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Li J, Nie J, Zhou Z, Guo M, Yang Q, Yuan D, Huang J, Li R, Li Q. Changes of FGF23 and hearing in chronic renal failure and their correlation analysis. Cytokine 2024; 174:156478. [PMID: 38134554 DOI: 10.1016/j.cyto.2023.156478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND To explore the association between fibroblast growth factor 23 (FGF23) and hearing in chronic renal failure (CRF). METHODS Pure tone audiometry was used to detect the hearing of patients with CRF; the level of serum FGF23, creatinine, blood urea nitrogen (BUN), parathyroid hormone (PTH), and mean binaural hearing threshold were compared to the control group (people without kidney disease). The rat model of renal failure was established by 5/6 nephrectomy, and the auditory brainstem response (ABR) of rats after modeling was detected by the Tucker Davis Technologies (TDT) system; the expression level of FGF23 in the peripheral blood, renal and cochlear tissue was also detected. RESULTS The incidence of hearing loss (HL) and serum FGF23 were higher in CRF patients than the control group; the sFGF23 was positively correlated with the mean binaural hearing threshold. Animal studies showed that the ABR threshold, creatinine, FGF23, BUN, and PTH increased after modeling; although, an increase in FGF23 was observed earlier than other indicators. The HL of rats with renal failure was significantly correlated with BUN, phosphate, PTH, sFGF23, kFGF23/β-actin, eFGF23/β-actin, weight, and modeling cycle. CONCLUSIONS Both CRF patients and rat models showed high-frequency HL. FGF23 was highly expressed in the serum of HL renal failure patients and rats, as well as in the renal tissue and cochlea of renal failure rats. Therefore, FGF23 may be involved in the occurrence and development of HL caused by CRF.
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Affiliation(s)
- Jiaqing Li
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingwen Nie
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhu Zhou
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Min Guo
- Department of Otolaryngology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qing Yang
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dunlu Yuan
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingjing Huang
- Department of Medical Record, The Third People's Hospital of Kunming, Kunming, China
| | - Ruomei Li
- Department of Otolaryngology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qing Li
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
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Acree L, Day T, Groves MW, Waller JL, Bollag WB, Tran SY, Padala S, Baer SL. Deep neck space infections in end-stage renal disease patients: Prevalence and mortality. J Investig Med 2024; 72:220-232. [PMID: 38102746 DOI: 10.1177/10815589231222198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Deep neck space infections (DNSI) are severe infections within the layers of neck fascia that are known to be associated with underlying immunocompromised states. Although uremia associated with kidney disease is known to cause immune system dysfunction, DNSI in patients with kidney disease has been poorly studied. This study investigated the prevalence of DNSI and the associated risk of mortality within the United States end-stage renal disease (ESRD) population, using a retrospective cohort study design and the United States Renal Data System database of patients (ages 18-100) who initiated dialysis therapy between 2005 and 2019. International Classification of Disease-9 and -10 codes were used to identify the diagnosis of DNSI and comorbid conditions. Of the 705,891 included patients, 2.2% had a diagnosis of DNSI. Variables associated with increased risk of DNSI were female sex, black compared to white race, catheter, or graft compared to arteriovenous fistula (AVF) access, autoimmune disease, chronic tonsillitis, diagnoses in the Charlson Comorbidity Index (CCI), tobacco use, and alcohol dependence. DNSI diagnosis was an independent risk factor for mortality, which was also associated with other comorbidity factors such as older age, catheter or graft compared to AVF access, comorbidities in the CCI, tobacco use, and alcohol dependence. Because of the increased mortality risk of DSNI in the ESRD population, health professionals should encourage good oral hygiene practices and smoking cessation, and they should closely monitor these patients to reduce poor outcomes.
