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Loin Pain/Hematuria Syndrome

Loin Pain/Hematuria Syndrome is a topic covered in the 5-Minute Clinical Consult.

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  • A rare and poorly understood syndrome characterized by unexplained chronic, severe, intermittent or persistent, unilateral or bilateral loin/flank pain with microscopic or gross hematuria
  • It is a diagnosis of exclusion.
  • Treatment focuses on pain management which requires reassurance, careful management of analgesia, and psychological support.



  • 0.01%
  • Range: 10 to 70 years
  • 70% of cases are in females.
  • More common in white female in 20s to 30s

Etiology and Pathophysiology

  • Uncertain
  • Several hypotheses have been proposed such as microvascular abnormalities, complement activation on arterioles, renal vasospasm, veno-caliceal fistula, abnormal ureteral peristalsis, intratubular crystal formation, abnormal platelet function, or psychogenic nature.
  • Glomerular basement membrane abnormalities (too thick or thin) leading to glomerular wall rupture and passage of red blood cell (RBC) into the urinary space, causing tubular obstruction and back leak of glomerular filtrate with resultant parenchymal edema and stretching of renal capsule have been proposed.

No report of genetic involvement

Risk Factors


General Prevention


Commonly Associated Conditions

  • Somatoform disorder
  • 50% of patients have a history of nephrolithiasis.

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Stephens, Mark B., et al., editors. "Loin Pain/Hematuria Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome.
Loin Pain/Hematuria Syndrome. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome. Accessed June 16, 2019.
Loin Pain/Hematuria Syndrome. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome
Loin Pain/Hematuria Syndrome [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 16]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Loin Pain/Hematuria Syndrome ID - 816807 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816807/all/Loin_Pain_Hematuria_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -