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Interventional Approaches for Loin Pain Hematuria Syndrome and Kidney-Related Pain Syndromes

  • Device-Based Approaches for Hypertension (M Schlaich, Section Editor)
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Abstract

Purpose of Review

Loin pain hematuria syndrome (LPHS) frequently presents with severe chronic pain that poses a clinical challenge. Current treatment approaches are mostly empirical and include a wide range of therapeutic strategies such as physical therapy, local and systemic analgesia, interventional and surgical approaches usually flanked by psycho-behavioral therapy, and other strategies. LPHS often impacts negatively on quality of life particularly in patients who are refractory to treatment.

Recent Findings

With recent advances in catheter-based treatment approaches and better understanding of the pathophysiology of LPHS, intraluminal renal denervation (RDN) has been proposed as a valuable treatment option for kidney-related pain syndromes. The present review provides a brief overview of the clinical challenges associated with LPHS, highlights recent insights into its underlying mechanisms, and summarizes currently available data on the use of RDN in the context of LPHS and kidney-related pain syndromes.

Summary

Renal denervation via various approaches including surgical and catheter-based techniques has shown promise in alleviating kidney-related pain syndromes. Randomized controlled trials are now required to better define its role in the management of these conditions.

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Abbreviations

LPHS:

Loin pain hematuria syndrome

RDN:

Renal denervation

ADPKD:

Autosomal-dominant polycystic kidney disease

ESRD:

End-stage renal disease

NCS:

Nutcracker syndrome

LRV:

Left renal vain

RA:

Renal artery

RF:

Radiofrequency

TBM:

Thin basement membrane nephropathy

CV:

Cardiovascular

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Authors and Affiliations

  1. Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia

    Leslie Marisol Lugo-Gavidia, Janis M. Nolde, Márcio Galindo Kiuchi, Omar Azzam, Revathy Carnagarin & Markus P. Schlaich

  2. Department of Cardiology, Fiona Stanley Hospital, Perth, Australia

    Sharad Shetty

  3. Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Australia

    Sharad Shetty & Markus P. Schlaich

  4. Departments of Internal Medicine, Royal Perth Hospital, Perth, Australia

    Omar Azzam

  5. Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia

    Markus P. Schlaich

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  1. Leslie Marisol Lugo-Gavidia
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Conflict of Interest

L.M.L.G. has received a scholarship from the National Council on Science and Technology, Mexico (CONACYT). M.P.S is supported by an NHMRC Research Fellowship and has received consulting fees, and/or travel and research support from Medtronic, Abbott, Novartis, Servier, Pfizer, and Boehringer-Ingelheim. SS has received personal fees and research support from Medtronic. J.M.N., M.G.K., O.A., and R.C. declare that they have no conflict of interest.

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Lugo-Gavidia, L.M., Nolde, J.M., Kiuchi, M.G. et al. Interventional Approaches for Loin Pain Hematuria Syndrome and Kidney-Related Pain Syndromes. Curr Hypertens Rep 22, 103 (2020). https://doi.org/10.1007/s11906-020-01110-9

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