Review

. 2025 Jul 1;111(7):4187-4210.

doi: 10.1097/JS9.0000000000002510. Epub 2025 May 20.

Asian consensus statement of experts on thermal ablation for secondary hyperparathyroidism in chronic kidney disease

Huihui Chai¹, Wenwen Yue¹, Liping Sun¹, Ling Zhang², Ji-Hoon Kim³, Wei-Che Lin^{4

5

6}, Jie Yu⁷, Mingan Yu⁸, Ningning Wang⁹, Hong Wang¹⁰, Shurong Wang¹¹, Ying Che¹², Qiang Lu¹³, Jie Ren¹⁴, Fangyi Liu⁷, Yang Liu⁷, Erjiao Xu¹⁵, Hui Xu¹⁶, Min Xu¹⁷, Jinge Zhu¹, Litao Ruan¹⁸, Xinping Sun¹⁹, Desheng Sun²⁰, Xiaolong Li²¹, Changbin Li²², Meng Yang²³, Songsong Wu²⁴, Fei Yu²⁵, Songyuan Yu¹, Yongwu Yu²⁶, Yifeng Zhang¹, Chun Ouyang⁹, Bo Zhang²⁷, Xiaoliang Zhang²⁸, Lina Zhang²⁹, Jun Luo³⁰, Zhengbiao Ji²¹, Jianqiao Zhou³¹, Li Zhou³², Yumin Zheng³³, Lin Fang³⁴, Qiyu Zhao¹⁷, Binghui Zhao³⁵, Xinju Zhao³⁶, Pengcheng Hu³⁷, Shengxiang Rao³⁸, Hong Jiang³⁹, Qingqing He⁴⁰, Linxue Qian⁴¹, Dong Xu⁴², Junyue Huang⁴³, Hongli Cui⁴⁴, Tianan Jiang¹⁷, Hong Han²¹, Zhijiang Han⁴⁵, Jingning Cheng⁴⁶, Youben Fan⁴⁷, Jung Hwan Baek⁴⁸, Ping Liang⁷, Huixiong Xu²¹, Chengzhong Peng¹

Affiliations

¹ Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China (Chai, Yue, Sun, Zhu, Yu, Zhang, Peng).
² Department of Nephrology, China-Japan Friendship Hospital, Beijing, China (Zhang).
³ Department of Radiology, Seoul National University Hospital, Seoul, Korea(Kim).
⁴ Department of Diagnostic Radiology_Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, China(Lin).
⁵ Thyroid head and neck ablation center_Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, China (Lin).
⁶ School of Medicine, College of Medicine_National Sun Yat-Sen University, Kaohsiung, Taiwan, China (Lin).
⁷ Department of Interventional Ultrasound, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China (Yu, Liu, Liu, Liang).
⁸ Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Yu).
⁹ Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Provinc e Hospital, Nanjing, Jiangsu, China(Wang, Ouyang).
¹⁰ Department of Thyroid &Breast Surgery, Zhongshan Hospital, Fudan University, Shanghai, China (Wang).
¹¹ Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics &Traumatology, Shandong, China (Wang).
¹² Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Che).
¹³ Department of Ultrasound, West China Hospital, Chengdu, China (Lu).
¹⁴ Department of Medical Ultrasound, Third Affiliated hospital of Sun-Yat Sen University, Guangzhou, China (Ren).
¹⁵ Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China (Xu).
¹⁶ Department of Nephrology, Xiangya Hospital of the Central South University, Hunan, China (Xu).
¹⁷ Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China (Xu, Zhao, Jiang).
¹⁸ Department of Ultrasound Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Ruan).
¹⁹ Department of Ultrasound, Tsinghua University Affiliated Chuiyangliu Hospital, Beijing China (Sun).
²⁰ Department of Medical Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China (Sun).
²¹ Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, China (Li, Ji, Han, Xu).
²² Center for Nephrology and Clinical Metabolomics and Division of Nephrology, Shanghai Tenth People's Hospital, Shanghai, China (Li).
²³ Department of General Surgery, China-Japan Friendship Hospital, Beijing (Yang).
²⁴ Department of Ultrasound, Shengli Clinical Medical College of Fujian Medical University; Fuzhou University Affiliated Provincial Hospital, Fuzhou, China (Wu).
²⁵ Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China (Yu).
²⁶ Department of Nephrology, Chuiyangliu Hospital affiliated with Tsinghua University, Beijing, China (Yu).
²⁷ Department of Ultrasound, China-Japan Friendship Hospital, Beijing China(Zhang).
²⁸ Department of Nephrology, Zhong Da Hospital, Southeast University, School of Medicine, Nanjing, Jiangsu, China (Zhang).
²⁹ Department of Nephrology, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial People's Hospital, Zhengzhou, China (Zhang).
³⁰ Department of Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Luo).
³¹ Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Zhou).
³² Department of Nephrology, West China Hospital, Sichuan University, China (Zhou).
³³ Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (Zheng).
³⁴ Department of Breast and Thyroid Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China (Fang).
³⁵ Department of Radiology, Shanghai Tenth People's Hospital, Shanghai, China (Zhao).
³⁶ Department of Nephrology, Peking University People's Hospital, Beijing, China (Zhao).
³⁷ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China (Hu).
³⁸ Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China (Rao).
³⁹ Department of Nephrology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China (Jiang).
⁴⁰ Department of Thyroid and Breast Surgery, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China (He).
⁴¹ Department of Medical Ultrasound, Beijing Friendship Hospital of Capital Medical University, Beijing, China (Qian).
⁴² Department of Diagnostic Ultrasound Imaging & Interventional Therapy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China (Xu).
⁴³ Department of Nephrology, Gansu Provincial Hospital, Lanzhou, Gansu, China (Huang).
⁴⁴ General Surgery, Chuiyangliu Hospital affiliated with Tsinghua University, Beijing China (Cui).
⁴⁵ Department of Radiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, China (Han).
⁴⁶ Department of ENT H&N Surgery, China-Japan Friendship Hospital, Beijing, China (Cheng).
⁴⁷ Department of General Surgery, Thyroid and Parathyroid Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Fan).
⁴⁸ Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea (Baek).

