Haematuria is not a risk factor of hypertension or renal impairment in patients with haemophilia

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 22; no. 4; pp. 549 - 555
• Main Authors: Sun, H. (L.), Yang, M., Sait, A. S., von Drygalski, A., Jackson, S.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.07.2016
• Subjects: Adult; Aged; Blood Pressure - physiology; cardiovascular risk; Cohort Studies; Glomerular Filtration Rate; haematuria; haemophilia; Hematuria - complications; Hematuria - diagnosis; Hemophilia A - complications; Humans; hypertension; Hypertension - epidemiology; Hypertension - etiology; Kidney Diseases - epidemiology; Kidney Diseases - etiology; Logistic Models; Male; Middle Aged; Multivariate Analysis; Obesity - complications; Prevalence; Prospective Studies; renal bleeding; renal disease; Risk Factors; Urinalysis; haematuria; haemophilia; cardiovascular risk; renal bleeding; hypertension; renal disease
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/hae.12921

Introduction An increased prevalence of hypertension has been reported in patients with haemophilia compared to the age‐matched general population, although the causes were unclear. To date, there has been limited data implicating haemophilia‐specific risk factors such as renal bleeding. Aim This two‐centre prospective cohort study aimed to assess the prevalence of gross/microscopic haematuria, and the associations between haematuria, blood pressure and renal function. Methods Of 135 adult males, with mild to severe haemophilia followed by the British Columbia and University of California San Diego Hemophilia Treatment Centers were included. Screening urinalysis and microscopy were performed during all routine visits. Haematuria was defined as history of gross haematuria or >3 red blood cells per high‐power field on microscopy in the absence of urinary tract infections. Logistic regressions were used to examine the significance of haematuria and other potential hypertension risk factors. Results The prevalence of hypertension was 44%, of whom 31% achieved adequate blood pressure control. Despite the high prevalence of haematuria (34%), renal dysfunction was rare. On univariate analysis, age, diabetes, dyslipidemia and obesity were associated with hypertension. On multivariate analysis, only age remains as a significant predictor of hypertension. Haematuria was not associated with hypertension, renal insufficiency or haemophilia severity. Conclusion In this cohort, hypertension and haematuria were prevalent while renal disease was rare. Haematuria was not associated with a diagnosis of hypertension or renal dysfunction. Larger prospective studies are needed to elucidate the mechanisms for increased prevalence of hypertension in haemophilia.