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Patients with secondary hyperparathyroidism underwent ultrasound guided RFA of parathyroid hyperplasia. Patients were alternately assigned to either group 1 (n\u2009=\u200928) with RFA of all 4 glands in one session or group 2 (n\u2009=\u200928) with RFA of 2 glands in a first session and other 2 glands in a second session. Serum parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) values were measured at a series of time points after RFA. RFA parameters, including operation duration and ablation time and hospitalization length and cost, were compared between the two groups. Mean PTH decreased in group 1 from 1865.18\u2009\u00b1\u2009828.93\u2009pg\/ml to 145.72\u2009\u00b1\u2009119.27\u2009pg\/ml at 1 day after RFA and in group 2 from 2256.64\u2009\u00b1\u20091021.72\u2009pg\/ml to 1388.13\u2009\u00b1\u2009890.15\u2009pg\/ml at 1 day after first RFA and to 137.26\u2009\u00b1\u2009107.12\u2009pg\/ml at 1 day after second RFA. Group 1\u2019s calcium level decreased to 1.79\u2009\u00b1\u20090.31\u2009mmol\/L at day 1 after RFA and group 2 decreased to 1.89\u2009\u00b1\u20090.26\u2009mmol\/L at day 1 after second session RFA (P\u2009&lt;\u20090.05). Multivariate analysis showed that hypocalcemia was related to serum ALP. Patients with ALP\u2009\u2265\u2009566\u2009U\/L had lower calcium compared to patients with ALP\u2009&lt;\u2009566\u2009U\/L up to a month after RFA (P\u2009&lt;\u20090.05). Group 1\u2019s RFA time and hospitalization were shorter and had lower cost compared with Group 2. US-guided RFA of parathyroid hyperplasia is a safe and effective method for treating secondary hyperparathyroidism. Single-session RFA was more cost-effective and resulted in a shorter hospital stay compared to two sessions. However, patients with two-session RFA had less hypocalcemia, especially those with high ALP.<\/jats:p>","DOI":"10.1038\/s41598-020-63299-8","type":"journal-article","created":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T10:03:08Z","timestamp":1586512988000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Efficacy of Ultrasound-guided Radiofrequency Ablation of Parathyroid Hyperplasia: Single Session vs. Two-Session for Effect on Hypocalcemia"],"prefix":"10.1038","volume":"10","author":[{"given":"Zeng","family":"Zeng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Zhong","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-Bin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Wen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Feng","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao-Hong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Gang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,4,10]]},"reference":[{"key":"63299_CR1","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1681\/ASN.V12102131","volume":"12","author":"SK Ganesh","year":"2001","unstructured":"Ganesh, S. 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