Efficacy of Radiofrequency Ablation/Microwave Ablation Technology for Treatment of Chronic Kidney Disease Complicated with Secondary Hyperparathyroidism

Abstract

It aimed to investigate the efficacy and safety (EAS) of radiofrequency ablation (RFA)/microwave ablation (MWA) in treating patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT). PubMed, EMbase, Medline, CBM, CNKI, Cochrane Online Library, and Web of Science were searched for randomized controlled or cohort studies of parathyroidectomy (PTX), RFA, or MWA for CKD with SHPT. After quality assessment, RevMan 5.3 was employed for meta-analysis. Results revealed that seven articles were retrieved and included, including 842 patients, with 435 in the RFA/MWA group and 407 in the PTX group. Based on the PTX group, intact parathyroid hormone (IPTH) at 1 day (MD = 145.87, 95% CI = 49.20–242.54, Z = 2.96, P = 0.003) and iPTH at 3 months (SMD = 1.32, 95% CI = 0.38–2.25, Z=2.75, P =0.006) in the RFA/MWA group were markedly increased, the length of hospital stay (LOS) (MD=−3.24, 95% CI=−4.55–1.92, Z = 4.83, P <0.00001) was remarkably shorter, and the hematoma rate (OD = 0.27, 95% CI = 0.08–0.91, Z = 2.10, P = 0.04) and hypocalcemia rate (OD = 0.43, 95% CI = 0.22–0.85, Z = 2.43, P = 0.02) were markedly decreased. However, no great difference was observed in serum calcium (Ca) and phosphorus (P) levels or hoarseness rate between the PTX group and the RFA/MWA group at three months after the operation. In short, the blood iPTH level of patients after RFA or MWA treatment was markedly increased, the rate of adverse events (AEs) was lower, and the length of LOS was shortened.