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2018 ; 3
(3
): 638-644
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Successful Use of Renal Denervation in Patients With Loin Pain Hematuria
Syndrome-The Regina Loin Pain Hematuria Syndrome Study
#MMPMID29854971
Prasad B
; Giebel S
; Garcia F
; Goyal K
; Shrivastava P
; Berry W
Kidney Int Rep
2018[May]; 3
(3
): 638-644
PMID29854971
show ga
INTRODUCTION: Loin pain hematuria syndrome (LPHS) is characterized by severe
unilateral or bilateral loin pain that suggests a renal origin but occurs in the
absence of identifiable or relevant urinary tract disease. Hematuria can either
be microscopic or macroscopic, but the renal abnormalities responsible for the
hematuria are unexplained. Debilitating pain refractory to conventional pain
medications is the main cause of morbidity. METHODS: We conducted a single-arm,
single-center study. Twelve patients between the ages of 21 and 62 years (11
female, 1 male) with LPHS underwent endovascular ablation of the renal nerves
between July 2015 and November 2016, using the Vessix renal denervation system.
The primary objective was to achieve 30% reduction in self-reported pain with the
McGill Pain Questionnaire (MPQ) at 6 months. The secondary objectives were to
measure changes in disability (Oswestry Disability Index [ODI]), mood (Geriatric
Depression Scale [GDS]), and quality of life (EuroQol-5D [EQ-5D] and the MOS
36-Item Short Form Survey [SF-36]) scores from baseline to 6 months
postprocedure. RESULTS: Ten of 12 patients at 3 months and 11 of 12 patients at 6
months reported a >30% reduction in pain based on the MPQ at 3 and 6 months. We
found consistent improvements in MPQ, ODI, GDS, EQ-5D, and SF-36 scores from
baseline to 6 months postprocedure. CONCLUSION: We conclude that renal
denervation is associated with a considerable improvement in pain, disability,
quality of life, and mood. Our results suggest that percutaneous catheter-based
delivery of radiofrequency energy is a safe, rapid treatment option that should
be considered in all patients with LPHS.