Hypertension, haematuria and renal functioning in haemophilia – a cross‐sectional study in Europe

Holme, Pål André; Combescure, Christophe; Tait, Robert C.; Berntorp, Erik; Rauchensteiner, Stephan; Moerloose, Philippe de

doi:10.1111/hae.12847

Cited by 42 publications

(68 citation statements)

References 37 publications

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“…It has been considered that microbleeding in the kidney could be an important factor predisposing to hypertension in PWH. Recently, the absence of a correlation between haematuria and hypertension was reported; however, this alone cannot exclude the possibility of microbleeding in the kidney being a factor involved in the development of hypertension, and further investigation is needed. The higher prevalence (23/29, 79.3%) of hypertension in patients with inhibitors, who show a higher tendency towards bleeding, seems to lend support to the notion of involvement of microbleeding in the kidney in the development of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Ischaemic events are rare, and the prevalence of hypertension is not high in Japanese adults with haemophilia: First multicentre study in Asia

et al. 2019

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Introduction With the increasing life expectancy of patients with haemophilia (PWH), the number of PWH with age‐related comorbidities, such as ischaemic events, is increasing. Aim We conducted this multicentre observational study to identify the risk factors for major ischaemic events in PWH. Methods This study was the first multicentre observational study, conducted with the participation of five haemophilia treatment centres in Japan, conducted in ≥30‐year‐old adult PWH. The latest data recorded in the medical charts between 1 January and 31 December 2016 were reviewed. Healthcare data collected from the National Health and Nutrition Survey were used as the control data. Results Data of a total of 711 patients were collected. Only two PWH (0.3%) had a history of ischaemic events. Age‐adjusted analysis indicated that the prevalence of hypertension defined as a blood pressure of 140/90 mm Hg or over was similar in the PWH to that in the males of the general population. However, when hypertension was defined more strictly (≥130/85 mm Hg), the prevalence was significantly lower in PWH than in the general male population. The hypertension in PWH was associated with the age, BMI, CKD, HIV infection and inhibitors. In particular, the odds ratio for the presence of inhibitors was high (odds ratio = 7.529). Conclusion Whether the present results can be attributed to Japanese ethnicity or to the presence of haemophilia per se remains uncertain. We propose to initiate a prospective study for further investigation.

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Section: Discussionmentioning

confidence: 99%

Ischaemic events are rare, and the prevalence of hypertension is not high in Japanese adults with haemophilia: First multicentre study in Asia

et al. 2019

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“…In a survey of the renal status in 26 people with hemophilia (age range, 17‐82 years), Beck and Evans reported a history of macroscopic hematuria in 69% of the patients. Later studies confirmed the high prevalence of hematuria among people with hemophilia . Although usually considered a benign condition, studies have found macroscopic hematuria associated with a reduction in renal function and an increased risk of hypertension, comorbid conditions that may complicate treatment in aging people with hemophilia.…”

Section: Introductionmentioning

confidence: 87%

“…As several studies have identified macroscopic hematuria as a risk factor for renal damage, an assessment of treatment that may prevent hematuria is important. Using data from the Age‐Related Developments and Comorbidities in Hemophilia (ADVANCE) Working Group's H3 Study, we examined whether frequent prophylactic factor replacement therapy corresponded with a reduced occurrence of macroscopic hematuria in this large cohort of people with hemophilia.…”

Section: Introductionmentioning

confidence: 99%

Hematuria in aging men with hemophilia: Association with factor prophylaxis

Qvigstad

Tait

Moerloose

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Introduction Macroscopic hematuria is considered a significant risk factor for urologic disease, and it is highly prevalent in people with hemophilia. Aim To determine whether prophylactic factor replacement therapy is associated with reduced occurrence of macroscopic hematuria in people with hemophilia in a post hoc analysis using data from a cross‐sectional study conducted by the Age‐Related Developments and Comobordities in Hemophilia (ADVANCE) Working Group that included males with hemophilia ≥40 years of age. Methods Data from 16 contributing centers, in 13 European countries and Israel, were analyzed using logistic regression. Of 532 recruited individuals, this analysis included 370 patients with moderate or severe hemophilia who received on‐demand or prophylactic therapy. Results For patients with a history of macroscopic hematuria, we analyzed the association between prophylaxis and reoccurrence of macroscopic hematuria within the past 5 years (n = 235 patients). Frequent (≥3 times/wk) prophylaxis was negatively associated with a recent episode of macroscopic hematuria (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.18‐0.76). We also analyzed whether prophylaxis corresponded to a lower lifetime number of macroscopic hematuria episodes (n = 285 patients). Frequent prophylaxis for >15 years was associated with a lower number of episodes compared to on‐demand treatment (OR, 0.29; 95% CI, 0.16‐0.54), whereas nonsteroidal anti‐inflammatory drugs (NSAIDs) and severe hemophilia were associated with a higher number. There was no association of prophylaxis <3 times/wk with hematuria. Conclusion Frequent prophylaxis was negatively associated with the number of episodes of macroscopic hematuria in people with hemophilia. Prevalence of macroscopic hematuria was higher among individuals with severe hemophilia and those regularly using NSAIDs.

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“…On multivariate analysis, HIV infection and hypertension were strongly associated with both ARD and CRD whilst inhibitors were associated with ARD, and increasing age with CRD. Although a recent European epidemiological study did not find a correlation between haematuria and renal dysfunction in PWH (Holme et al , ), the risk of haematuria increases with age and can be a significant problem for PWH and health care professionals. Urology referral is recommended for patients with haematuria and mild haemophilia or recurrent haematuria in patients of any severity; it should also be considered for elderly patients in order to exclude an underlying malignancy.…”

Section: Renal Diseasementioning

confidence: 94%

Haemophilia and ageing

Shapiro

Makris

2018

Br J Haematol

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Summary Advances in the development of effective and safe treatments for haemophilia over the last 50 years have resulted in a significant increase in the life expectancy of persons with haemophilia (PWH). The management of this new cohort of middle‐aged and elderly PWH is challenging because of the opposing risks of haemophilia and age‐related cardiovascular disease and malignancy. Furthermore, this cohort of ageing PWH has the additional comorbidities of human immunodeficiency virus/hepatitis C and chronic haemophilic arthropathy. This article reviews the prevalence, underlying mechanisms and treatment strategies for managing these comorbidities. International collaboration is essential for registry data and further prospective trials to inform optimal evidence‐based management for this rare disorder in the future.

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Hypertension, haematuria and renal functioning in haemophilia – a cross‐sectional study in Europe

Cited by 42 publications

References 37 publications

Ischaemic events are rare, and the prevalence of hypertension is not high in Japanese adults with haemophilia: First multicentre study in Asia

Ischaemic events are rare, and the prevalence of hypertension is not high in Japanese adults with haemophilia: First multicentre study in Asia

Hematuria in aging men with hemophilia: Association with factor prophylaxis

Haemophilia and ageing

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