PREVALENCE OF HEMATURIA IN PATIENTS WITH HEMOPHILIA A AND B AND ITS ASSOCIATION WITH COMORBIDITIES: EXPERIENCE FROM A BRAZILIAN CENTER

Abstract

Background: Hemophilia A and B are X-linked inherited bleeding disorders. Hematuria is a common manifestation among patients, resulting in a worsening of quality of life. Results of previous studies regarding the association between hematuria and hemophilia have been inconsistent, leading to the need for further analysis. Aims: Determine the prevalence of macroscopic or microscopic hematuria in patients with hemophilia, as well as its association with comorbidities. Methods: Transversal unicenter study with adult patients (≥18 years old) bearing hemophilia A or B under active outpatient clinic in a reference center over the year of 2019. Hematuria was defined as any macroscopic episode or ≥3 red blood cells per high power field in urine analysis. Using simple and multivariable logistic analysis, age, diagnosis type, disease severity, comorbidities and creatinine clearance have been studied as potential characteristics associated with the prevalence of hematuria. Results: In total, 179 male patients were included. Mean age was 26 years (sd = 15), the majority of them were diagnosed with hemophilia A (76%) and 66% presented a severe disease. Despite our young population, the prevalence of comorbidities was high, mainly hypertension (10%), dyslipidemia (10%), diabetes (5%) and obesity (10%). The prevalence of hematuria was 39% (95% CI 32% - 47%), of these a half presented at least one macroscopic episode. Age (OR = 1.03[1.01-1.05]), hemophilia B (OR = 0.47[0.21-0.99]), hypertension (OR = 3.88[1.45-11.55]), obesity (OR = 2.92[1.11-8.24]) and creatinine clearance (OR = 0.99[0.98-1.00]) were associated with hematuria in univariable analysis. No independent factors were found in multivariable analysis. Conclusions: Hematuria is common among patients with hemophilia and further studies are needed to elucidate the relationship between hematuria and increased morbidity.