Ultrasonographic detection of thyroid nodules in hemodialysis patients in Japan

The study of thyroid nodules in hemodialyzed patients using ultrasonography has been described in a limited number of reports. The thyroid glands of 143 patients with end-stage renal disease on hemodialysis were examined by ultrasonography using frequency probes. Although a goiter (thyroid volume > 20 mL) was observed in only 20 patients (14%), nodular lesions of the thyroid gland were more frequent and found in 85 patients (59.4%), especially in female patients (42 patients, 72.4%). The etiology of thyroid nodular lesions was as follows: cyst in 43 (30.0%), adenomatous goiter in 14 (9.8%), adenoma in 11 (7.7%), hypoechoic lesion in 17 (11.9%), and intrathyroid calcification in 8 (5.6%). Ultrasound-guided fine-needle aspiration cytology was performed in 5 patients, but no abnormal cells were found. Compared to patients without nodules, the age was higher in patients with cysts (54 ± 15 vs. 63 ± 13 years; P < 0.05) and hypoechoic lesions (70 ± 13 years; P < 0.05). The serum thyroglobulin level was higher in patients with adenomatous goiters (26 ± 28 vs. 148 ± 166 ng/mL; P < 0.05). The thyroid volume was greater in patients with adenomatous goiters (14.2 ± 5.7 vs. 19.0 ± 7.3 mL; P < 0.05) and adenomas (18.2 ± 6.7 mL; P < 0.05). In conclusion, patients undergoing hemodialysis frequently develop thyroid abnormalities and ultrasonography is a useful imaging modality to identify these lesions.