Abstract: TH-PO0638
Renal Denervation for the Management of Bilateral Loin Pain Hematuria Syndrome
Session Information
- CKD: Clinical - Guidelines, Biomarkers, Progression, Procedures, Outcomes, and More
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kirby, Grant Thomas, The University of Kansas Medical Center, Kansas City, Kansas, United States
- Le, Dustin, Jefferson Health, Wayne, Pennsylvania, United States
Introduction
Loin pain hematuria syndrome (LPHS) is a rare entity which presents with unilateral or bilateral flank pain. Lab, imaging, and urologic findings are benign, with hematuria typically being the only and hallmark feature of the disease. Infections, nephrolithiasis, or trauma can precede symptom onset, but in most cases there is no clear inciting event. LPHS represents a diagnostic and therapeutic challenge for managing clinicians as no randomized controlled trials exist evaluating the effectiveness of therapies. We present a case of hematuria free LPHS, refractory to numerous therapies, experiencing robust response with bilateral renal denervation.
Case Description
A 43-year-old female presented to nephrology clinic for evaluation of intractable bilateral flank pain. Medical history was remarkable for obesity, fibromyalgia, and a prior urinary tract infection (UTI). Her UTI was treated successfully with antibiotics, but the patient later developed intermittent, severe, loin pain. Urology preformed a cystoureterogram, which demonstrated friable ureteral mucosa with urinalysis showing only 1+ blood. Pain persisted into the following weeks and repeat cystoureterogram demonstrated resolution of prior findings, and was referred to nephrology for further evaluation. Repeat imaging, stone analysis, urine culture, and urine microscopy were all unremarkable. A presumptive diagnosis of LPHS was made, and the patient was trialed on muscle relaxants, gabapentin, acetaminophen, non-steroidal anti-inflammatory drugs, and narcotic analgesics without relief. Due to debility, bilateral renal denervation was pursued.
Interventional cardiology preformed an aortogram with angiography to access the renal arteries. A renal denervation catheter was used to ablate 10 points of the left renal artery and 14 points of the right. Symptom control occurred within 48 hours post-procedure. Patient was successfully weaned off all symptomatic relieving medications, and pain control has persisted 3 months post-procedure.
Discussion
LPHS is a rare disease that poses both diagnostic and therapeutic challenges. Conservative interventions often provide little benefit in this population. Renal auto-transplantation was previously considered a therapeutic option for refractory cases but is associated with significant morbidity and mortality. Renal denervation is an emerging technology that may provide an alternative therapeutic option.