Percutaneous renal denervation in the management of kidney-related pain syndromes: a case series
Abstract
Introduction
Positive effects on pain reduction following
renal denervation (RDN) have been described in patients with kidney-related pain syndromes, yet data on the safety and efficacy of redo RDN procedures are limited.
Methods
Consecutive patients with a history of chronic loin pain, hypertension and preserved renal function (eGFR ≥40 ml/min) scheduled for RDN were included. Changes in perceived pain, opioid and
antihypertensive medication use, and blood pressure were prospectively assessed 3 months after each procedure.
Results
Two patients presented with a history of Autosomal Dominant Polycystic Kidney Disease (n = 2) and one with Loin Pain Hematuria Syndrome (n = 1). Two patients underwent a redo 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.