1
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Greenberg D, Rosenblum ND, Tonelli M. The multifaceted links between hearing loss and chronic kidney disease. Nat Rev Nephrol 2024; 20:295-312. [PMID: 38287134 DOI: 10.1038/s41581-024-00808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Abstract
Hearing loss affects nearly 1.6 billion people and is the third-leading cause of disability worldwide. Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. From a developmental perspective, the structures responsible for hearing have a common morphogenetic origin with the kidney, and genetic abnormalities that cause familial forms of hearing loss can also lead to kidney disease. On a cellular level, normal kidney and cochlea function both depend on cilial activities at the apical surface, and kidney tubular cells and sensory epithelial cells of the inner ear use similar transport mechanisms to modify luminal fluid. The two organs also share the same collagen IV basement membrane network. Thus, strong developmental and physiological links exist between hearing and kidney function. These theoretical considerations are supported by epidemiological data demonstrating that CKD is associated with a graded and independent excess risk of sensorineural hearing loss. In addition to developmental and physiological links between kidney and cochlear function, hearing loss in patients with CKD may be driven by specific medications or treatments, including haemodialysis. The associations between these two common conditions are not commonly appreciated, yet have important implications for research and clinical practice.
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Affiliation(s)
- Dina Greenberg
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Norman D Rosenblum
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
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2
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Rivetti S, Romano A, Mastrangelo S, Attinà G, Maurizi P, Ruggiero A. Aminoglycosides-Related Ototoxicity: Mechanisms, Risk Factors, and Prevention in Pediatric Patients. Pharmaceuticals (Basel) 2023; 16:1353. [PMID: 37895824 PMCID: PMC10610175 DOI: 10.3390/ph16101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Aminoglycosides are broad-spectrum antibiotics largely used in children, but they have potential toxic side effects, including ototoxicity. Ototoxicity from aminoglycosides is permanent and is a consequence of its action on the inner ear cells via multiple mechanisms. Both uncontrollable risk factors and controllable risk factors are involved in the pathogenesis of aminoglycoside-related ototoxicity and, because of the irreversibility of ototoxicity, an important undertaking for preventing ototoxicity includes antibiotic stewardship to limit the use of aminoglycosides. Aminoglycosides are fundamental in the treatment of numerous infectious conditions at neonatal and pediatric age. In childhood, normal auditory function ensures adequate neurocognitive and social development. Hearing damage from aminoglycosides can therefore strongly affect the normal growth of the child. This review describes the molecular mechanisms of aminoglycoside-related ototoxicity and analyzes the risk factors and the potential otoprotective strategies in pediatric patients.
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Affiliation(s)
- Serena Rivetti
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
| | - Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.R.); (A.R.); (S.M.); (G.A.); (P.M.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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3
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Fadel FI, Yamamah GAN, Hasanin RM, Mostafa EA, Abdalgeleel SA, Salah MM, Galal REE, Abdel Mawla MA. Hearing assessment in Egyptian children with chronic renal failure on regular hemodialysis and renal transplantation children. Ther Apher Dial 2021; 26:960-968. [PMID: 34951736 DOI: 10.1111/1744-9987.13783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hearing impairment is frequent in patients with end-stage renal disease (ESRD). We aimed to assess the prevalence of hearing impairment in children on regular hemodialysis and renal transplantation. MATERIALS AND METHODS Transient-evoked otoacoustic emissions (TEOAEs) has been done for 80 children on regular hemodialysis and 40 with renal transplant. RESULTS In hemodialysis group, TEOAEs showed that 53.8% children had hearing affection, it was significantly related to dialysis duration, dialysis adequacy, vascular access infection, hepatitis C virus (HCV) infection, and ototoxic drugs (p = 0.001, 0.037, 0.011, 0.004, 0.030, 0.007, and 0.044, respectively). In renal transplant group hearing impairment was 25%. There was significant relation with period of dialysis before transplantation and biopsy proved rejection (p = 0.008, <0.001, respectively). CONCLUSION Hearing impairment is a common finding in ESRD patients. Thus audiological assessment must be done in these patients.
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Affiliation(s)
- Fatina I Fadel
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Rasha M Hasanin
- Department of Pediatrics, National Research Center, Giza, Egypt
| | - Eman A Mostafa
- Department of Pediatrics, National Research Center, Giza, Egypt
| | | | - Mohab M Salah
- Department of Pediatrics, National Research Center, Giza, Egypt
| | - Rasha E E Galal
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
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4
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Diepstraten FA, Hoetink AE, van Grotel M, Huitema ADR, Stokroos RJ, van den Heuvel-Eibrink MM, Meijer AJM. Aminoglycoside- and glycopeptide-induced ototoxicity in children: a systematic review. JAC Antimicrob Resist 2021; 3:dlab184. [PMID: 34917943 PMCID: PMC8669239 DOI: 10.1093/jacamr/dlab184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
Background Ototoxicity has been reported after administration of aminoglycosides and glycopeptides. Objectives To identify available evidence for the occurrence and determinants of aminoglycoside- and glycopeptide-related ototoxicity in children. Materials and methods Systematic electronic literature searches that combined ototoxicity (hearing loss, tinnitus and/or vertigo) with intravenous aminoglycoside and/or glycopeptide administration in children were performed in PubMed, EMBASE and Cochrane Library databases. Studies with sample sizes of ≥50 children were included. The QUIPS tool and Cochrane criteria were used to assess the quality and risk of bias of included studies. Results Twenty-nine aminoglycoside-ototoxicity studies met the selection criteria (including 7 randomized controlled trials). Overall study quality was medium/low. The frequency of hearing loss within these studies ranged from 0%–57%, whereas the frequency of tinnitus and vertigo ranged between 0%–53% and 0%–79%, respectively. Two studies met the criteria on glycopeptide-induced ototoxicity and reported hearing loss frequencies of 54% and 55%. Hearing loss frequencies were higher in gentamicin-treated children compared to those treated with other aminoglycosides. In available studies aminoglycosides had most often been administered concomitantly with platinum agents, diuretics and other co-medication. Conclusions In children the reported occurrence of aminoglycoside/glycopeptide ototoxicity highly varies and seems to depend on the diagnosis, aminoglycoside subtype and use of co-administered medication. More research is needed to investigate the prevalence and determinants of aminoglycoside/glycopeptide ototoxicity. Our results indicate that age-dependent audiological examination may be considered for children frequently treated with aminoglycosides/glycopeptides especially if combined with other ototoxic medication.
