title: Renal Denervation in Patients With Loin Pain Hematuria Syndrome.
abstract: Loin pain hematuria syndrome (LPHS) is a painful and incapacitating condition that typically affects young women. Treatment options, including opiates and/or surgical denervation of the renal nerves by autotransplantation, have variable success. In this report, we describe the successful use of endovascular renal nerve ablation in this population. Four women with LPHS and intractable pain unresponsive to conservative measures underwent endovascular ablation of the renal nerves between July and November 2015 using the Vessix renal denervation system. The number and frequency of pain medications and responses to the EQ-5D, McGill Pain Questionnaire, Geriatric Depression Score, 36-Item Short-Form Health Survey, and Oswestry Disability Index were measured at baseline and 3 and 6 months postprocedure to evaluate changes in pain, disability, quality of life, and mood. There were improvements in pain, disability, and quality of life from baseline to 6 months postprocedure. By 6 months, 2 of 4 patients had discontinued all pain medications, whereas the other 2 had reduced their doses of these medications by 75%. These results suggest that percutaneous catheter-based renal nerve ablation with radiofrequency energy may be a treatment option for some patients with LPHS.
authors.affiliation: Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, Canada. Electronic address: bprasad@sasktel.net.
authors.forename: Bhanu
authors.initials: B
authors.lastname: Prasad
authors.affiliation: Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Giebel
authors.affiliation: Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, Canada.
authors.forename: Francisco
authors.initials: F
authors.lastname: Garcia
authors.affiliation: Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, Canada.
authors.forename: Kunal
authors.initials: K
authors.lastname: Goyal
authors.affiliation: Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, Canada.
authors.forename: Jennifer Rose
authors.initials: JR
authors.lastname: St Onge
mesh_terms: D000328:Adult; D005260:Female; D021501:Flank Pain / Q000601:surgery*; D006417:Hematuria / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000294:innervation*; D008875:Middle Aged; D013562:Sympathectomy; D013577:Syndrome
keywords: Renal denervation; endovascular ablation of the renal nerves; loin pain hematuria syndrome (LPHS); opioids; pain management; quality of life