Abstract
BackgroundThyroid diseases are frequent in patients with end-stage renal disease, but data on renal transplant recipients are conflicting. This study evaluated the incidence of thyroid disease and cancer in a population of kidney transplant recipients performed in a single center.MethodsSeven hundred sixty patients receiving a kidney transplantation between January 2000 and October 2017 were followed with thyroid ultrasonography to determine nodules together with thyroid hormone levels. Ultrasound-guided fine-needle aspiration citology (FNAc) was performed to the nodules > 10 mm .ResultsTwo hundred four patients (26.8%) patients demonstrated functional or morphologic changes in the thyroid gland compared with pre-transplant period. Among the 204 patients with newly diagnosed thyroid disease, 165 patients had single or multiple nodular lesions less than 1 cm in diameter, and were followed yearly. Nodule size progression was observed in 23 patients (13.9%), and they underwent a FNAc. A total of sixty-two patients (30.3%) underwent FNAc. The biopsy samples were cytologically interpreted as benign in 20 patients (32.2%), suspicious in 40 patients (64.5%), or at high risk of cancer in 2 patients (3.2%). Forty-two patients underwent total thyroidectomy. At histological examination, 18 patients had a thyroid cancer (papillary cancer in 17 patients, follicular cancer in one). Thyroid cancer was more frequent in male patients with a mean time from transplant to diagnosis of 5.6 years. At a mean follow-up was 8 ± 1.2 years, all patients are alive with a normal functioning graft.ConclusionsThyroid diseases are common in transplant recipients. Thyroid disease may evolve after transplantation, probably as a consequence of immunosuppression. A complete evaluation of thyroid disease is mandatory in kidney transplant recipients because early diagnosis and appropriate treatment of thyroid disease and cancer may significantly decrease the morbidity and mortality in these patients.
Highlights
Thyroid diseases are frequent in patients with end-stage renal disease, but data on renal transplant recipients are conflicting
These data suggest that a periodical evaluation of thyroid function should be recommended in kidney transplant recipients, but there are few studies investigating the rate of thyroid disease in kidney transplant recipients
This study evaluated the incidence of thyroid disease and cancer in a population of kidney transplant recipients performed in a single center
Summary
Thyroid diseases are frequent in patients with end-stage renal disease, but data on renal transplant recipients are conflicting. Veroux et al BMC Surgery 2019, 18(Suppl 1): the risk of cancer in patients with ESRD is higher during dialysis period than during functioning kidney transplant intervals [13]. Taken together, these data suggest that a periodical evaluation of thyroid function should be recommended in kidney transplant recipients, but there are few studies investigating the rate of thyroid disease in kidney transplant recipients. This study evaluated the incidence of thyroid disease and cancer in a population of kidney transplant recipients performed in a single center
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