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Affiliation(s)
- F A Diepstraten
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
| | - A E Hoetink
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Utrecht, UMC Brain Centre, Utrecht, The Netherlands
| | - M van Grotel
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
| | - A D R Huitema
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands.,Department of Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - R J Stokroos
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Utrecht, UMC Brain Centre, Utrecht, The Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands.,Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A J M Meijer
- Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
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5
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Kim JH, Lee DH, Lee B, Lim SH, Ahn YH, Kang HG, Ha IS, Cheong HI. Renal Syndromic Hearing Loss Is Common in Childhood-onset Chronic Kidney Disease. J Korean Med Sci 2020; 35:e364. [PMID: 33200591 PMCID: PMC7669456 DOI: 10.3346/jkms.2020.35.e364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/01/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population. This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD. METHODS In this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2-5, age at onset of renal symptom < 18 years) were recruited. We referred to the "renal" syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD. RESULTS A total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL. CONCLUSION One-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.
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Affiliation(s)
- Ji Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Han Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Bongjin Lee
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seon Hee Lim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Yo Han Ahn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- Wide River Institute of Immunology, Seoul National University, Seoul, Korea.
| | - Il Soo Ha
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Il Cheong
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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6
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Characterization of Hearing Loss in Adult Patients With Nondialysis Chronic Kidney Disease. Otol Neurotol 2020; 41:e776-e782. [DOI: 10.1097/mao.0000000000002656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Müller-Wiefel DE. Treatment of Peritonitis in Pediatric Continuous Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686089901902s74] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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8
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Rusthoven E, Monnens LA, Schröder CH. Effective Treatment of Peritoneal Dialysis-Associated Peritonitis with Cefazolin and Ceftazidime in Children. Perit Dial Int 2020. [DOI: 10.1177/089686080102100409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the use of the combination of cefazolin and ceftazidime for initial treatment of peritoneal dialysis (PD)-related peritonitis in pediatric patients. Design Retrospective nonrandomized study. Setting Pediatric dialysis units of the University Medical Center of Utrecht and Nijmegen, The Netherlands. Patients 40 children (median age 5.4 years) who were treated with PD during the study period of 4.5 years. Interventions All 50 episodes of peritonitis that occurred during the study period were evaluated by review of medical records. Patients were given intraperitoneal ceftazidime 500 mg/L dialysis fluid, and cefazolin 500 mg/L as a loading dose, followed by a maintenance dose of ceftazidime 125 mg/L and cefazolin 100 mg/L, intraperitoneally, 4 times daily. Antibiotics were continued for 14 days. Results After identification of the causative microorganism, one of the antibiotics was discontinued in 34 cases, and the antibiotic schedule was adapted in 2 cases. All cases were initially cured within 3 days. In 5 cases (10%), there was a peritonitis with the same organism recurring within 2 weeks after completion of treatment. There were 4 cases of PD-related peritonitis caused by pseudomonas, all of which were cured. Conclusions The antibiotic combination of cefazolin and ceftazidime is effective for the initial therapy of PD-related peritonitis in children. The toxic complications of aminoglycosides are avoided with this combination.
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Affiliation(s)
- Esther Rusthoven
- Department of Pediatrics, Wilhelmina Children's University Hospital, Utrecht; Department of Pediatrics, University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Leo A.H. Monnens
- Department of Pediatrics, Wilhelmina Children's University Hospital, Utrecht; Department of Pediatrics, University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Cornelis H. Schröder
- Department of Pediatrics, Wilhelmina Children's University Hospital, Utrecht; Department of Pediatrics, University Medical Center Nijmegen, Nijmegen, The Netherlands
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9
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Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss. Braz J Otorhinolaryngol 2017; 83:580-584. [PMID: 27649632 PMCID: PMC9444766 DOI: 10.1016/j.bjorl.2016.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/07/2016] [Indexed: 11/21/2022] Open
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10
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Kaipa R, Tether H. Speech, language, and hearing function in twins with Alport syndrome: A seven-year retrospective case report. J Otol 2017; 12:86-96. [PMID: 29937843 PMCID: PMC5963462 DOI: 10.1016/j.joto.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/09/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022] Open
Abstract
Alport syndrome is an X-linked syndrome that results in nephritis, renal failure, sensorineural hearing loss, and eye deficits. As a result of sensorineural hearing loss, these individuals are likely to experience difficulties in the area of speech and language. While studies in the past have examined the speech and language characteristics of children with syndromic sensorineural hearing loss, to our knowledge there are no previous studies to have documented the speech and language characteristics of these children on a long-term basis. The current study addresses this limitation by reporting speech, language, hearing, and function of twin brothers with X-linked Alport syndrome across a seven-year period. Information was collected by examining the medical records of the participants as well as through a verbal interview with the participants' guardian. Results revealed that the participants' hearing abilities gradually deteriorated over the seven-year period which affected their speech and language development as well. The kidney function tests revealed significant presence of hematuria (blood in the urine) as well as proteinuria (protein in the urine) suggesting chronic kidney dysfunction. This longitudinal study demonstrates the functional relationship between the kidneys and the cochlea, although they appear to be independent of one another. As individuals with Alport syndrome exhibit systemic complications, interdisciplinary collaboration is essential among health care providers including audiologists, speech-language pathologists, nephrologists, and ophthalmologist to promote evidence-based practice.
