{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:24:45Z","timestamp":1783441485903,"version":"3.54.6"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study compared the efficacy of microwave ablation (MWA) and parathyroidectomy (PTX) in the treatment of secondary hyperparathyroidism (SHPT) and evaluated the improvement of bone metabolic markers (BMMs) and bone mineral density (BMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Eligible patients with SHPT treated between January 2019 and August 2022 were enrolled in the study and were divided into two groups: MWA and PTX. Outcome measures included the treatment success rate, percentage of patients whose intact parathyroid hormone (iPTH) concentration was within the target range, serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), C-terminal cross-linked telopeptide of type I collagen (\u03b2-CXT), and BMD. Data on the procedure time, intraoperative blood loss volume, length and cost of hospitalization, incidence of postoperative complications, and recurrence rates were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 107 patients with SHPT\u201448 in the MWA group and 59 in the PTX group\u2014 were included in the study. There were no significant differences in baseline data between the two groups (p&amp;gt;0.05). At the final follow-up, both therapies decreased iPTH, Ca, P, ALP, OC, and \u03b2-CXT levels and increased BMD (p&amp;lt;0.05). Nonetheless, the decrease in iPTH, ALP, OC, and \u03b2-CXT was more pronounced 6 and 12 months after PTX (p&amp;lt;0.05). The percentage of patients whose iPTH level was within the target range was significantly higher in the MWA group (p&amp;lt;0.05). The incidence of severe hypocalcemia was significantly lower in the MWA group (p&amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MWA can improve BMMs and BMD, and is a minimally invasive approach with great potential for treating patients with SHPT who cannot tolerate PTX.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1424248","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T11:18:06Z","timestamp":1741605486000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of microwave ablation and parathyroidectomy for treating severe secondary hyperparathyroidism"],"prefix":"10.3389","volume":"16","author":[{"given":"Shuiping","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincheng","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoguang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuzhen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianrong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuolin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guorong","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiantang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"98","DOI":"10.2215\/CJN.12941213","article-title":"Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study","volume":"10","author":"Tentori","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2012.11.012","article-title":"Secondary and tertiary hyperparathyroidism","volume":"16","author":"Jamal","year":"2013","journal-title":"J Clin Densitom"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.02.010","article-title":"Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of fracture and need for parathyroidectomy in CKD","volume":"53","author":"Goldsmith","year":"2009","journal-title":"Am J Kidney Dis"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq219","article-title":"Serum iPTH, calcium and phosphate, and the risk of mortality in a European haemodialysis population","volume":"26","author":"Floege","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.12.034","article-title":"Cost-effectiveness of cinacalcet hydrochloride for hemodialysis patients with severe secondary hyperparathyroidism in Japan","volume":"60","author":"Komaba","year":"2012","journal-title":"Am J Kidney Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000289","article-title":"Differential influence of vitamin D analogs on left ventricular mass index in maintenance hemodialysis patients","volume":"37","author":"Sezer","year":"2014","journal-title":"Int J Artif Organs"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0048070","article-title":"Effects and safety of calcimimetics in end stage renal disease patients with secondary hyperparathyroidism: a meta-analysis","volume":"7","author":"Zhang","year":"2012","journal-title":"PloS One"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12310","article-title":"Long-term outcomes of total parathyroidectomy with or without autoimplantation for hyperparathyroidism in chronic kidney disease: A meta-analysis","volume":"19","author":"Jia","year":"2015","journal-title":"Ther Apher Dial"},{"key":"B9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1159\/000486844","article-title":"Effect of hybrid blood purification treatment on secondary hyperparathyroidism for maintenance hemodialysis patients","volume":"46","author":"Gao","year":"2018","journal-title":"Blood Purif"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10390917","article-title":"Parathyroidectomy in the management of secondary hyperparathyroidism","volume":"13","author":"Lau","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2016.1184924","article-title":"Long-term mortality after parathyroidectomy among chronic kidney disease patients with secondary hyperparathyroidism: a systematic review and meta-analysis","volume":"38","author":"Chen","year":"2016","journal-title":"Ren Fail"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12740","article-title":"Microwave ablation vs. parathyroidectomy for secondary hyperparathyroidism in maintenance hemodialysis patients","volume":"23","author":"Jiang","year":"2019","journal-title":"Hemodial Int"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2021.1904153","article-title":"A short-term non-randomized controlled study of ultrasound-guided microwave ablation and parathyroidectomy for secondary hyperparathyroidism","volume":"38","author":"Zhao","year":"2021","journal-title":"Int J Hyperthermia"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2021.1885754","article-title":"Microwave ablation versus parathyroidectomy for severe secondary hyperparathyroidism in patients on hemodialysis: a retrospective multicenter study","volume":"38","author":"Diao","year":"2021","journal-title":"Int J Hyperthermia"},{"key":"B15","doi-asserted-by":"publisher","first-page":"10289","DOI":"10.1038\/s41598-022-14623-x","article-title":"Efficacy and safety of radiofrequency ablation versus parathyroidectomy for secondary hyperparathyroidism in dialysis patients: a single-center retrospective study","volume":"12","author":"Ren","year":"2022","journal-title":"Sci Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016151875","article-title":"US-guided microwave ablation of hyperplastic parathyroid glands: safety and efficacy in patients with end-stage renal disease-A pilot study","volume":"282","author":"Zhuo","year":"2017","journal-title":"Radiology"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2016.1194485","article-title":"Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis","volume":"32","author":"Diao","year":"2016","journal-title":"Int