Hearing loss in patients of chronic renal failure: a study of 100 cases

Central Auditory Processing Impairment in Renal Failure

This study is the first to investigate central auditory processing impairment in patients with slight decrease in renal function (PSR), who had no risk factors, evidence of renal injury, and albuminuria. The aim was to determine the scores of dichotic digits test (DDT) and word-in-noise perception (WINP) test in PSR. The survey was cross-sectional-comparative. The case group consisted of 30 PSR, with an estimated glomerular filtration rate of 60-90 mL/min at 1.73 m2. The control group consisted of 60 normal participants. They were matched with the case group based on sex, education level, dominant hand and age. The measures were the 28-item general health questionnaire, mini-mental state examination, Petersburg sleep quality index, acoustic immittance assessment, pure tone audiometry, speech reception threshold evaluation, DDT and WINP test. Both groups had normal stress levels, night sleep, mental states, and hearing thresholds. The mean scores of the WINP test in the right and left ears of the case group were significantly different from the control group (PvRight = 0.026, PvLeft = 0.029 ). The mean difference of DDT scores in the right and left ears of the case group compared to the control group showed significant difference (PvRight = 0.039, PvLeft = 0.048 ). Therefore, slight decrease in renal function can be one of the causes of central auditory processing impairment. Affected patients with normal hearing thresholds may have difficulty in discrimination the pitch of words, and speech perception in competing situations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-023-04345-5.

Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review

This article aims to ascertain the prevalence of loss of hearing in patients with chronic kidney disease (CKD) and also to examine potential causes of sensorineural hearing loss (SNHL) in patients suffering from CKD. It has been discovered in recent years that there is a relationship between the occurrence of SNHL and CKD. Nowadays many people are suffering from CKD. These patients deal with several otorhinolaryngological issues, such as SNHL, candidiasis, epistaxis, halitosis, dysgeusia, xerostomia, and lip and thyroid malignancies. One of the most frequent otorhinolaryngological complications is audiovestibular system impairment. There are various proposed mechanisms for the appearance of loss of hearing in people suffering from CKD. The kidney and the inner ear have multiple functional and structural similarities, which may be the cause of these problems in CKD patients. In addition, changes in the homeostasis of water and electrolytes can affect the endolymphatic fluid and result in endolymphatic hydrops. Finally, some medications, like aminoglycosides and loop diuretics, are well known for their ototoxicity and are utilized to treat patients with CKD. Only a small number of population-based research have so far been able to show a connection between CKD and audiovestibular system impairment. Some investigation has shown that CKD patients are more likely than healthy people to experience vestibular impairment. The quality of life of a patient can be reduced by hearing loss. People with hearing loss experience communication issues in daily life, which negatively affects their cognitive and psychosocial functioning. Social isolation and a poor quality of life in terms of health can all result from hearing loss. In addition, decreased renal function has also been linked to poor quality of life, hospitalization, and cognitive dysfunction.

Analysis of hearing prognosis risk factors in pediatric unilateral sudden sensorineural hearing loss

OBJECTIVES

Pediatric idiopathic sudden hearing loss (PISSNHL) is a rare disease with no established factor affecting its prognosis. In this study, we investigate the risk factors affecting the prognosis of PISSNHL.

MATERIAL AND METHODS

Among the patients who visited our hospital from January 2010 to December 2021, the characteristics associated prognosis of 54 patients with unilateral PISSNHL were retrospectively confirmed.

RESULTS

Patients' recovery was determined by applying Siegel's criteria (SC) and AAO-HNS criteria (AC). Twenty-seven (50 %) and 29 patients (54.3 %) recovered for SC and AC, respectively. Age, sex, side, duration between onset and treatment, administration of intra-tympanic steroid injection, accompanying symptoms (tinnitus and dizziness), BMI, serum creatinine level, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte count (PLR), lymphocyte count, and platelet count were not significantly different between the recovery group and the poor recovery group (P > 0.05). The patients were divided into five groups according to the initial hearing of the affected ear and again according to their audiogram type. The initial hearing levels, hearing level severity, and the audiogram type were significantly different between the deaf group (>100 dB HL) and the non-deaf group (P < 0.05).

CONCLUSION

The prognosis of PISSNHL is closely related to the initial hearing at the onset. If the initial hearing level is <100 dB, the recovery rate is approximately 50 %, therefore requiring active treatment and emotional support. It may also be related to the type of audiometric curve.

Association Between Sensorineural Hearing Loss and Various Stages of Chronic Kidney Disease

Objectives To compare the proportion of sensorineural hearing impairment (SHI) among patients of chronic kidney disease (CKD) stages 3&4 with CKD stage 5.