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Affiliation(s)
- Ramesh Kaipa
- Department of Communication Sciences and Disorders, Oklahoma State University, United States
| | - Hannah Tether
- Department of Communication Sciences and Disorders, Oklahoma State University, United States
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11
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Renda R, Renda L, Selçuk ÖT, Eyigör H, Yılmaz MD, Osma Ü. Cochlear sensitivity in children with chronic kidney disease and end-stage renal disease undergoing hemodialysis. Int J Pediatr Otorhinolaryngol 2015; 79:2378-83. [PMID: 26590002 DOI: 10.1016/j.ijporl.2015.10.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Auditory system abnormalities commonly occur in patients with chronic renal disease and end-stage renal disease undergoing hemodialysis. The aim of this study was to determine the relationship between cochlear sensitivity and hemodialysis in dialytic and non-dialytic chronic kidney disease patients. METHODS The study included children aged 6-18 years that were divided into 3 groups: 36 non-dialytic patients with chronic kidney disease, 16 end-stage renal disease patients undergoing hemodialysis, and 30 healthy controls. Blood urea nitrogen, serum cystatin C levels, duration of chronic kidney disease, and the duration of hemodialysis were compared between the chronic kidney disease patients and end-stage renal disease patients undergoing hemodialysis. Hearing health was measured via tympanometry, pure-tone audiometry and distortion product otoacoustic emissions testing. RESULTS Distortion product otoacoustic emission amplitudes and signal-to-noise ratios were significantly lower at all frequencies tested in the non-dialytic and dialytic groups than in the control group (p<0.05). Patients with normal hearing had significantly lower distortion product otoacoustic emission amplitudes and signal-to-noise ratios than the healthy controls (p<0.05). The duration of CKD, the cystatin C level, and the blood urea level were not associated with hearing loss. The present findings suggest that there was a significant association between the duration of HD and hearing loss. CONCLUSION The present findings show that there was impaired cochlear function in the dialytic and non-dialytic patient groups, regardless of hearing loss, as compared to the control group. Patients with chronic renal disease-both dialytic and non-dialytic-should be monitored to prevent any further deterioration by avoiding potential ototoxic agents, even if their hearing thresholds are within normal limits.
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Affiliation(s)
- Rahime Renda
- Department of Pediatric Nephrology, Antalya Research and Education Hospital, Antalya, Turkey.
| | - Levent Renda
- Department of Otolaryngology - Head and Neck Surgery, Antalya Research and Education Hospital, Antalya, Turkey
| | - Ömer Tarık Selçuk
- Department of Otolaryngology - Head and Neck Surgery, Antalya Research and Education Hospital, Antalya, Turkey
| | - Hülya Eyigör
- Department of Otolaryngology - Head and Neck Surgery, Antalya Research and Education Hospital, Antalya, Turkey
| | - Mustafa Deniz Yılmaz
- Department of Otolaryngology - Head and Neck Surgery, Antalya Research and Education Hospital, Antalya, Turkey
| | - Üstün Osma
- Department of Otolaryngology - Head and Neck Surgery, Antalya Research and Education Hospital, Antalya, Turkey
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Jamaldeen J, Basheer A, Sarma AC, Kandasamy R. Prevalence and patterns of hearing loss among chronic kidney disease patients undergoing haemodialysis. Australas Med J 2015; 8:41-6. [PMID: 25810786 DOI: 10.4066/amj.2015.2258] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The prevalence, degree, and patterns of hearing loss associated with chronic kidney disease (CKD) reported by various studies differ significantly. The effects of haemodialysis and duration of disease on hearing loss remain unclear. AIMS The aim of this study was to determine the prevalence and degree of hearing loss in CKD patients on haemodialysis. METHODS This study included 120 CKD patients on haemodialysis. Information regarding age, gender, duration of disease, subjective hearing loss, exposure to ototoxic drugs, comorbidities like diabetes, hypertension, and hypothyroidism, renal functions, electrolytes and number of haemodialysis sessions received were obtained. An equal number of age and sex matched controls were used to determine prevalence of hearing loss in CKD patients after subjecting both groups to pure tone audiometry. We compared CKD patients with and without hearing loss for association of hearing loss with disease duration, number of haemodialysis, and blood parameters. RESULTS Hearing loss was present in 41.7 per cent of CKD patients, significantly higher than controls (p=0.001), and was mild in the majority of patients. Impairment was noted across high and low frequencies of audiometric testing. Median duration of disease was the same (18 months) among CKD patients with and without hearing loss (p=0.62). CKD patients with hearing loss received 72 haemodialysis compared to 122 sessions by those without hearing loss (p=0.04). CONCLUSION Mild sensorineural hearing loss is common in CKD. Hearing loss has no specific pattern as it prevails at high and low frequencies. Hearing loss may be inversely associated with the number of haemodialysis sessions but not with duration of disease.
