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

Abstract

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.

Keywords: cardiovascular risk; haematuria; haemophilia; hypertension; renal bleeding; renal disease.