This case series describes 3 patients with kidney related pain syndromes treated with RDN.
After the initial procedures, a reduction in perceived pain, along with a 50 % and 75 % reduction in the daily dosage of opioids, was observed in two patients. One patient showed no reduction in perceived pain or opioid use and underwent a redo procedure after 3 years, again with no reduction in perceived pain or opioid use. One patient who initially responded returned at 2 years with recurrent symptoms and underwent a redo procedure. After 3 months, a significant improvement in pain and opioid use was observed. Mean 24-hour systolic blood pressure decreased in all patients and after each procedure with a mean decrease of 12 mmHg. No adverse events were observed [
1].
Of note, two patients had Autosomal Dominant Polycystic Kidney Disease (ADPKD) and one with Loin Pain Hematuria Syndrome (LPHS). These two are the most important non-urological conditions to cause chronic severe kidney-related pain. Loin pain is a serious issue that causes profound disability due to the heavy use of opioids or other strong analgesics. Reduction in analgesic dose and frequency can allow some of these patients to restore same basic life activities and is therefore a very important therapeutic goal.
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 unknown, while renal function generally remains stable, debilitating pain refractory to conventional pain medications is the main cause of morbidity [
2].