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Affiliation(s)
- Jishana Jamaldeen
- Department of Otorhinolaryngology, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Aneesh Basheer
- Department of General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Akhil Chandra Sarma
- Department of Otorhinolaryngology, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Ravichandran Kandasamy
- Department of Biostatistics, Pondicherry Institute of Medical Sciences, Pondicherry, India
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13
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Gulleroglu K, Baskin E, Aydin E, Ozluoglu L, Moray G, Haberal M. Hearing Status in Pediatric Renal Transplant Recipients. EXP CLIN TRANSPLANT 2014; 13:324-8. [PMID: 25365361 DOI: 10.6002/ect.2014.0158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Renal transplant provides a long-term survival. Hearing impairment is a major factor in subjective health status. Status of hearing and the cause of hearing impairment in the pediatric renal transplant group have not been evaluated. Here, we studied to evaluate hearing status in pediatric renal transplant patients and to determine the factors that cause hearing impairment. MATERIALS AND METHODS Twenty-seven pediatric renal transplant recipients were investigated. All patients underwent audiologic assessment by means of pure-tone audiometry. The factors on hearing impairment were performed. RESULTS Sensorineural hearing impairment was found in 17 patients. There was marked hearing impairment for the higher frequencies between 4000 and 8000 Hz. Sudden hearing loss developed in 2 patients, 1 of them had tinnitus. Decrease of speech understanding was found in 8 patients. The cyclosporine level was significantly high in patients with hearing impairment compared with group without hearing impairment. Cyclosporine levels also were found to be statistically significantly high when compared with the group with decrease of speech understanding and the group without decrease of speech understanding. Similar relations cannot be found between tacrolimus levels and hearing impairment and speech understanding. CONCLUSIONS Sensorineural hearing impairment prevalence was high in pediatric renal transplant recipients when compared with the general population of children. Cyclosporine may be responsible for causing hearing impairment after renal transplant. We suggest that this effect is a dose-dependent toxicity.
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Affiliation(s)
- Kaan Gulleroglu
- Pediatric Nephrology Department, Baskent University, Ankara, Turkey
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Cuna V, Battaglino G, Capelli I, Sala E, Donati G, Cianciolo G, La Manna G. Hypoacusia and Chronic Renal Dysfunction: New Etiopathogenetic Prospective. Ther Apher Dial 2014; 19:111-8. [DOI: 10.1111/1744-9987.12232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Vania Cuna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Giuseppe Battaglino
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Irene Capelli
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Elisa Sala
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Gabriele Donati
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Giuseppe Cianciolo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Gaetano La Manna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
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Lopez PS, Camargo da Silva DP, Martin LC, Montovani JC. Could the type of treatment for chronic kidney disease affect the auditory system?☆☆Please cite this article as: Lopez PS, Silva DPC, Martin LC, Montovani JC. Could the type of treatment for chronic Kidney disease affect the auditory system? Braz J Otorhinolaryngol. 2014;80:54-9. Braz J Otorhinolaryngol 2014; 80:54-9. [PMID: 24626893 PMCID: PMC9444552 DOI: 10.5935/1808-8694.20140012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/01/2013] [Indexed: 11/20/2022] Open
Abstract
Introdução Doença renal crônica (DRC) é definida pela presença de lesão renal levando à perda lenta e progressiva da função renal. A influência do tratamento da DRC sobre a audição ainda é inconclusiva. Objetivo Comparar testes auditivos entre pacientes com DRC submetidos a diferentes tipos de tratamento. Material e método Cohort transversal. Os grupos foram divididos de acordo com o tratamento: hemodiálise (n = 35), diálise peritoneal (n = 15), conservador (n = 51) e 27 pacientes saudáveis (controle). Pacientes com idade superior a 60 anos, perda auditiva congênita, síndromes genéticas, infecções de orelha média e transplante renal foram excluídos da pesquisa. A avaliação audiológica incluiu audiometria tonal, emissões otoacústicas evocadas transientes e Potencial Evocado Auditivo de Tronco Encefálico (PEATE); e as variáveis avaliadas foram: sexo, idade, diagnóstico de hipertensão arterial e diabetes, estadiamento da DRC, tempo de diagnóstico do diabetes e da hipertensão arterial, duração da DRC e do tratamento. Resultados A idade, presença de hipertensão arterial e tempo de DRC foram estatisticamente significantes e controlados. O grupo conservador apresentou piores limiares auditivos na audiometria tonal e o intervalo III-V do PEATE significativamente maior que o da hemodiálise. Conclusão O tratamento conservador mostrou piores resultados na avaliação auditiva, independente de diabetes e de hipertensão, reforçando que os pacientes submetidos a tratamento para DRC merecem avaliação auditiva completa para melhor compreensão da doença e de seus efeitos sobre o sistema auditivo.
