Microwave Ablation Effective for Mild to Moderate SHPT

More patients treated with MWA plus calcitriol reached iPTH levels below 150 pg/mL: 23.33% vs 8.54%.
More patients treated with MWA plus calcitriol reached iPTH levels below 150 pg/mL: 23.33% vs 8.54%.

CHICAGO—Microwave ablation (MWA), a procedure typically reserved for severe secondary hyperparathyroidism (SHPT), can be beneficial in treating milder disease, researchers reported at the American Society of Nephrology's 2016 Kidney Week 2016 meeting.

“It is worthwhile attempting to treat mild-to-moderate SHPT with MWA,” Zongli Diao, DrMed, MD, of Beijing Friendship Hospital in China, told Renal & Urology News.  “Less than 30% of SHPT patients had target iPTH levels. MWA would improve the situation.”

Adjunctive MWA significantly reduced intact parathyroid hormone levels (iPTH) and prevented progression to severe SHPT over a year of follow up compared with receiving calcitriol alone, Dr Diao and colleagues reported.

Twenty-eight patients at their hemodialysis center with iPTH levels of 300 to 800 pg/mL were randomly assigned to MWA plus calcitriol or calcitriol alone for 3 months. No difference was observed in the speed at which patients arrived at target iPTH levels, but a greater proportion of the MWA group reached the lower limit of the target range below 150 pg/mL: 23.33% vs 8.54%. Although iPTH levels were higher in the MWA group at baseline, they dropped significantly lower than in the calcitriol group following treatment. The minimum and maximum differences between MWA and calcitriol groups were 58.06 pg/mL at month 2 and 275.11 pg/mL at month 8, respectively. Severe SHPT developed in 1 MWA patient and 6 calcitriol-only recipients. The MWA group also ultimately needed less weekly calcitriol: 1.56 vs 4.72 µg.

“Compared with calcitriol alone, MWA plus calcitriol can decrease iPTH levels and prevent development of severe SHPT from mild to moderate SHPT,” Dr Diao explained. “MWA plus calcitriol is more effective than calcitriol alone for mild to moderate SHPT.”

The major limitation in this study was its small sample size. Future, multicenter studies, with large sample sizes should be performed to verify the efficacy of the technique, he stated.

This work was supported by grants from Beijing municipal administration of hospitals' youth programme (QML20160101).

Click here for more coverage from the American Society of Nephrology's Kidney Week 2016 in Chicago.

Reference

  1. Diao Z, Liu W, Weikang G. Microwave Ablation for Mild-to-Moderate Secondary Hyperparathyroidism Patients on Hemodialysis. Presented at: Kidney Week 2016. November 15-20, 2016. Chicago. Abstract SA-PO967.
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