TO038SUCCESSFUL USE OF RENAL DENERVATION (RDN) IN PATIENTS WITH LOIN PAIN HEMATURIA SYNDROME (LPHS): PRAIRIE LPHS STUDY
Bibliographic record
Abstract
INTRODUCTION AND AIMS: Loin Pain Hematuria Syndrome (LPHS) is characterized by severe unilateral loin pain that suggests a renal origin but occurs in the absence of identifiable or relevant urinary tract disease. Hematuria can be microscopic or macroscopic, and the renal abnormalities responsible for the hematuria are often unexplained. Treatment options are either opiates and/or surgical denervation of the renal nerves that includes auto transplantation or even nephrectomy with varying success. The primary objective was to achieve 30% reduction in subjective pain ratings using a Visual Analog Scale (VAS). The secondary objectives were: a) changes in self-reported pain (McGill Pain Questionnaire), changes in self-reported disability (Oswestry Disability Index [ODI]), changes in Quality of Life (EQ-5D, Short Form Health Survey [SF-36]) and changes in mood (Geriatric Depression Score) at 3 and 6 months compared to baseline. METHODS: We conducted a single center, single-arm study. Ten patients between the ages of 28-62 years (nine female, one male) with LPHS underwent endovascular ablation of the renal nerves between July2015 and November 2016 using the Vessix ™renal denervation system. Secondary causes of flank pain were excluded with cystoscopy, triphasic CT of the abdomen and pelvis, CT angiogram and MAG3 split function renogram. RDN was performed after seeking Health Canada approval for this indication. Individual patient consent was obtained prior to the procedure. The number and frequency of pain medications, EQ-5D, McGill Pain Questionnaire, Geriatric Depression Score, SF-36, and ODI were measured at baseline and at 3 months post-procedure to evaluate changes in pain, disability, quality of life and mood. RESULTS: 4/10 patients were off all medications at 3 months and 6/10 patients had a 70% reduction in the dose of opiates. There were consistent improvements in pain (McGill Pain Questionnaire), disability (ODI), mood (Geriatric Depression Score) and quality of life (EQ-5D and SF-36) from baseline to 6 months post-procedure. CONCLUSIONS: This is the first reported study that shows successful outcomes post RDN in patients with LPHS. We conclude that RDN is associated with decline in the number of pain medications and considerable improvement in quality of life and pain. These results suggest that percutaneous catheter-based delivery of radiofrequency energy is a safe, rapid treatment option that should be considered in all patients with LPHS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".