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Affiliation(s)
- Priscila Suman Lopez
- Department of Ophthalmology, Otolaryngology, Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo (UNESP), São Paulo, SP, Brazil
| | - Daniela Polo Camargo da Silva
- Department of Ophthalmology, Otolaryngology, Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo (UNESP), São Paulo, SP, Brazil
| | - Luis Cuadrado Martin
- Department of Clinical Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo (UNESP), São Paulo, SP, Brazil
| | - Jair Cortez Montovani
- Department of Ophthalmology, Otolaryngology, Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo (UNESP), São Paulo, SP, Brazil
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CT Assessment of Bone Remodeling in the Otic Capsule in Chronic Renal Failure: Association With Hearing Loss. AJR Am J Roentgenol 2013; 200:396-9. [DOI: 10.2214/ajr.11.8474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Lin C, Hsu HT, Lin YS, Weng SF. Increased risk of getting sudden sensorineural hearing loss in patients with chronic kidney disease: a population-based cohort study. Laryngoscope 2012; 123:767-73. [PMID: 22927011 DOI: 10.1002/lary.23669] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the risk of getting Sudden Sensorineural Hearing Loss (SSHL) among patients with chronic kidney disease (CKD). STUDY DESIGN A retrospective cohort study. METHODS Population-based representative insurance claims data were used to examine the risk of getting SSHL among patients with chronic kidney disease. Data extracted from the Taiwan National Health Insurance Research Database yielded 37,421 patients with newly diagnosed renal insufficiency and 37,421 subjects without renal insufficiency from between 2000 and 2004. RESULTS The incidence of SSHL at the end of 2009 was determined. The incidence of SSHL was 1.57 times higher in the CKD-carrying group compared to the incidence in the non-CKD group (10.24 vs. 6.52 per 10,000 person-years), with adjusted hazard ratio (HR) of 1.46 (95% CI = 1.194-1.787) using Cox proportional hazard regressions. Age was an independent risk factor of getting SSHL, with adjusted HRs of 2.01, 3.178, and 2.285 for age ranges of 35 ≈ 49, 50 ≈ 64 and ≥ 65 compared with age range of 0 ≈ 35. Diabetes Mellitus was another independent risk factor with HR of 1.31 (95% CI = 1.003-1.711). CONCLUSIONS Present results suggested a significant association between CKD and increased risk of getting SSHL. Comorbidity of diabetes in patients with CKD appeared to be associated with increased risk of getting SSHL, especially for the patients who are 35 years of age and older.
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Affiliation(s)
- Charlene Lin
- Department of Molecular and Cell Biology, University of California, Berkeley, USA
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Iverson KC, McKinnon BJ. Cochlear implantation after renal transplantation. Am J Otolaryngol 2012; 33:150-3. [PMID: 21345517 DOI: 10.1016/j.amjoto.2010.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 11/28/2010] [Accepted: 12/12/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cochlear implantation after renal transplantation is uncommon and poses unique challenges that have only recently been described in the medical literature. This work reports our experience with cochlear implantation in patients who have undergone renal transplantation. STUDY DESIGN A retrospective review was performed. SETTING This study was performed in a tertiary academic medical center. PATIENTS Two patients were identified as having undergone cochlear implantation after renal transplantation. INTERVENTIONS Uneventful unilateral cochlear implantations were performed. MAIN OUTCOME MEASURES Postoperative complications to include wound infection or dehiscence were reported as well as audiometric data. RESULTS Cochlear implantation was completed uneventfully in both patients without postoperative complications. One patient expired two years after the procedure as a result of multiple comorbidities. Both patients achieved successful use of their device. CONCLUSIONS This study adds to the growing evidence that successful cochlear implantation can be achieved in appropriately selected renal transplant patients. Decision making should rely on surgical candidacy as well as assessment of surgical risk in collaboration with the transplant service.
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Affiliation(s)
- Kenneth Charles Iverson
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912-4060, USA.
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Laakkonen H, Lönnqvist T, Valanne L, Karikoski J, Holmberg C, Rönnholm K. Neurological development in 21 children on peritoneal dialysis in infancy. Pediatr Nephrol 2011; 26:1863-71. [PMID: 21547426 DOI: 10.1007/s00467-011-1893-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/05/2011] [Accepted: 04/07/2011] [Indexed: 10/18/2022]
Abstract
Few studies have focused on the neurodevelopment of infants on peritoneal dialysis (PD). Infants are the most demanding patient group on PD and thus are vulnerable to neurological sequelae. We studied 21 patients <2 years of age (mean 0.59 years) at onset of PD. They were evaluated by a neurologist, otologist, physiotherapist, and occupational therapist during PD. Neuropsychological tests were collected from all patients at least 5 years old, and the brain images were reviewed. Eleven patients (52%) had a pre- or neonatal problem or comorbidity as risk factor for their development at onset of PD. All infants tolerated PD well. At the end of the study, 71% had some neurological abnormality, 29% a major impairment (all with predialysis risk factors), and 43% a minor one. Brain infarcts were detected in four patients (19%) and other ischemic lesions in three (14%). Three patients (14%) developed hearing defect. Mortality rate was 5%. PD is a safe treatment modality for end-stage renal failure in infants. Some patients had risk factors for development, but their neurological problems did not progress during PD. Patients without risk factors tolerated PD well without major neurological sequelae.
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Affiliation(s)
- Hanne Laakkonen
- Department of Pediatrics, Hyvinkää Hospital, Hyvinkää, Finland.
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Naderpour M, Mortazavi F, Jabbari-Moghaddam Y, Sharifi-Movaghar MH. Auditory brain stem response and otoacoustic emission results in children with end-stage renal disease. Int J Pediatr Otorhinolaryngol 2011; 75:704-7. [PMID: 21420741 DOI: 10.1016/j.ijporl.2011.02.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/19/2010] [Accepted: 02/21/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Abnormalities in auditory system are frequent in patients with end stage renal disease (ESRD). There is not yet any consensus for the effect of renal failure and hemodialysis on auditory complications. The aim of this study was to evaluate the auditory abnormalities in pediatric ESRD patients undergoing long term hemodialysis and compare the results with those of nondialytic chronic renal failure (CRF) children and controls. METHODS Children aged 1-16 years were evaluated in three groups: 25 ESRD patients undergoing hemodialysis, 25 nondialytic patients with CRF, and 25 age and sex-matched normal counterparts. Patients with history of otological diseases, ear trauma, diabetes mellitus, receiving ototoxic drugs and syndromes with hearing abnormalities were excluded. The auditory brainstem response (ABR) and otoacoustic emission (OAE) were tested in all subjects. Frequency of cases with abnormal findings was compared between the groups. RESULTS The ABR testing was abnormal in 11 (44%) dialytic patients with normal results in all nondialytic CRF cases and controls (p<0.001). The OAE testing was abnormal in all dialytic patients with abnormal ABR testing results (44%), in 1 (4%) nondialytic CRF patient and in no controls (p<0.001). There ware no significant differences with regard to age, gender, height, weight, blood pressure, serum levels of blood urea nitrogen (BUN), creatinine, sodium, and potassium, glomerular filtration rate (GFR), duration of dialysis and dialysis adequacy between dialytic patients with and without abnormal results of ABR/OAE testing. CONCLUSION Sensorineural hearing loss is rare among nondialytic pediatric patients with CRF but very common in ESRD children undergoing long term dialysis.