J Hyperthermia"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2015.08.021","article-title":"Efficacy of ablation therapy for secondary hyperparathyroidism by ultrasound guided percutaneous thermoablation","volume":"42","author":"Zhao","year":"2016","journal-title":"Ultrasound Med Biol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.192914","article-title":"Bone turnover markers: emerging tool in the management of osteoporosis","volume":"20","author":"Shetty","year":"2016","journal-title":"Indian J Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jocd.2019.03.004","article-title":"Consensus statement on the use of bone turnover markers for short-term monitoring of osteoporosis treatment in the Asia-Pacific region","volume":"24","author":"Wu","year":"2021","journal-title":"J Clin Densitom"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-858730159-5","article-title":"Treatment-related changes in bone mineral density as a surrogate biomarker for fracture risk reduction: meta-regression analyses of individual patient data from multiple randomised controlled trials","volume":"8","author":"Black","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-019-02217-y","article-title":"Bone metabolism markers and hungry bone syndrome after parathyroidectomy in dialysis patients with secondary hyperparathyroidism","volume":"51","author":"Ge","year":"2019","journal-title":"Int Urol Nephrol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2017.1354256","article-title":"Effects of parathyroidectomy on bone metabolism in haemodialysis patients with secondary hyperparathyroidism","volume":"77","author":"Ma","year":"2017","journal-title":"Scand J Clin Lab Investig"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06186-1","article-title":"Predictors of bone mineral density improvement after parathyroidectomy for secondary hyperparathyroidism: A retrospective single-center analysis","volume":"45","author":"Okada","year":"2021","journal-title":"World J Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s12882-018-0934-1","article-title":"Changes in bone mineral density after total parathyroidectomy without autotransplantation in the end-stage renal disease patients with secondary hyperparathyroidism","volume":"19","author":"Fang","year":"2018","journal-title":"BMC Nephrol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what\u2019s changed and why it matters","volume":"92","author":"Ketteler","year":"2017","journal-title":"Kidney Int"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3934","article-title":"Risk factors of severe hypocalcemia after US-guided percutaneous microwave ablation of the parathyroid gland in patients with secondary hyperparathyroidism","volume":"35","author":"Wei","year":"2020","journal-title":"J Bone Miner Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.024","article-title":"Importance of bone turnover for therapeutic decisions in patients with CKD-MBD","volume":"100","author":"Ott","year":"2021","journal-title":"Kidney Int"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.06.031","article-title":"Diagnosis and management of osteoporosis in advanced kidney disease: a review","volume":"79","author":"Ginsberg","year":"2022","journal-title":"Am J Kidney Dis"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.86","article-title":"Bone turnover markers: use in osteoporosis","volume":"8","author":"Naylor","year":"2012","journal-title":"Nat Rev Rheumatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.4158\/EP171966.RA","article-title":"Update on the biology of osteocalcin","volume":"23","author":"Karsenty","year":"2017","journal-title":"Endocr Pract"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.259085","article-title":"Bone turnover markers in the diagnosis and monitoring of metabolic bone disease","volume":"63","author":"Greenblatt","year":"2017","journal-title":"Clin Chem"},{"key":"B33","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1359\/jbmr.1999.14.5.792","article-title":"Novel serum markers of bone resorption: clinical assessment and comparison with established urinary indices","volume":"14","author":"Woitge","year":"1999","journal-title":"J Bone Miner Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1046\/j.1464-410x.2001.02308.x","article-title":"Early changes of bone histology and circulating markers of bone turnover after parathyroidectomy in hemodialysis patients with severe hyperparathyroidism","volume":"56","author":"Yajima","year":"2001","journal-title":"Clin Nephrol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1999.00617.x","article-title":"Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure","volume":"56","author":"Rix","year":"1999","journal-title":"Kidney Int"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.11.5249","article-title":"Bone mineral recovery after parathyroidectomy in patients with primary and renal hyperparathyroidism","volume":"83","author":"Abdelhadi","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04265.x","article-title":"Bone turnover markers predict changes in bone mineral density after parathyroidectomy in patients with renal hyperparathyroidism","volume":"76","author":"Lu","year":"2012","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02511-1","article-title":"Two-year changes of biochemical profiles and bone mineral density after percutaneous ultrasound-guided microwave ablation for primary hyperparathyroidism","volume":"71","author":"Wu","year":"2021","journal-title":"Endocrine"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.04.065","article-title":"Bone mineral density changes after parathyroidectomy are dependent on biochemical profile","volume":"165","author":"Lee","year":"2019","journal-title":"Surgery"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1055\/a-0850-8679","article-title":"Trabecular bone score, bone mineral density and bone markers in patients with primary hyperparathyroidism 2 years after parathyroidectomy","volume":"51","author":"Miguel","year":"2019","journal-title":"Horm Metab Res"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2004.01984.x","article-title":"Marked and sustained increase in bone mineral density after parathyroidectomy in patients with primary hyperparathyroidism; a six-year longitudinal study with or without parathyroidectomy in a Japanese population","volume":"60","author":"Nomura","year":"2004","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01809-7","article-title":"Subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism: an updated systematic review and meta-analysis","volume":"404","author":"Yuan","year":"2019","journal-title":"Langenbecks Arch Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1424248\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T11:18:08Z","timestamp":1741605488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1424248\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":42,"alternative-id":["10.3389\/fendo.2025.1424248"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1424248","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"article-number":"1424248"}}