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Abstract: PO1963

Iodine-Induced Hypothyroidism in Pediatric Patients Receiving Peritoneal Dialysis: Is Risk Mitigation Possible?

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Mannemuddhu, Sai Sudha, East Tennessee Children's Hospital, Knoxville, Tennessee, United States
  • Morgans, Heather, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Warady, Bradley A., Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
Background

Children with end-stage kidney disease who receive chronic peritoneal dialysis (PD) are at increased risk for thyroid dysfunction. Iodine-induced hypothyroidism (IIH) from exposure to iodine-containing agents is poorly appreciated, particularly in infants and small children.

Methods

An international survey was conducted to better understand current practices pertaining to iodine exposure and the frequency of IIH in patients receiving PD, and to assess awareness of this issue amongst pediatric nephrologists.

Results

89 centers responded to the survey. Hypothyroidism in PD patients was diagnosed in 64% of responding centers, although only 1/3 of centers suspected/diagnosed IIH. Etiologies of IIH included exposure to povidone-iodine containing PD caps (53%), cleaning solutions with iodine (37%), and iodinated contrast (10%). While the majority of centers (58%) routinely evaluate thyroid function, only 34% aim to limit iodine exposure by avoidance of iodine-containing cleaning solutions (73%) and contrast agents (33%), monitoring of initial PD drain volume (30%), and use of a non-iodine PD cap (23%). Of centers not routinely evaluating for or utilizing methods to prevent IIH, 81% reported being unaware of the risk.

Conclusion

Hypothyroidism is diagnosed in a substantial percentage of pediatric PD programs. Education pertaining to the risk of IIH associated with iodine exposure may decrease the incidence.