Catheter-based renal denervation as therapy for chronic severe kidney-related pain.

Autor:	de Jager RL; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands., Casteleijn NF; Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., de Beus E; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands., Bots ML; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands., Vonken EE; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands., Gansevoort RT; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Blankestijn PJ; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2018 Apr 01; Vol. 33 (4), pp. 614-619.
DOI:	10.1093/ndt/gfx086
Abstrakt:	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 m2 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.
Databáze:	MEDLINE
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