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Affiliation(s)
- Masoud Naderpour
- Department of Otolaryngology - Head and Neck Surgery, Pediatric Health Research Center, Tabriz University of Medical Sciences, Iran
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21
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Vilayur E, Gopinath B, Harris DC, Burlutsky G, McMahon CM, Mitchell P. The association between reduced GFR and hearing loss: a cross-sectional population-based study. Am J Kidney Dis 2010; 56:661-9. [PMID: 20673695 DOI: 10.1053/j.ajkd.2010.05.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 05/24/2010] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) has long been associated with hearing loss in certain syndromes. Reported evidence to date has come from only small observational studies. We present the first community-based study to show an association between nonsyndromal CKD and hearing loss. STUDY DESIGN Cross-sectional population-based study to examine the relationship between CKD and age-related hearing loss. SETTING & PARTICIPANTS The Blue Mountains Hearing Study is a survey of age-related hearing loss conducted in 1997-2004; a total of 2,564 participants had audiometric testing and complete renal data. PREDICTOR OR FACTOR Moderate CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2). OUTCOMES Bilateral hearing loss, defined as average pure-tone threshold >25 dB for measurements at frequencies of 0.5, 1.0, 2.0, and 4.0 kHz. MEASUREMENTS Baseline biochemistry tests, including serum creatinine, were performed. Pure-tone audiometry was performed in sound-treated booths. RESULTS Moderate CKD was present in 513 of 2,564 participants. Of persons with moderate CKD, 279 (54.4%) had measured hearing loss compared with 581 (28.3%) with eGFR ≥60 mL/min/1.73 m(2). Moderate CKD was independently associated with hearing loss (OR, 1.43; 95% CI, 1.10-1.84; P = 0.006) after adjusting for age; sex; noise exposure; education; diabetes, hypertension, and stroke histories; and smoking. Participants with eGFR <45 mL/min/1.73 m(2) had the highest prevalence of hearing loss (73%) compared with those with eGFR ≥90 mL/min/1.73 m(2) (19%; multivariate adjusted OR, 2.4 [95% CI, 1.3-4.5]). Analyses were repeated after excluding participants reporting furosemide use (a known ototoxic agent); the association between moderate CKD and hearing loss remained significant (multivariate adjusted OR, 1.40 [95% CI, 1.08-1.83]; P = 0.01). LIMITATIONS The present study is not longitudinal and does not permit causal inference from the observed associations. CONCLUSIONS Moderate CKD per se was associated independently with hearing loss. Recognizing this link could lead to earlier hearing assessment with appropriate interventions to preserve the hearing of patients with CKD.
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Affiliation(s)
- Eswari Vilayur
- Centre for Transplantation and Renal Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, New South Wales, Sydney, Australia
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Abstract
Furosemide, a potent loop diuretic, is frequently used in different stages of acute kidney injury, but its clinical roles remain uncertain. This review summarises the pharmacology of furosemide, its potential uses and side effects, and the evidence of its efficacy. Furosemide is actively secreted by the proximal tubules into the urine before reaching its site of action at the ascending limb of loop of Henle. It is the urinary concentrations of furosemide that determine its diuretic effect. The severity of acute kidney injury has a significant effect on the diuretic response to furosemide; a good 'urinary response' may be considered as a 'proxy' for having some residual renal function. The current evidence does not suggest that furosemide can reduce mortality in patients with acute kidney injury. In patients with acute lung injury without haemodynamic instability, furosemide may be useful in achieving fluid balance to facilitate mechanical ventilation according to the lung-protective ventilation strategy.
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Affiliation(s)
- K M Ho
- Royal Perth Hospital and University of Western Australia, Perth, WA, Australia.
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Cortina G, Wiesmayr S, Jungraithmayr T, Roussinow D, Nekahm-Heis D, Zorowka P, Zimmerhackl LB. Successful implantation of a cochlear implant in a four-yr-old boy after kidney transplantation: a case report. Pediatr Transplant 2009; 13:933-5. [PMID: 19032419 DOI: 10.1111/j.1399-3046.2008.01090.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sensorineural hearing loss is common in children with chronic renal insufficiency. The implantation of a CI is performed routinely in children with profound sensorineural hearing loss. A feared complication is a local infection with subsequent meningitis. Because of this risk, a successful implantation of a CI in children under immunosuppression after kidney transplantation has yet to be described. A four-yr-old boy with congenital renal dysplasia and posterior urethral valves, who was successfully transplanted with a kidney from his father at the age of two and a half yr, is presented. The boy had profound bilateral hearing loss before transplantation, most likely due to ototoxic antibiotic medication and long-term furosemide use. A hearing aid was insufficient; therefore, a CI was performed 20 months after the transplantation and no complications occurred in the 24 months of follow-up. This is the first report of a successful CI in a child after kidney transplantation.
