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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 m...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Nature Singapore
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613591/ https://www.ncbi.nlm.nih.gov/pubmed/37184818 http://dx.doi.org/10.1007/s11604-023-01444-9 |
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author | Takata, Noriko Miyagawa, Masao Okada, Tomohisa Kawaguchi, Naoto Fujimoto, Yutaka Kouchi, Yoshihiro Tsuruoka, Shintaro Uwatsu, Kotaro Kido, Teruhito |
author_facet | Takata, Noriko Miyagawa, Masao Okada, Tomohisa Kawaguchi, Naoto Fujimoto, Yutaka Kouchi, Yoshihiro Tsuruoka, Shintaro Uwatsu, Kotaro Kido, Teruhito |
author_sort | Takata, Noriko |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-10613591 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Nature Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-106135912023-10-31 Effect of preparation method for radioactive iodine therapy on serum electrolytes Takata, Noriko Miyagawa, Masao Okada, Tomohisa Kawaguchi, Naoto Fujimoto, Yutaka Kouchi, Yoshihiro Tsuruoka, Shintaro Uwatsu, Kotaro Kido, Teruhito Jpn J Radiol Original Article 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. Springer Nature Singapore 2023-05-15 2023 /pmc/articles/PMC10613591/ /pubmed/37184818 http://dx.doi.org/10.1007/s11604-023-01444-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Takata, Noriko Miyagawa, Masao Okada, Tomohisa Kawaguchi, Naoto Fujimoto, Yutaka Kouchi, Yoshihiro Tsuruoka, Shintaro Uwatsu, Kotaro Kido, Teruhito Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title_full | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title_fullStr | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title_full_unstemmed | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title_short | Effect of preparation method for radioactive iodine therapy on serum electrolytes |
title_sort | effect of preparation method for radioactive iodine therapy on serum electrolytes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613591/ https://www.ncbi.nlm.nih.gov/pubmed/37184818 http://dx.doi.org/10.1007/s11604-023-01444-9 |
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