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Affiliation(s)
- Lillian Acree
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Tyler Day
- Department of Dentistry, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Michael W Groves
- Department of Otolaryngology - Head and Neck Surgery, Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Medicine Augusta University, Augusta, GA, USA
- Departments of Physiology, Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Sarah Y Tran
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
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Kara İ, Öztürk İ, Doğaner A, Yıldız MG, Güzel FB, Kılıç A, Orhan İ, Altınören O. The effect of autosomal dominant polycystic kidney disease on mucociliary clearance. Eur Arch Otorhinolaryngol 2023; 280:2359-2364. [PMID: 36854810 DOI: 10.1007/s00405-023-07891-4] [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: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Autosomal dominant polycystic kidney disease (ADPKD) is a renal disease with genetic transmisson. Mutations in the PKD1 and PKD2 genes, which encode integral membrane proteins of the cilia of primary renal tubule epithelial cells, are seen in ADPKD. The aim of this study was to evaluate the sinonasal epithelium, which is epithelium with cilia, by measuring the nasal mucociliary clearance time, and to investigate the effect of ADPKD on nasal mucociliary clearance. METHODS The study included 34 patients, selected from patients followed up in the Nephrology Clinic, and 34 age and gender-matched control group subjects. The nasal mucociliary clearance time (NMCT) was measured with the saccharin test. RESULTS The mean age of the study subjects was 47.15 ± 14.16 years in the patient group and 47.65 ± 13.85 years in the control group. The eGFR rate was determined as mean 72.06 ± 34.26 mL/min in the patient group and 99.79 ± 17.22 mL/min in the control group (p < 0.001). The NMCT was determined to be statistically significantly longer in the patient group (903.6 ± 487.8 s) than in the control group (580 ± 259 s) (p = 0.006). CONCLUSIONS The study results showed that the NMCT was statistically significantly longer in patients with ADPKD compared to the control group, but in the linear regression analysis results, no correlation was determined between eGFR and NMCT.
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Affiliation(s)
- İrfan Kara
- Department of Otorhinolaryngology, Medical Faculty, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey.
| | - İlyas Öztürk
- Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - Adem Doğaner
- Department of Bioistatistics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Muhammed Gazi Yıldız
- Department of Otolaryngology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - Fatma Betül Güzel
- Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - Ahmet Kılıç
- Department of Otolaryngology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - İsrafil Orhan
- Department of Otolaryngology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - Orçun Altınören
- Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
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Simsir M, Yildiz MG, Karatas M, Dalgic A, Ozturk I, Tatar E, Eren N, Erken E, Gungor O, Altunoren O. Hearing Impairments as an Overlooked Condition in Kidney Transplant Recipients. Transpl Int 2022; 35:10198. [PMID: 35497888 PMCID: PMC9039001 DOI: 10.3389/ti.2022.10198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/17/2022] [Indexed: 11/13/2022]
Abstract
It is not known whether hearing disorders improves with kidney transplantation. One of the neurotoxic effects of immunosuppressive drugs may be unrecognized hearing loss. In this study, our aim was to evaluate the hearing disorders in kidney transplant patients. Hearing problems in 46 kidney transplant patients [eGFR ≥ 60 ml/min/1.73 m2 (30 Tacrolimus, 16 mTOR inhibitor users)], 23 hemodialysis patients, and 20 healthy controls were evaluated with a questionnaire and high-frequency audiometry. More than half (58.7%) of the transplant patients had at least one hearing problem. Hearing loss was observed in 50%, 60.9% and 76.1% of the transplant patients at 8,000, 16,000 and 20,000 Hz. Hearing thresholds of transplant and hemodialysis patients increased from 4,000 to 20,000 Hz and was higher than that of controls. Hearing thresholds were higher at 1,000–2,000 Hz in patients using tacrolimus and at 16,000–20,000 Hz in patients using mTOR inhibitor. No correlation was found between hearing threshold and blood tacrolimus or mTOR inhibitor levels. Most kidney transplant and hemodialysis patients have hearing loss at higher frequencies than medium frequencies. Hearing loss in chronic kidney patients is likely to be permanent and kidney transplantation may not improve hearing problems. Hearing problems may be more pronounced at medium frequencies in patients receiving tacrolimus but at higher frequencies in patients receiving mTOR inhibitors.