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Affiliation(s)
- G Cortina
- Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria
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24
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Abdelwhab S, Lotfy G, Abdelmaksoud S. Relation between Asymmetric Dimethylarginine (ADMA) and Hearing Loss in Patients with Renal Impairment. Ren Fail 2009; 30:877-83. [DOI: 10.1080/08860220802356556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Aspris AK, Thodi CD, Balatsouras DG, Thodis ED, Vargemezis V, Danielides V. Auditory brainstem responses in patients under treatment of hemodialysis. Ren Fail 2008; 30:383-90. [PMID: 18569911 DOI: 10.1080/08860220801947405] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
This study evaluated the effects of end stage chronic renal failure (CRF) on auditory function and changes in auditory function following a single session of hemodialysis. The experimental group included 31 patients with end-stage renal failure on chronic hemodialysis. The control group consisted of 31 healthy volunteers. The patients were examined prior to and following a session of hemodialysis. Measurements included pure tone audiometry, tympanometry and acoustic reflex measurements, auditory brainstem responses (ABR), and blood now chemistry parameters. Controls underwent the same test battery, with the exception of biochemical and hematological assessment. Prior to hemodialysis sessions, all ABR latencies except interpeak latency I-III were significantly prolonged in the experimental group. A comparison between controls and the experimental group following hemodialysis indicated that wave V absolute latency and interpeak latencies III-V and I-V were significantly prolonged in the slow repetition rate paradigm. In the fast repetition rate, absolute latencies of waves I and V and III-V interpeak latencies were prolonged in the experimental group. Comparison of ABR recordings prior to and following hemodialysis showed overall significant difference between the measures. Post hoc analysis showed a significant improvement in wave I and V latencies in the slow repetition rate and wave V latency in the fast repetition rate. This study showed that neural conduction along the auditory pathway is delayed in patients with end stage CRF as compared to healthy subjects. Dialysis sessions improve overall neural auditory function. However, patients with end stage CRF show delayed conduction even after a session of hemodialysis.
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Orendorz-Frączkowska K, Medyńska A, Jabłonka A, Gawron W. Stan czynnościowy narządu słuchu w zespole nerczycowym w przebiegu pierwotnej glomerulopatii u dzieci. Otolaryngol Pol 2008; 62:182-7. [DOI: 10.1016/s0030-6657(08)70237-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bains KS, Chopra H, Sandhu JS, Aulakh BS. Cochlear Function in Chronic Kidney Disease and Renal Transplantation: A Longitudinal Study. Transplant Proc 2007; 39:1465-8. [PMID: 17580163 DOI: 10.1016/j.transproceed.2007.02.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 02/23/2007] [Indexed: 10/23/2022]
Abstract
Hearing loss on pure-tone and brainstem-evoked response audiometry is well documented in chronic kidney disease patients, but there are only scant data in renal allograft recipients. The aim of this study was to evaluate cochlear function on pure-tone and brainstem-evoked response audiometry among patients of chronic kidney disease to document changes after renal transplantation. The study included 20 healthy controls and 40 patients: 10 each at stage 3 and 4 and 20 with stage 5 chronic kidney disease. Patients with known causes for hearing loss were not included. Patients with stage 5 chronic kidney disease were reevaluated 1 year after renal transplantation. Compared with healthy controls, chronic kidney disease patients showed a highly significant bilateral sensorineural hearing loss at all frequencies of 0.25 to 8.0 kHz, which was more marked in higher frequencies. A highly significant delay in the latencies of waves I, III, and V and interpeak latencies of I to III and I to V was also noted on brainstem-evoked response audiometry. Compared with their pretransplant values, there was a significant improvement in the delay in absolute latencies of I, III, and V among renal allograft recipients. There was no correlation of audiometry findings with gender, degree of renal failure, and serum sodium. Hearing loss was seen in 70% of stage 3 and 4 chronic kidney disease and 60% in stage 5. The intensity of hearing loss was variable. In conclusion, chronic kidney disease patients shows definitive audiologic dysfunction with some improvement in hearing and wave latencies after successful renal transplantation.
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Affiliation(s)
- K S Bains
- Department of Nephrology, Dayanand Medical College, 1101/1 Tagore Nagar, Ludhiana, Punjab 141001, India
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Gerson AC, Butler R, Moxey-Mims M, Wentz A, Shinnar S, Lande MB, Mendley SR, Warady BA, Furth SL, Hooper SR. Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors. ACTA ACUST UNITED AC 2006; 12:208-15. [PMID: 17061289 DOI: 10.1002/mrdd.20116] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.
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Affiliation(s)
- Arlene C Gerson
- Department of Pediatrics, Johns Hopkins University Medical Institute, Baltimore, Maryland, USA.
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Gipson DS, Wetherington CE, Duquette PJ, Hooper SR. The nervous system and chronic kidney disease in children. Pediatr Nephrol 2004; 19:832-9. [PMID: 15221430 PMCID: PMC1989764 DOI: 10.1007/s00467-004-1532-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2003] [Revised: 04/15/2004] [Accepted: 04/27/2004] [Indexed: 11/25/2022]
Abstract
This paper provides a review of the literature on the nervous system involvement incurred by children and adolescents with chronic kidney disease (CKD), with a particular focus on neuropsychological functioning. In addition to an historical overview of earlier literature, published studies from the past 14 years that address both central and peripheral nervous system function in children with CKD are reviewed (1990-2003). These studies span work in neuroimaging, electrophysiology, and neuropsychology. A key focus for this review is on variables that might affect neurodevelopmental status in these children. The paper concludes with suggestions for achieving progress in the understanding of this complication of kidney disease in children.
