Microwave ablation: an effective treatment for mild-to-moderate secondary hyperparathyroidism in patients undergoing haemodialysis

Figures & data

Figure 1. Parathyroid nodule presents a hypoechoic signal before MWA (A). The ablation needle was inserted into the parathyroid nodule under ultrasound sound guide (B).

Figure 2. Randomisation and follow-up. Of 314 patients who underwent randomisation, 14 received MWA initially and then were treated according to the KDOQI guidelines; 14 were treated using calcitriol alone, in accordance with the KDOQI guidelines. In the MWA group, 13 completed the study, and one patient’s follow-up ended early because of the development of severe SHPT. In the control group, eight patients completed the study, and the follow-up of six patients ended early because of the development of severe SHPT.

Table 1. Clinical baseline data for the study participants.

	Control group (N = 14)	MWA group (N = 14)	p value
Sex (Male:Female)	6:8	5:9	0.99
Age (years)	55 ± 10.47	54.93 ± 10.69	0.78
Dialysis age (months)	115.57 ± 27.91	116.5 ± 26.87	0.87
Cause of end stage renal disease			NA
Chronic glomerulonephritis (%)	7 (50)	6 (43)
Diabetic nephropathy (%)	1 (7)	3 (21)
Hypertensive nephropathy (%)	3 (21)	1 (7)
Drug-induced kidney damage (%)	2 (14)	2 (14)
Autosomal dominant polycystic kidney disease (%)	1 (7)	1 (7)
Unknown (%)	0	1(7)
Serum iPTH level (pg/mL)	530.11 ± 144.39	571.74 ± 186.24	0.51
Number of parathyroid nodules (per patient)	2.07 ± 1.00	2.07 ± 1.00	0.99
Number of parathyroid nodules ablated (per patient)	NA	1.79 ± 0.98	NA
Size of parathyroid nodules
Maximum diameter (Interquartile range) (cm)	0.6 (0.5–0.8)	1.25 (0.83–1.6)	<0.001
Minimum diameter (Interquartile range) (cm)	0.5 (0.35–0.6)	0.7 (0.6–0.88)	<0.001
Location of nodules
Posterior aspect of left lobe of thyroid gland (n)	15	13
Posterior aspect of right lobe of thyroid gland (n)	14	16
Follow time (months)	12 (4–12)	12 (12–12)	0.114

Figure 3. Changes in serum levels of intact parathyroid hormone (iPTH). The levels of iPTH in the microwave ablation (MWA) group (B) were lower than those in the calcitriol alone group (A). Upper limit of the target range in iPTH (300 pg/mL). Lower limit of the target range in iPTH (150 pg/mL).

Figure 4. Changes in serum levels of calcium. The serum levels of calcium in the microwave ablation (MWA) group (B) were lower than those in the calcitriol alone group (A). Upper limit of the target range in calcium (2.10 mmol/L). Lower limit of the target range in calcium (2.38 mmol/L).

Figure 5. Changes in serum levels of phosphorus. There was no significant difference in serum phosphorus levels between the MWA (B) and calcitriol alone groups (A). Upper limit of the target range in phosphorus (1.13 mmol/L). Lower limit of the target range in phosphorus (1.78 mmol/L).