The effects of percutaneous ethanol injection on secondary hyperparathyroidism in chronic renal failure patients; a before-and-after study

Document Type : Original article

Authors

1 Endocrine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Radiology, Imam Reza Educational Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4 Cognitive Neuroscience PhD student, Institute for Cognitive Science Studies, Tehran, Iran

5 Nephrology Ward, Department of Internal Medicine, Imam Reza Educational Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

6 Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

7 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/rcm.2025.88504.1547

Abstract

Introduction: Parathyroidectomy is the only curative treatment for primary hyperparathyroidism; which needs to be performed in about 10% of dialysis patients with secondary or tertiary hyperparathyroidism. This study aims to evaluate the effectiveness and safety of percutaneous ethanol injection treatment (PEIT) in patients with treatment-resistant hyperparathyroidism in renal failure.
Methods: In this before-and-after study, nine chronic renal failure patients with indications for parathyroidectomy were enrolled. The parathyroid lesion was localized using Sestamibi scintigraphy, and participants underwent ultrasonography-guided injections of 96% ethanol into the parathyroid lesions. Parathyroid function tests and other biochemical markers were measured before and one month after the intervention.
Results: Nine renal failure patients with hyperparathyroidism were evaluated, including six males and three females. The mean age was 45.44 years, and the mean duration of hemodialysis was12 months. One month after ethanol injection, then Wilcoxon Signed Ranks Test indicated a statistically significant reduction in PTH levels (P=0.01), with a large effect size of 0.867. Likely due to the short follow-up period and the gradual changes in calcium levels, no significant adjustments were observed (P=0.374).
Conclusion: In conclusion, our findings suggest that PEIT could be an acceptable treatment for secondary hyperparathyroidism in chronic renal failure. This treatment can reduce PTH levels with no considerable complications.

Keywords

References

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Reviews in Clinical Medicine
Volume 12, Issue 4 - Serial Number 4
December 2025
Pages 121-125

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