Department of Nephrology, Shengli Clinical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China.
Department of Ultrasonography, Shengli Clinical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China.
Ren Fail. 2023 Dec;45(1):2215334. doi: 10.1080/0886022X.2023.2215334.
To study the complications of ultrasound-guided radiofrequency ablation (RFA) in chronic kidney disease (CKD) patients undergoing renal replacement therapy with secondary hyperparathyroidism (SHPT).
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.
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%; = .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 ( = -2.222; = .0026). Subgroup analysis further showed that the patients in the severe hypocalcemia group were younger ( = .005), had more ablated nodules ( = .003) and higher blood phosphorus ( = .012) and alkaline phosphatase (ALP) levels ( = .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.
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.
研究超声引导下射频消融（RFA）治疗继发性甲状旁腺功能亢进（SHPT）行肾脏替代治疗的慢性肾脏病（CKD）患者的并发症。
本回顾性研究分析了 2017 年 7 月至 2021 年 1 月期间 103 例 SHPT 患者的临床资料，包括一般信息、检查结果、治疗次数、时间间隔和术后并发症。
103 例患者中，52 例在一个月内接受了两次 RFA 治疗。第二次治疗时喉返神经损伤的发生率明显高于第一次治疗（第一次 vs. 第二次，5.77% vs. 21.15%； = .021）。所有纳入的 103 例患者中，103 例患者中有 27 例在第一次 RFA 治疗后出现并发症。当我们将患者分为并发症组和非并发症组时，并发症组中消融的结节更多（ = -2.222； = .0026）。亚组分析进一步表明，严重低钙血症组患者年龄较小（ = .005），消融的结节较多（ = .003），血磷和碱性磷酸酶（ALP）水平较高（ = .012）。单因素分析表明，年龄、血清磷、ALP 和消融结节数量与第一次 RFA 后发生严重低钙血症的风险增加相关。
两次治疗之间间隔 1 个月以上可能有助于避免喉返神经损伤。年龄、血清磷、ALP 和消融结节数量与第一次 RFA 后发生严重低钙血症的风险增加相关。
