Complications after radiofrequency ablation of hyperparathyroidism secondary to chronic kidney disease

Abstract

Objective

To study the complications of ultrasound-guided radiofrequency ablation (RFA) in chronic kidney disease (CKD) patients undergoing renal replacement therapy with secondary hyperparathyroidism (SHPT).

Methods

This retrospective study reviewed the clinical data, including general information, examination results, treatment times, time interval, and postoperative complications, of 103 SHPT patients who received ultrasound-guided RFA treatment from July 2017 to January 2021.

Results

Of 103 patients, 52 required two sessions of RFA within a month. The incidence of recurrent laryngeal nerve injury at the second treatment was significantly higher than that at the first treatment (first session vs. second session, 5.77% vs. 21.15%; p = .021). Of all the enrolled 103 patients, 27 suffered complications after the first session of RFA. When we separated patients into complications group and non-complication group, we detected more ablated nodules in the complications group (Z = −2.222; p = .0026). Subgroup analysis further showed that the patients in the severe hypocalcemia group were younger (p = .005), had more ablated nodules (p = .003) and higher blood phosphorus (p = .012) and alkaline phosphatase (ALP) levels (p = .002). Univariate analysis showed that age, serum phosphorus, ALP, and number of ablated nodules were associated with a higher risk of severe hypocalcemia after the first session of RFA.

Conclusions

An interval of more than 1 month between two treatments may help to avoid recurrent laryngeal nerve injury. Age, serum phosphorus, ALP, and number of ablated nodules were associated with a higher risk of severe hypocalcemia after the first session of RFA.

Keywords:

• Chronic kidney diseases
• secondary hyperparathyroidism
• radiofrequency ablation
• complications
• recurrent laryngeal nerve injury
• severe hypocalcemia

Acknowledgements

The authors thank Yu-cheng Lin, MM of Department of Ultrasonography, Shengli Clinical College of Fujian Medical University for his support in providing figures of RFA procedure.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Datasets are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the Fujian Province Clinical Key Specialty Construction Project [2017739], the Natural Science Foundation of Fujian Province [2019J01185], and the Natural Science Foundation of Fujian Province [2022J01998].