PMID: 40391972
DOI: 10.1097/JS9.0000000000002510

Review

Asian consensus statement of experts on thermal ablation for secondary hyperparathyroidism in chronic kidney disease

Huihui Chai et al. Int J Surg. 2025.

. 2025 Jul 1;111(7):4187-4210.

doi: 10.1097/JS9.0000000000002510. Epub 2025 May 20.

Authors

Affiliations

¹ Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China (Chai, Yue, Sun, Zhu, Yu, Zhang, Peng).
² Department of Nephrology, China-Japan Friendship Hospital, Beijing, China (Zhang).
³ Department of Radiology, Seoul National University Hospital, Seoul, Korea(Kim).
⁴ Department of Diagnostic Radiology_Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, China(Lin).
⁵ Thyroid head and neck ablation center_Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, China (Lin).
⁶ School of Medicine, College of Medicine_National Sun Yat-Sen University, Kaohsiung, Taiwan, China (Lin).
⁷ Department of Interventional Ultrasound, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China (Yu, Liu, Liu, Liang).
⁸ Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Yu).
⁹ Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Provinc e Hospital, Nanjing, Jiangsu, China(Wang, Ouyang).
¹⁰ Department of Thyroid &Breast Surgery, Zhongshan Hospital, Fudan University, Shanghai, China (Wang).
¹¹ Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics &Traumatology, Shandong, China (Wang).
¹² Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Che).
¹³ Department of Ultrasound, West China Hospital, Chengdu, China (Lu).
¹⁴ Department of Medical Ultrasound, Third Affiliated hospital of Sun-Yat Sen University, Guangzhou, China (Ren).
¹⁵ Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China (Xu).
¹⁶ Department of Nephrology, Xiangya Hospital of the Central South University, Hunan, China (Xu).
¹⁷ Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China (Xu, Zhao, Jiang).
¹⁸ Department of Ultrasound Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Ruan).
¹⁹ Department of Ultrasound, Tsinghua University Affiliated Chuiyangliu Hospital, Beijing China (Sun).
²⁰ Department of Medical Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China (Sun).
²¹ Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, China (Li, Ji, Han, Xu).
²² Center for Nephrology and Clinical Metabolomics and Division of Nephrology, Shanghai Tenth People's Hospital, Shanghai, China (Li).
²³ Department of General Surgery, China-Japan Friendship Hospital, Beijing (Yang).
²⁴ Department of Ultrasound, Shengli Clinical Medical College of Fujian Medical University; Fuzhou University Affiliated Provincial Hospital, Fuzhou, China (Wu).
²⁵ Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China (Yu).
²⁶ Department of Nephrology, Chuiyangliu Hospital affiliated with Tsinghua University, Beijing, China (Yu).
²⁷ Department of Ultrasound, China-Japan Friendship Hospital, Beijing China(Zhang).
²⁸ Department of Nephrology, Zhong Da Hospital, Southeast University, School of Medicine, Nanjing, Jiangsu, China (Zhang).
²⁹ Department of Nephrology, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial People's Hospital, Zhengzhou, China (Zhang).
³⁰ Department of Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Luo).
³¹ Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Zhou).
³² Department of Nephrology, West China Hospital, Sichuan University, China (Zhou).
³³ Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (Zheng).
³⁴ Department of Breast and Thyroid Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China (Fang).
³⁵ Department of Radiology, Shanghai Tenth People's Hospital, Shanghai, China (Zhao).
³⁶ Department of Nephrology, Peking University People's Hospital, Beijing, China (Zhao).
³⁷ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China (Hu).
³⁸ Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China (Rao).
³⁹ Department of Nephrology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China (Jiang).
⁴⁰ Department of Thyroid and Breast Surgery, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China (He).
⁴¹ Department of Medical Ultrasound, Beijing Friendship Hospital of Capital Medical University, Beijing, China (Qian).
⁴² Department of Diagnostic Ultrasound Imaging & Interventional Therapy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China (Xu).
⁴³ Department of Nephrology, Gansu Provincial Hospital, Lanzhou, Gansu, China (Huang).
⁴⁴ General Surgery, Chuiyangliu Hospital affiliated with Tsinghua University, Beijing China (Cui).
⁴⁵ Department of Radiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, China (Han).
⁴⁶ Department of ENT H&N Surgery, China-Japan Friendship Hospital, Beijing, China (Cheng).
⁴⁷ Department of General Surgery, Thyroid and Parathyroid Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Fan).
⁴⁸ Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea (Baek).

