Blood Pressure Reactivity and Urinary Abnormalities in Young Athletes.

BACKGROUND

Urinary abnormalities such as hematuria and proteinuria are occasionally detected in pediatric athletes and are commonly attributed to transient exercise-induced renal stress. However, these findings may also reflect early alterations in cardiovascular regulation, particularly in blood pressure (BP) responses to physical effort.

OBJECTIVE

To evaluate the prevalence of urinary abnormalities in young athletes and investigate their association with cardiovascular parameters, with particular focus on hemodynamic response to exercise.

METHODS

This retrospective cross-sectional study included 861 pediatric athletes (mean age 13.7 ± 2.1 years) undergoing mandatory pre-participation sports screening. Participants were classified according to the presence (n = 80) or absence (n = 781) of urinary abnormalities. Demographic characteristics, anthropometric measures, urine chemistry, blood pressure and heart rate at rest and after exercise, and echocardiographic findings were compared between groups.

RESULTS

Urinary abnormalities were detected in 9.3% of athletes. Hematuria and proteinuria were significantly more frequent in this group (P < 0.001). No differences were observed in age, sex distribution, body mass index, or type of sport practiced. However, athletes with urinary abnormalities showed higher resting diastolic blood pressure (64.9 ± 8.5 vs. 62.7 ± 6.5 mmHg, P = 0.005) and a greater increase in diastolic pressure after exercise both in absolute (ΔDBP: 5.8 ± 10.5 vs. 3.1 ± 9.4 mmHg, P = 0.017) and relative terms (ΔDBP%: 7.8% vs. 4.3%, P = 0.045). No significant differences were observed in heart rate dynamics or echocardiographic findings.

CONCLUSIONS

Pediatric athletes with urinary abnormalities exhibited a modest but consistent increase in diastolic BP reactivity to exercise. These findings suggest a modest association between urinary findings and post-exercise hemodynamic adaptation, supporting the integration of cardiovascular assessment into the interpretation of urinary screening results in young athletes.