title: Efficacy of microwave ablation for severe secondary hyperparathyroidism in subjects undergoing hemodialysis.
abstract: Severe secondary hyperparathyroidism (SHPT) is a serious problem in patients undergoing hemodialysis. The efficacy and safety of microwave ablation (MWA), a minimally invasive treatment, for severe SHPT are as yet unclear. To clarify the role of MWA, we administered it to patients with severe SHPT and assessed its efficacy and safety. This was a prospective, single-center, single-arm, clinical trial. We enrolled patients with severe SHPT attending our hemodialysis center who met the inclusion and exclusion criteria. We then assessed primary outcome measures (serum concentrations of intact parathyroid hormone) and secondary outcome measures (serum concentrations of calcium and phosphorus). Twenty-six patients were enrolled in this study, 10 of whom (38.46%) were responsive to MWA and 16 (61.54%) of whom were not. The main complication was hypocalcemia (10 cases, 38.46%), which had occurred in all cases by one week after administration of MWA. Responding patients with hypocalcemia all achieved normal serum calcium concentrations within seven months and non-responding patients within three months. There were no changes in serum phosphorus concentrations after MWA in either responders or non-responders. Microwave ablation is relatively ineffective in patients with severe SHPT undergoing maintaining hemodialysis and should not be the initial therapy in such cases.
authors.affiliation: a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
authors.forename: Zongli
authors.initials: Z
authors.lastname: Diao
authors.affiliation: a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Wang
authors.affiliation: a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
authors.forename: Dishan
authors.initials: D
authors.lastname: Li
authors.affiliation: a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
authors.forename: Wenhu
authors.initials: W
authors.lastname: Liu
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000628:therapy; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000032:analysis / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012720:Severity of Illness Index
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium
keywords: Microwave ablation; efficacy; hemodialysis; secondary hyperparathyroidism; ultrasonography