Comparison of Short- and Long-Term Efficacy of Ultrasound-Guided Percutaneous Radiofrequency Ablation and Parathyroidectomy in Patients on Dialysis with Secondary Hyperparathyroidism

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Background: Previously, we showed that ultrasound-guided percutaneous radiofrequency ablation (RFA) can treat refractory SHPT(Zhang et al Kidney Int Rep). In this study, we compared Short- and Long-Term efficacy of two methods in SHPT management. Methods: A retrospective analysis was conducted between 2015 and 2022. The preoperative and postoperative changes in iPTH, Ca, and P levels were collected, and the recurrence rate was analyzed. Results: A total of 144 patients were included, with 109 undergoing RFA and 35 undergoing PTX. The median follow-up was 40.8 months (IQR 28.5–57.6). The incidence of hypocalcemia was significantly lower in the RFA group compared to the PTX group (33.9% vs. 54.3%, p < 0.05). There were no significant difference between the two groups (p > 0.05). Binary logistic regression analysis revealed that postoperative iPTH level was an independent risk factor for recurrence (OR = 1.002, 95% CI: 1.000–1.003, p = 0.01). Conclusion: Both RFA and PTX significantly reduce serum Ca, P, and iPTH levels in patients with SHPT with no significant difference in recurrence rates. Table 1.Short-term and long-term data of Short- and Long-Term Efficacy of Ultrasound-Guided Percutaneous Radiofrequency Ablation and Parathyroidectomy in dialysis Patients with Secondary Hyperparathyroidism - Surgical Procedure RFA PTX P value Preoperative data blank blank blank N 109 35 blank Age range 52(42,59) 48(41,56) 0.396 Follow-up(months) 36.96(27.06,54.84) 59.00(48.00,84.00) 0.001 Serum calcium（mmol/l） 2.39±0.02 2.57±0.03 0.001 Serum phosphorus（mmol/l） 2.33±0.05 2.66±0.07 0.423 iPTH（pg/ml） 1500（990，2274） 1656（1351，2303） 0.087 ALP（iu/l） 231.00（135.75，516.25） 255.00（178.00，464.00） 0.266 Short-term Postoperative data blank blank blank Serum calcium（mmol/l） 1.98±0.02 1.86±0.04 0.024 Phosphorus（mmol/l） 1.75（1.33，2.19） 1.50（1.33，1.76） 0.396 iPTH（pg/ml） 255.70（105.05，422.80） 78.08（21.96，295.70） 0.001 Long-term Postoperative data blank blank blank Serum calcium（mmol/l） 2.15±0.41 2.27±0.29 0.289 Phosphorus（mmol/l） 1.59±0.60 1.96±0.64 0.108 iPTH（pg/ml） 383.71±493.65 434.80±372.70 0.711 severe hypocalcemia（%） 33.30 54.30 0.026 Recurrence Rate（%） 20.00 26.10 0.510 blank blank blank blank

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