Thyroid Nodule Incidence, Characteristics, and Localization in Hemodialysis Patients With End-Stage Renal Disease: A Cross-Sectional Study in Palestine.

Abstract

Background: Patients with end-stage kidney disease (ESKD) undergoing hemodialysis frequently exhibit thyroid dysfunction or morphological abnormalities such as thyroid nodules. Although prior studies indicate a high prevalence of thyroid abnormalities in ESKD patients, few have explored the specific incidence, types, and anatomical distribution of thyroid nodules in this population.

Purpose: This study aimed to determine the prevalence, types, and anatomical distribution of thyroid nodules in ESKD patients on hemodialysis and to evaluate the relationship between hemodialysis duration and nodule occurrence.

Methods: A cross-sectional study was conducted at Beit Jala Hospital, Palestine, involving 200 ESKD patients receiving hemodialysis. Thyroid ultrasound was used to assess nodule presence, morphology, and distribution. Patient demographics, medical history, and dialysis duration were analyzed using statistical methods.

Results: Thyroid nodules were identified in 41.0% (n = 82) of participants, with no significant gender differences (p = 0.839). Solid nodules (58.5%) were more prevalent than cystic nodules (41.4%), and unilateral multinodular goiter (60.5%) was more common than bilateral multinodular goiter (39.5%), though these differences were not statistically significant. A significant correlation was observed between hemodialysis duration and nodule prevalence, with a higher incidence in patients on dialysis for ≥ 5 years (p = 0.003), suggesting prolonged dialysis may contribute to nodule formation.

Conclusion: This study confirms a high prevalence of thyroid nodules in ESKD patients on hemodialysis, predominantly solid nodules, and unilateral multinodular goiter. The significant association between longer dialysis duration and increased nodule prevalence highlights the need for routine thyroid monitoring in this population. Further research is needed to elucidate underlying mechanisms and optimize clinical management of thyroid abnormalities in ESKD patients.