Abstract: Objective To explore the safety and efficacy of microwave ablation (MWA) in uremic patients with secondary hyperparathyroidism (SHPT). Methods Eighteen patients with end-stage renal disease and SHPT received microwave ablation guided by color Doppler ultrasound. Laboratory tests including serum parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) were conducted before the therapy and after the therapy for 2 hours, one day, one week, one month, 6 months and one year. Improvement of SHPT- related symptoms after ablation and complications during and after MWA were recorded. Results Fifty-six hyperparathyroidism nodules in 18 patients were treated by MWA. In patients treated with MWA, serum PTH was 460.47±473.79 ng/L after 2 hours, 448.92±306.36 ng/L after one day, 354.69±325.87 ng/L after one week, 275.60±232.95 ng/L after one month, 304.60±277.67 ng/L after 6 months and 293.76±277.68 ng/L after one year, significant different as compared with the value before treatment (1593.72±567.40 ng/L; t= 6.504, 5.849, 7.976, 5.745, 4.757 and 3.467, respectively; P＜0.001 for all the PTH values). However, there was no significant difference between the PTH levels after MWA (F=0.194, P=0.9640). After MWA, hypocalcaemia occurred in 10 patients (55.56%) and was rapidly corrected with calcium supplement, arteriovenous fistula occlusion was found in 3 patients (16.67%), and transient hoarseness happened in 3 patients (16.67%). Conclusion MWA is a safe and effective measure to manage SHPT.

Key words: secondary hyperparathyroidism, ultrasound, microwave ablation