From the Journals

Hematuria is highly prevalent in pediatric hemophilia A and B



The presence of hematuria on screening urinalysis was found to be highly prevalent in children with hemophilia, according to results from a retrospective chart review.

The findings emphasize the need to measure the population‐wide prevalence of hematuria in pediatric patients with hemophilia, in addition to better understanding its influence on renal function.

“Little is known about the prevalence of haematuria in [patients with hemophilia] or its long‐term impact on the renal system,” wrote Kyle A. Davis, MD, of the Nationwide Children’s Hospital in Columbus, and his coauthors. The results were published in Haemophilia.

The researchers retrospectively reviewed data from 93 patients with hemophilia A and B who were treated at a pediatric hemophilia treatment center from August 2011 to September 2015. The children in the study were all male and aged 2 years and older.

The team detected the frequency of hematuria, defined as greater than or equal to three red blood cells (RBCs) for each high power field, on screening urinalysis.

Other clinical data, including demographic, treatment, and laboratory information were also collected and analyzed.

After analysis, the researchers found that hematuria was detected in 45% of patients with hemophilia (mean RBCs, 332; median RBCs, 7), 76% of whom were identified using urinalysis, rather than clinical symptoms.

In total, recurrent hematuria was seen in 52% of patients. Hemophilia A and older age were associated with a higher likelihood of hematuria. However, there was no correlation between the severity of hemophilia or the treatment regimen and hematuria.

“We suspect patients with haemophilia may be having unrecognized, recurrent microscopic haematuria,” the researchers wrote.

The authors noted a key limitation of the study was the retrospective design.

“We suggest paediatric haematologists should consider routine evaluation for hypertension and renal disease in their patients,” the researchers wrote.

No funding sources were reported. The authors reported financial affiliations with Bioverativ, CSL Behring, Medscape, Shire, the American Society of Hematology, and others.

SOURCE: Davis KA et al. Haemophilia. 2019 Jul 10. doi: 10.1111/hae.13815.

Next Article: