Medline ® Abstract for Reference 41
of 'Pain syndromes in autosomal dominant polycystic kidney disease'
Catheter-based renal denervation as therapy for chronic severe kidney-related pain.
de Jager RL, Casteleijn NF, de Beus E, Bots ML, Vonken EE, Gansevoort RT, Blankestijn PJ
Nephrol Dial Transplant. 2017;
Background: Loin pain haematuria syndrome (LPHS) and autosomal dominant polycystic kidney disease (ADPKD) are the most important non-urological conditions to cause chronic severe kidney-related pain. Multidisciplinary programmes and surgical methods have shown inconsistent results with respect to pain reduction. Percutaneous catheter-based renal denervation (RDN) could be a less invasive treatment option for these patients.
Methods: Our aim was to explore the change in perceived pain and use of analgesic medication from baseline to 3, 6 and 12 months after RDN. Patients with LPHS or ADPKD, who experienced kidney-related pain≥3 months with a visual analogue scale (VAS) score≥ 50/100 could be included. Percutaneous RDN was performed with a single-electrode radiofrequency ablation catheter.
Results: RDN was performed in 11 patients (6 with LPHS and 5 with ADPKD). Perceived pain declined in the whole group by 23 mm (P = 0.012 for the total group). In patients with LPHS and ADPKD, the median daily defined dosage of analgesic medication decreased from 1.6 [interquartile range (IQR) 0.7-2.3]and 1.4 (IQR 0.0-7.4) at baseline to 0.3 (IQR 0.0-1.9; P = 0.138) and 0.0 (IQR 0.0-0.8; P = 0.285) at 12 months, respectively. Mean estimated glomerular filtration rate decreased in the whole group by 5.4 mL/min/1.73 m 2 at 6 months compared with baseline (P = 0.163).
Conclusions: These results suggest that percutaneous catheter-based RDN reduces pain complaints and the use of analgesic medication in patients with LPHS or ADPKD. The present results can serve as the rationale for a larger, preferably randomized (sham) controlled study.
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.