(3):619-626.

Keywords

blood urea nitrogen
creatinine
differentiated thyroid carcinoma
estimated glomerular filtrate
radioactive iodine

Authors

Liang Yin
Weilong Li
Xiaolan Lv
Yangyang Lin
Qiang Jia
Jian Tan
Xue Li
Danyang Sun
Yan Wang
Zhaowei Meng

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