Nationwide Children's Hospital, Columbus, Ohio.
Haemophilia. 2019 Sep;25(5):782-788. doi: 10.1111/hae.13815. Epub 2019 Jul 10.
Haematuria is a recognized complication of haemophilia A and B (HA, HB). Adult persons with haemophilia (PWH) have a higher prevalence of renal disease than the general population. There is limited literature investigating the prevalence of haematuria in paediatric PWH.
Our paediatric haemophilia treatment centre (HTC) had previously used quality improvement methods to increase the frequency of screening urinalyses at annual comprehensive visits. We retrospectively reviewed the data collected to determine the prevalence of haematuria and explore for associations in those with haematuria.
Retrospective chart review to identify the frequency of haematuria on screening urinalysis in all male PWH ≥2 years old. Haematuria was defined as ≥3 red blood cells (RBCs) per high power field. Univariate logistic regression was performed to evaluate for associations with haematuria.
A total of 93 patients met eligibility criteria. Sixty-seven with HA (11 mild, 17 moderate, 39 severe) and 26 with HB (three mild, 16 moderate, seven severe). Forty-two of ninety-three (45%) patients were identified as having haematuria (median RBCs 7, mean RBCs 332). Of those with haematuria, 76% were identified by screening UA, as opposed to clinical symptoms, and 52% had recurrent haematuria. Older age and HA were associated with an increased likelihood of haematuria.
Our study demonstrated that the prevalence of haematuria was high in PWH treated at our paediatric HTC. Future investigation is needed to determine the population-wide prevalence of haematuria in paediatric PWH and its impact on renal function.
血尿是血友病 A 和 B(HA、HB)的一种公认并发症。成年血友病患者(PWH)的肾脏疾病患病率高于一般人群。关于儿科 PWH 血尿患病率的文献有限。
我们的儿科血友病治疗中心(HTC)之前曾使用质量改进方法增加年度综合就诊时尿分析筛查的频率。我们回顾性审查了收集的数据,以确定血尿的患病率,并探讨血尿患者的关联因素。
回顾性图表审查以确定所有≥2 岁男性 PWH 筛查尿分析中血尿的频率。血尿定义为每高倍镜视野≥3 个红细胞(RBC)。进行单变量逻辑回归分析以评估与血尿的关联。
共有 93 名患者符合入选标准。67 名 HA(11 名轻度、17 名中度、39 名重度)和 26 名 HB(3 名轻度、16 名中度、7 名重度)。93 名患者中有 42 名(45%)被确定为血尿(中位数 RBCs 7,平均 RBCs 332)。在血尿患者中,76%是通过筛查 UA 而不是临床症状发现的,52%有复发性血尿。年龄较大和 HA 与血尿的可能性增加相关。
我们的研究表明,在我们的儿科 HTC 治疗的 PWH 中,血尿的患病率很高。需要进一步研究以确定儿科 PWH 中血尿的全人群患病率及其对肾功能的影响。