Assessment of renal stiffness in primary hyperparathyroidism using shear-wave elastography and changes after microwave ablation.

PURPOSE: The present study aimed to evaluate changes in renal stiffness in primary hyperparathyroidism (PHPT) using shear-wave elastography (SWE), and to assess treatmentrelated improvements following microwave ablation (MWA).

METHODS

This retrospective study included 53 PHPT patients (mean age, 56.4±10.8 years; 48 women, 5 men) and 70 healthy controls (mean age, 54.5±9.7 years; 58 women, 12 men). Baseline renal SWE values (measured in the renal cortex) and biochemical parameters (parathyroid hormone [PTH], calcium, phosphate) were compared between groups. The control group served only for baseline comparisons and was not followed longitudinally. In the patient group, posttreatment SWE and biochemical changes were assessed at 1 day, 1 month, 3 months, 6 months, and 1 year. Statistical analysis included paired and independent t-tests, while regression analysis identified predictors of renal stiffness.

RESULTS

Baseline SWE values were higher in PHPT patients than in controls (9.16±2.64 kPa vs. 5.02±0.63 kPa, P<0.01). After MWA, SWE values significantly decreased (1-year mean, 5.15±1.19 kPa; P<0.01). PTH and calcium levels also improved post-treatment (P<0.01). Regression analysis showed that PTH (β=0.02, P<0.01) and calcium (β=1.82, P=0.018) independently predicted renal stiffness.

CONCLUSION

Reductions in renal stiffness and improvements in biochemical parameters were observed in PHPT patients following MWA. These preliminary findings suggest that SWE may have potential as a non-invasive tool for assessing and monitoring renal involvement in PHPT.