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.
Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.
Curr Hypertens Rep. 2020 Oct 31;22(12):103. doi: 10.1007/s11906-020-01110-9.
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.
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. 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.
腰痛血尿综合征（LPHS）常表现为严重的慢性疼痛，这给临床带来了挑战。目前的治疗方法大多是经验性的，包括广泛的治疗策略，如物理治疗、局部和全身镇痛、介入和手术方法，通常辅以心理-行为治疗，以及其他策略。LPHS 常对生活质量产生负面影响，特别是在对治疗有抵抗的患者中。
随着基于导管的治疗方法的最新进展和对 LPHS 病理生理学的更好理解，腔内肾去神经支配（RDN）已被提议作为治疗与肾脏相关的疼痛综合征的一种有价值的治疗选择。本综述简要概述了与 LPHS 相关的临床挑战，强调了其潜在机制的最新见解，并总结了目前关于 RDN 在 LPHS 和与肾脏相关的疼痛综合征背景下的应用的数据。通过各种方法（包括手术和导管技术）进行的肾去神经支配已显示出缓解与肾脏相关的疼痛综合征的潜力。现在需要进行随机对照试验来更好地确定其在这些疾病管理中的作用。