PMID: 40391972
DOI: 10.1097/JS9.0000000000002510

Abstract

Secondary hyperparathyroidism (SHPT) is characterized by parathyroid hyperplasia, persistently elevated parathyroid hormone levels, and disturbances in mineral metabolism. Currently, a considerable amount of literature has consistently shown that thermal ablation is effective in maintaining parathyroid hormone levels within an appropriate range, normalizing calcium and phosphorus levels, improving clinical symptoms, and reducing the volume of parathyroid glands. However, there are currently no established guidelines regarding its utilization. The Asian consensus statement of experts on thermal ablation for SHPT in chronic kidney disease was jointly initiated by experts from China and Korea in the fields of nephrology, interventional ultrasound or radiology, thyroid surgery, ultrasound medicine, nuclear medicine, and diagnostic radiology-to formulate recommendations aimed at establishing standardized protocols for thermal ablation targeting the parathyroid glands. Based on the systematic review of literatures related to ultrasound-guided thermal ablation of parathyroid glands and the professional opinions of experts, the consensus statement covers the relevant content regarding thermal ablation treatment for SHPT, including indications, contraindications, pre-ablation evaluation, operational procedures, post-ablation follow-up, therapeutic effect evaluation, complications prevention and treatment. According to the Grading of Recommendations Assessment, Development and Evaluation, a total of 18 recommendations were given. This consensus statement will positively promote the standardization of ultrasound-guided thermal ablation of parathyroid glands.

Keywords: interventional ultrasound; parathyroid; secondary hyperparathyroidism; thermal ablation.

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References

1. Portillo MR, Rodríguez-Ortiz ME. Secondary hyperparthyroidism: pathogenesis, diagnosis, preventive and therapeutic strategies. Rev Endocr Metab Disord 2017;18:79–95.
1. Mao J, You H, Wang M, et al. Single-cell RNA sequencing reveals transdifferentiation of parathyroid chief cells into oxyphil cells in patients with uremic secondary hyperparathyroidism. Kidney Int 2024;105:562–81.
1. Levy AR, Xing S, Brunelli SM, et al. Symptoms of secondary hyperparathyroidism in patients receiving maintenance hemodialysis: a prospective cohort study. Am J Kidney Dis 2020;75:373–83.
1. Isakova T, Nickolas TL, Denburg M, et al. KDOQI US commentary on the 2017 KDIGO clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Am J Kidney Dis 2017;70:737–51.
1. Bozic M, Diaz-Tocados JM, Bermudez-Lopez M, et al. Independent effects of secondary hyperparathyroidism and hyperphosphataemia on chronic kidney disease progression and cardiovascular events: an analysis from the NEFRONA cohort. Nephrol Dialysis Trans 2022;37:663–72.

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Asian consensus statement of experts on thermal ablation for secondary hyperparathyroidism in chronic kidney disease

Affiliations

Asian consensus statement of experts on thermal ablation for secondary hyperparathyroidism in chronic kidney disease

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