Comparative Effectiveness of Percutaneous Ethanol Injection Therapy and Parathyroidectomy in the Treatment of Secondary and Tertiary Hyperparathyroidism

Background: Secondary and tertiary hyperparathyroidism is a common complication of chronic renal failure. Percutaneous ethanol injection therapy (PEIT) appears to be able to control appropriate parathyroid function alternatively to surgery. Methods: The records of 91 patients with chronic renal failure with secondary or tertiary hyperparathyroidism between January 2006 and July 2015 were reviewed retrospectively. Fifty-five patients underwent PEIT, while 36 patients underwent parathyroidectomy. Effectiveness and complication were compared between the two groups. Results: Parathyroid hormone level (PTH) after treatment <160 pg/mL was used to indicate successfulness of the treatment. The PEIT group showed lesser effectiveness than surgery group; 1.8% versus 61.1%, P = 0.000, odds ratio (OR) = 0.012 and 95% confidence interval (CI) = 0.001–0.970. There was no complication in the PEIT group. Symptomatic hypocalcemia was found to be 11.1% in the surgery group; P = 0.011, OR = 0.889, and 95% CI = 0.792–0.998. Conclusion: The efficacy of PEIT in the treatment of secondary and tertiary hyperparathyroidism was much lower than that of parathyroidectomy.

Publication History

Article published online:
11 May 2021