Abstract
We compared the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) and parathyroidectomy (PTX) for the treatment of secondary hyperparathyroidism (SHPT). In this single-center retrospective study, we divided patients into PTX (nβ=β53) and RFA (nβ=β47) groups. The primary outcome was the proportion of patients who achieved the target intact parathyroid hormone (iPTH) concentration range (β€β300Β pg/mL). Secondary outcomes were the differences in the changes in iPTH, calcium, and phosphorus levels over time and prognosis. iPTH concentrations of 82.1% and 64.1% in the PTX and RFA groups, respectively, were within the recommended range at the endpoint (Pβ=β0.07). iPTH concentrations in the PTX and RFA groups dropped sharply after treatment (82βΒ±β163Β pg/mL and 280βΒ±β307Β pg/mL, respectively, Pβ<β0.001). There was no difference in the trends of iPTH, calcium, and phosphorus levels between the two groups (Pβ>β0.05). Survival analysis revealed no differences in all-cause mortality and cumulative response rate between the two groups (Pβ=β0.90, Pβ=β0.14, respectively). Notably, the incidence of infection and length of the hospital stay in the RFA group were significantly lower. The preoperative bone-specific alkaline phosphatase concentration was a risk factor for postoperative hypocalcemia. US-guided RFA is minimally invasive and compared to PTX in terms of long-term efficacy and complications in the treatment of severe SHPT in maintenance dialysis patients. It may be used as an alternative technique to PTX; however, further studies are needed.
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