Iodine-induced hypothyroidism (IIH) in paediatric patients receiving peritoneal dialysis: Is risk mitigation possible?

Autor:	Mannemuddhu SS; Department of Pediatric Nephrology, East Tennessee Children's Hospital, Knoxville, USA.; Department of Medicine, University of Tennessee, Knoxville, USA., Morgans HA; Division of Pediatric Nephrology, Children's Mercy Kansas City, MO, USA.; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, USA., Warady BA; Division of Pediatric Nephrology, Children's Mercy Kansas City, MO, USA.; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, USA.
Jazyk:	angličtina
Zdroj:	Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis [Perit Dial Int] 2024 Jan; Vol. 44 (1), pp. 73-77. Date of Electronic Publication: 2023 Jul 03.
DOI:	10.1177/08968608231183853
Abstrakt:	Children with kidney failure who receive maintenance peritoneal dialysis (PD) are at increased risk for thyroid dysfunction. A poorly appreciated cause of hypothyroidism related to PD is iodine overload from exposure to iodine-containing cleaning solutions, iodinated contrast agents or povidone-iodine-containing PD caps, particularly in infants and small children. An international survey was conducted to understand current practices regarding iodine exposure in PD patients, the frequency of iodine-induced hypothyroidism (IIH) in patients receiving PD, and to assess awareness of this issue among paediatric nephrologists. Eighty-nine paediatric nephrology centres responded to the survey. Hypothyroidism in PD patients was diagnosed in 64% ( n = 57) of responding centres, although only 19 of these centres (33%) suspected or diagnosed IIH. Aetiologies of IIH included exposure to povidone-iodine-containing PD caps (53%), cleaning solutions with iodine (37%) and iodinated contrast (10%). While most centres (58%, n = 52) routinely evaluate thyroid function, only 34% ( n = 30) specifically aim to limit iodine exposure. Of centres not routinely evaluating for or utilising methods to prevent iodine exposure and hypothyroidism, 81% reported being unaware of the risk of IIH in PD patients. Hypothyroidism is diagnosed in a substantial percentage of paediatric PD programmes internationally. Increased education on the risk of iodine exposure in children receiving PD may decrease the incidence of IIH as an aetiology of hypothyroidism. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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