Ultrasound-guided radiofrequency ablation (RFA) may be used as an alternative to parathyroidectomy (PTX) for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing dialysis, according to a recent report.1

Mian Ren, MD, of Hangzhou Medical College in China, and colleagues compared these treatments in a retrospective study of 100 patients, of whom 47 received RFA and 53 underwent PTX. The primary outcome was the number of patients who achieved the intact parathyroid hormone (iPTH) target range (300 pg/mL or less).

The primary outcome was achieved in 64.1% of the RFA group and 82.1% of the PTX group, which was not a statistically significant difference, according to study findings published in Scientific Reports. The mean iPTH concentrations in the RFA and PTX groups decreased markedly immediately after treatment to 280 pg/mL and 82 pg/mL, respectively.

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Survival analyses demonstrated no significant between-group differences in all-cause mortality and cumulative response rate or in the fluctuation curves of iPTH, calcium, and phosphorus levels. The incidence of infection and length of hospital stay, however, were significantly lower in the RFA compared with the PTX group (6.4% vs 39.6% and 4.5 vs 15.5 days, respectively), the investigators reported.

The authors concluded that ultrasound-guided RFA “is a promising, safe, effective, and minimally invasive method for [treating] severe secondary hyperparathyroidism in maintenance dialysis patients.”

Study limitations included a relatively small sample size and a retrospective design, the authors noted.

Dr Ren’s team said their findings are consistent with those of a previous retrospective cohort study of 56 patients with SHPT, which also demonstrated significant declines in iPTH concentrations.2

References

  1. Ren M, Zheng D, Wu J, et al. Efficacy and safety of radiofrequency ablation versus parathyroidectomy for secondary hyperparathyroidism in dialysis patients: a single-center retrospective study. Sci Rep. 2022;12:10289. doi:10.1038/s41598-022-14623-x
  2. Peng C, Zhang Z, Liu J, et al. Efficacy and safety of ultrasound-guided radiofrequency ablation of hyperplastic parathyroid gland for secondary hyperparathyroidism associated with chronic kidney disease. Head Neck. 2017;39:564-571. doi:10.1002/hed.24657

Topics:

Dialysis Endocrine Disorders Parathyroid Hormone Radiofrequency Treatment Secondary Hyperparathyroidism Surgery