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Affiliation(s)
- Melis Simsir
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Muhammed Gazi Yildiz
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Murat Karatas
- Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Abdullah Dalgic
- Department of Otolaryngology Head and Neck Surgery, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Ilyas Ozturk
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Erhan Tatar
- Department of Nephrology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Necmi Eren
- Department of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ertugrul Erken
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ozkan Gungor
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Orcun Altunoren
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Purnami N, Roosmilasari A, Artono A, Mardiana N. Correlation between blood urea nitrogen level and cochlear outer hair cell function in non-dialysis chronic kidney disease patients. J Public Health Res 2022; 11. [PMID: 35285593 PMCID: PMC8973202 DOI: 10.4081/jphr.2022.2533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Hearing loss due to impaired cochlear function, which results from increased blood urea nitrogen (BUN) level, is one of the important clinical problems in chronic kidney disease (CKD) patients with uremia. This study aims to determine correlation between blood urea nitrogen (BUN) levels and cochlear outer hair cell (OHC) dysfunction in non-dialysis stage 3-5 CKD patients so that the BUN levels may also be used to determine the presence of cochlear OHC dysfunction. Design and methods: An observational analytic study with a cross sectional design and consecutive sampling. This study was conducted from November 2019 to February 2020 at the Department of Internal Medicine, Soetomo Hospital, Surabaya, Indonesia, and Otorhinolaryngology-Head and Neck Surgery Department, Soetomo Hospital, Surabaya, Indonesia. Non-dialysis CKD patients who met the inclusion and exclusion criteria were subjected to a Distortion Product Otoacoustic Emissions (DPOAE) test to assess cochlear OHC function at the Otorhinolaryngology- Head and Neck Surgery, Soetomo Hospital, Surabaya. Results: Female patients were in larger number than male patients in a ratio of 1 : 2. Most of the patients were between 51-60 years of age. DPOAE distribution was refer in 25 patients (83.3%) and pass in 5 patients (16.7%). The highest pass was at 2000 Hz in 24 patients (80.0%), while the refer results were mostly at 12,000 Hz in 29 patients (96.7%). The highest average signal to noise ratio (SNR) was at 2000 Hz and 4000 Hz (12.77 dB and 11.13 dB), while the lowest at 11,000 Hz and 12,000 Hz (1.60 dB and 1.03 dB). Pearson’s correlation test on DPOAE results did not show a significant correlation (p>0.05) between BUN levels and impaired cochlear OHC function. Conclusions: There was no correlation between increased blood urea nitrogen levels and cochlear outer hair cell function disorders in non-dialysis patients with CKD stage 3-5. Significance for public health One of the most commonly found disabilities in the world is hearing loss, which has a prevalence of 5% of the world population or affecting 466 million people. One that contributes to the prevalence of hearing loss is Chronic Kidney Disease (CKD). Its contribution to hearing loss prevalence may reach 45% to 80%. This is because CKD itself may cause malfunctions of some organs, including auditory organs. Therefore, early detection of hearing loss among patients with CKD is necessary by determining correlation of a kidney disease marker, the blood urea nitrogen (BUN), and cochlear Outer Hair Cell (OHC) dysfunction. The otoacoustic emission examination (OAE) should be used to detect cochlear dysfunction as it has 95% sensitivity and 90% specificity. It was expected that by the finding of correlation between BUN levels and cochlear OHC dysfunction in CKD patients, possible hearing loss of these patients can be anticipated early.
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Affiliation(s)
- Nyilo Purnami
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic Medical Center, Surabaya.
| | - Alfarika Roosmilasari
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic Medical Center, Surabaya.
| | - Artono Artono
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic Medical Center, Surabaya.
| | - Nunuk Mardiana
- 2Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic Medical Center, Surabaya.
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Corona R, Ordaz B, Robles-Osorio L, Sabath E, Morales T. Neuroimmunoendocrine Link Between Chronic Kidney Disease and Olfactory Deficits. Front Integr Neurosci 2022; 16:763986. [PMID: 35173591 PMCID: PMC8841736 DOI: 10.3389/fnint.2022.763986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022] Open
Abstract
Chronic kidney disease (CKD) is a multifactorial pathology that progressively leads to the deterioration of metabolic functions and results from deficient glomerular filtration and electrolyte imbalance. Its economic impact on public health is challenging. Mexico has a high prevalence of CKD that is strongly associated with some of the most common metabolic disorders like diabetes and hypertension. The gradual loss of kidney functions provokes an inflammatory state and endocrine alterations affecting several systems. High serum levels of prolactin have been associated with CKD progression, inflammation, and olfactory function. Also, the nutritional status is altered due to impaired renal function. The decrease in calorie and protein intake is often accompanied by malnutrition, which can be severe at advanced stages of the disease. Nutrition and olfactory functioning are closely interconnected, and CKD patients often complain of olfactory deficits, which ultimately can lead to deficient food intake. CKD patients present a wide range of deficits in olfaction like odor discrimination, identification, and detection threshold. The chronic inflammatory status in CKD damages the olfactory epithelium leading to deficiencies in the chemical detection of odor molecules. Additionally, the decline in cognitive functioning impairs the capacity of odor differentiation. It is not clear whether peritoneal dialysis and hemodialysis improve the olfactory deficits, but renal transplants have a strong positive effect. In the present review, we discuss whether the olfactory deficiencies caused by CKD are the result of the induced inflammatory state, the hyperprolactinemia, or a combination of both.
