Pretransplant Thyroid Findings in Patients With End-Stage Renal Disease

Patients with end-stage renal diseases can display abnormal thyroid gland function due to altered hormone excretion and transport. In this study, we aimed to evaluate the incidence of thyroid diseases by fine-needle aspiration cytology in kidney transplant candidates and to estimate the outcomes of these patients.

We reevaluated thyroid fineneedle aspiration biopsies, which were performed between January 2000 and December 2015, of 181 candidates for kidney transplant. Patient demographics and thyroid ultrasonography and biopsy findings were recorded.

The fine-needle aspiration biopsy findings of 181 patients were as follows: 162 were benign 5 were thyroiditis, 9 were atypia of undetermined significance/follicular lesion of undetermined significance, and 5 were malignant. Only 13 patients (7.1%) underwent thyroid operation after fine-needle aspiration, with 5 of these patients receiving a benign diagnosis, 3 receiving diagnosis of atypia of undetermined significance/follicular lesion of undetermined significance, and 5 patients showing malignancy. In the 5 patients with benign cytology, histopathologic findings were also benign. In the 3 patients with atypia of undetermined significance/follicular lesion of undetermined significance, the final diagnosis was adenomatous hyperplasia. Finally, in the 5 patients (2.8%) showing malignancy, results after fine-needle aspiration showed papillary thyroid carcinoma. In the 5 patients with papillary thyroid carcinoma, 4 underwent renal transplant. Survival of these 4 patients was 92 ± 42 months without tumor recurrence.

Fine-needle aspiration is a useful diagnostic modality in evaluation of thyroid nodules in kidney transplant candidates. Early detection and treatment of thyroid nodules are essential to decrease the morbidity and mortality of these patients.