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Affiliation(s)
- Debbie S Gipson
- Division of Nephrology and Hypertension, University of North Carolina, 349 MacNider Hall, Campus Box 7155, NC 27599-7155, Chapel Hill, USA.
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Abstract
Bacterial peritonitis is a major threat to long-term peritoneal membrane function in pediatric patients receiving chronic peritoneal dialysis (CPD). This review summarizes the demographics, risk factors, and current recommendations regarding diagnostic procedures, management, and prevention of peritonitis in children. Albeit decreasing in incidence, bacterial peritonitis remains a major cause of technique failure in children with endstage renal disease receiving CPD. The use of standardized diagnostic procedures, efficacious antibacterial treatment, and objective response criteria are crucial in improving the outcome of this complication. Current guidelines recommend combining a first- and third-generation cephalosporin for empiric therapy in uncomplicated cases. The initial use of a glycopeptide/third-generation cephalosporin combination should be restricted to patients with risk factors for severe disease, as defined by clinical presentation, young age (<2 years), and recent infection with a methicillin resistant micro-organism. Several risk factors for primary or relapsing peritonitis have been identified, some of which are amenable to preventive measures. These relate to catheter design and implantation technique, connection methodology, early catheter removal in refractory or relapsing peritonitis, and eradication of Staphylococcus aureus from the catheter exit site and/or nasal reservoirs in patients and their caregivers.
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Affiliation(s)
- Franz Schaefer
- Division of Pediatric Nephrology, University Children's Hospital Heidelberg, Heidelberg, Germany.
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31
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Qvist E, Pihko H, Fagerudd P, Valanne L, Lamminranta S, Karikoski J, Sainio K, Rönnholm K, Jalanko H, Holmberg C. Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood. Pediatr Transplant 2002; 6:53-62. [PMID: 11906644 DOI: 10.1034/j.1399-3046.2002.1o040.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Patient and graft survival rates of pediatric renal transplant recipients are currently excellent, but there are few reports regarding the long-term neurodevelopmental outcome after renal transplantation (Tx) in early childhood. Children with renal failure from infancy would be expected to have a less favorable developmental prognosis. We report the neurodevelopmental outcome in 33 school-age children transplanted between 1987 and 1995 when < 5 yr of age. We prospectively performed a neurological examination, magnetic resonance imaging (MRI) of the brain, electroencephalograms (EEGs), audiometry, and neuropsychological tests (NEPSY), and measured cognitive performance (WISC-R); we related these results to school performance and to retrospective risk factors prior to Tx. Twenty-six (79%) children attended normal school and 76% had normal motor performance. Six of the seven children attending a special school had brain infarcts on MRI. The EEG was abnormal in 11 (35%), and five (15%) received anti-convulsive treatment after Tx. Sensorineural hearing loss was documented in six patients. The mean intelligence quotient (IQ) was 87, and 6-24% showed impairment in neuropsychological tests. The children attending a special school had been more premature, but had not had a greater number of pre- or neonatal complications. They had experienced a greater number of hypertensive crises (p = 0.002) and seizures (p = 0.03), mainly during dialysis, but the number of septic infections and the mean serum aluminum levels were not significantly greater than in the children with normal school performance. In these previously lethal diseases, the overall neurodevelopmental outcome is reassuring. However, it is of crucial importance to further minimize the risk factors prior to Tx.
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Affiliation(s)
- Erik Qvist
- Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
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Stavroulaki P, Nikolopoulos TP, Psarommatis I, Apostolopoulos N. Hearing evaluation with distortion-product otoacoustic emissions in young patients undergoing haemodialysis. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2001; 26:235-42. [PMID: 11437849 DOI: 10.1046/j.0307-7772.2001.00464.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sensorineural hearing loss is frequently reported in young patients with chronic renal failure having haemodialysis. The effect of a single session of haemodialysis on hearing acuity was assessed prospectively in nine children with end-stage renal disease using pure-tone audiometry (PTA) and distortion-product otoacoustic emissions (DPOAEs). Results were compared with those obtained from nine audiologically normal healthy children also tested with PTA and DPOAEs twice during a 4-h interval. Sensorineural hearing loss of unknown aetiology was found in 55.5% of renal patients, mainly in the higher frequencies. Patients on HD had mean PTA thresholds significantly poorer than those of the control group in the frequency range 1000-12 000Hz (P < 0.05). Their mean DPOAE amplitudes were significantly lower in all frequencies > 1184 Hz (P < 0.05). Furthermore, patients' ears with normal PTA thresholds between 250 and 4000 Hz also had decreased DPOAE amplitudes. No significant changes in PTA thresholds or DPOAE amplitudes were encountered in renal patients before and after a HD session (P > 0.05). Changes in PTA thresholds or DPOAE amplitudes were not significantly different than those in the control group (P > 0.05). In conclusion, sensorineural hearing loss of unknown origin, especially in high frequencies, is frequent in young renal patients under HD and single HD sessions do not seem to alter the hearing acuity of these patients. DPOAEs seem to be more sensitive to incipient cochlear damage than behaviour thresholds in monitoring renal patients.
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Affiliation(s)
- P Stavroulaki
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital 'P. & A. Kyriakou', Athens, Greece.
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de los Santos CA, Baú AR, d'Avila DO, de Souza EO, Moussalle S, Gomes NH. Audiometric changes in patients undergoing hemodialysis and renal transplantation. Transplant Proc 1999; 31:3011-2. [PMID: 10578369 DOI: 10.1016/s0041-1345(99)00646-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- C A de los Santos
- Department of Internal Medicine (Division of Nephrology), PUCRS School of Medicine, Porto Alegre, Brazil
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