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Affiliation(s)
- Rebeca Corona
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Benito Ordaz
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | | | - Ernesto Sabath
- Facultad de Nutrición, Universidad Autónoma de Querétaro, Querétaro, Mexico
| | - Teresa Morales
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
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Vengalasetti YV, Chertow GM, Popat R. Dysgeusia and Dysosmia in Chronic Kidney Disease: NHANES 2011-2014. J Ren Nutr 2021; 32:537-541. [DOI: 10.1053/j.jrn.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/21/2021] [Accepted: 11/03/2021] [Indexed: 11/11/2022] Open
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Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière's disease: a nationwide cohort study. Sci Rep 2021; 11:20194. [PMID: 34642430 PMCID: PMC8511089 DOI: 10.1038/s41598-021-99792-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Several studies have demonstrated the harmful effects of chronic kidney disease (CKD) on the audiovestibular system. Through a time-to-event analysis, we aimed to compare the association of CKD with sudden sensorineural hearing loss (SSNHL), and Ménière’s disease against a control population without CKD. We used a total of 1,025,340 patients from the Korean National Health Insurance Service database from 2002 to 2013. The CKD group (n = 2572) included patients diagnosed with CKD more than three times between January 2003 and December 2005. The non-CKD group (n = 5144) consisted of two patients without CKD for every patient with CKD. Each patient was monitored until December 2013. We calculated the incidence, survival rate, and hazards ratio (HR) of SSNHL and Ménière’s disease. In the CKD group, the incidence of SSNHL and Ménière’s disease was 1.39 and 3.64 per 1000 person-years, respectively. Patients with CKD showed an adjusted HR of 2.15 and 1.45 for SSNHL and Ménière’s disease, respectively. Middle-aged patients with CKD were associated with a higher incidence of developing SSNHL and Ménière’s disease than those without CKD. Female patients with CKD had a higher risk of developing SSNHL; however, there was no significant difference in the risk of Ménière’s disease in patients with CKD according to sex. Our findings suggest that CKD is associated with an increased incidence of SSNHL and Ménière’s disease. Therefore, audiovestibular surveillance should be considered in patients with CKD.
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Ezzatt OM, Hamed MG, Gamil Y. Oropharyngeal and otorhinological changes in end stage renal patients undergoing hemodialysis. J Clin Exp Dent 2021; 13:e701-e708. [PMID: 34306534 PMCID: PMC8291163 DOI: 10.4317/jced.58292] [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: 02/02/2021] [Accepted: 04/16/2021] [Indexed: 11/03/2022] Open
Abstract
Background The study aimed to assess oropharyngeal and otorhinolaryngological changes in end stage renal disease (ESRD) patients undergoing hemodialysis and correlate the findings to renal functions. Material and Methods This case-control study compared oral and otorhinolaryngological findings in 85 patients with (ESRD) on maintenance hemodialysis to age and sex matched 85 healthy controls. Frequencies of findings were calculated and compared and correlation between biochemical and the oral health parameters in case group was determined using T-test, chi-square and Pearson correlation test (significance were set at P<0.05). Results The frequency of oral signs and mucosal symptoms were significantly higher among ESRD compared to healthy controls. Dry mouth (34.12%), bad odour (32.94%), increased tongue coating (50.59%) and pale mucosa (45.88%) were the most commonly reported. Otorhinolaryngological findings was higher in cases than in controls, with otomycosis (10.59%) and allergic rhinitis (5.88%) being the most frequent findings. Serum creatinine and blood urea mean levels were higher in ESRD patients with oral and otorhinolaryngological findings compared to those without findings. Conclusions Oral and nasal manifestations in patients with ESRD on maintenance hemodialysis were significantly higher in comparison to healthy individuals and were related to their serum creatinine and blood urea mean levels. Key words:Chronic kidney disease, renal dialysis, Oral manifestation, nasal, case control, Egypt.
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Affiliation(s)
- Ola M Ezzatt
- Associate professor in department of Oral Medicine, Periodontology, Oral Diagnosis and Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mohamed G Hamed
- Assistant professor in department of Otorhinolaryngology, Faculty of Medicine, Helwan University and ENT consultant in Arayah Hospital in Maadi, Cairo, Egypt
| | - Yasmine Gamil
- Lecturer in department of Oral Medicine, Periodontology and Oral Diagnosis. Faculty of Dentistry, Modern University of Information and Technology (MTI). Cairo, Egypt
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