Hemodialysis of chronic kidney failure patients requiring ablative radioiodine therapy

Ablative radioiodine therapy is the standard treatment for thyroid carcinoma, but as 131I is predominantly cleared by renal excretion, its clearance will be reduced in patients with chronic kidney disease, particularly in anuric patients on dialysis. The high dose of radioactivity used in the procedure results in an increased risk of radioactive exposure to the patient, the dialysis staff, and the machinery. Here, we describe how to successfully hemodialyze patients with chronic kidney failure requiring ablative 131I therapy for thyroid cancer while minimizing risks to the patient and dialysis staff. With appropriate training, hemodialysis treatments can be safely delivered to patients receiving radiotherapy.