Materials and Methods This is a cross-sectional study of 30 patients with CKD stages 3 and 4 and 30 patients in stage 5. All patients had an audiological evaluation with pure tone audiometry.

Results Our study had 49 males (82%) and 11 females (18%), with the age ranging from 20 to 60 years (mean: 45.13 years). The mean SHI values in stage 3&4 were 28.44 dB and in CKD stage 5 was 31.22 dB. In the right ear, the mean hearing loss in stage 3, stage 4, and stage 5 was 28.17 dB, 28.67 dB, and 31.84 dB, respectively. In the left ear, the mean SHI values in stage 3, stage 4, and stage 5 were 27.05 dB, 31.89 dB, and 30.61 dB, respectively.

The mean SHI in stage 3&4 for age group 20 to 30 years was 13.66 dB, for 31 to 40 years was 26.33 dB, for 41 to 50 years was 35.18 dB, for 51 to 60 years was 37.12 dB. The mean SHI in stage 5 for the age group of 20 to 30 years was 16.48 dB, for 31 to 40 years was 28.29 dB, for 41 to 50 years was 31.82 dB, for 51 to 60 years was 34.35 dB. There was a significant correlation between hearing loss and CKD with respect to age (p < 0.001). The duration of renal illness and associated comorbidities was not a significant contributor to hearing loss in our study (p > 0.05).

Conclusion As per our study, with progression in the stage of chronic kidney disease, the hearing loss also increased indicating a possible link between the two. We also noted that the hearing loss increased with the increasing age.

Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière's disease: a nationwide cohort study

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.

Hearing loss among patients with type 2 diabetes mellitus: a cross-sectional study

BACKGROUND

Hearing loss is an underestimated comorbid condition in type 2 diabetes.

OBJECTIVES

Investigate hearing loss as a comorbidity associated with type 2 diabetes mellitus and evaluate the factors associated with hearing loss.

DESIGN

Cross-sectional.

SETTING

Tertiary care center, diabetes clinic.

PATIENTS AND METHODS

Patients with type 2 diabetes, aged 30 to 60 years, were randomly selected to participate. All patients underwent clinical ear examinations and were referred for full audiological evaluation. Otoacoustic emission was used to assess inner function, tympanometry to assess middle-ear function, and pure tone air/bone audiometry to assess hearing sensitivity. Risk factors for hearing loss were assessed by multivariate logistic regression.

MAIN OUTCOME MEASURE

Frequency, severity and risk factors for hearing loss.

SAMPLE SIZE

157 RESULTS: Of the 157 patients, 77 had hearing loss in both ears (49.0%), 13 in the right ear only (8.3%), 14 in the left ear only (8.9%), and 53 (33.8%) had normal hearing. In the 181 ears with sensorineural hearing loss, 90 had mild loss (49.7%), 69 moderate loss (38.2%), 16 severe loss (8.8%) and 6 had profound loss (3.3%). Disabling hearing loss was observed in 46 (29%) patients. A higher frequency of hearing loss was present in patients with glycated hemoglobin levels ≥8%. In the multivariate logistic regression analysis, the most important factors associated with hearing loss were longer diabetes duration, poor glycemic control and the presence of hypertension.

CONCLUSIONS

Hearing loss is an underestimated comorbid condition in type 2 diabetes that warrants frequent hearing assessments and management. Strict glycemic and hypertension control is essential for the minimization of the effects of diabetes on hearing sensitivity.

LIMITATIONS

Small sample size, limited age window (30-60 years), which was chosen to eliminate the natural aging effect on hearing. Cross-sectional nature was not ideal for the assessment of causality.

CONFLICT OF INTEREST

None.

The association between reduced kidney function and hearing loss: a cross-sectional study

Background

The relationship between kidney function and hearing loss has long been recognized, but evidence of this association mostly comes from small observational studies or other populations. The aim of this study is to explore the association between reduced kidney function and hearing loss in a large population-based study among the middle-aged and elderly Chinese.

Methods

Data collected from the Chinese Health and Retirement Longitudinal Study (CHARLS) in 2015 were used for analysis. A cross-sectional study was conducted among 12,508 participants aged 45 years and older. Hearing loss, the outcome of this study, was defined according to interviewees’ responses to three survey questions related to hearing in the CHARLS. Estimated glomerular filtration rate (eGFR) was employed to assess kidney function, and participants were classified into three categories based on eGFR: ≥90, 60–89 and < 60 mL/min/1.73 m². Multivariable logistic regression was employed to adjust for potential confounders, including demographics, health-related behaviors, and cardiovascular risk factors.

Results

The overall prevalence of self-reported hearing loss in the study population was 23.6%. Compared with participants with eGFR ≥90 mL/min/1.73 m², participants with eGFR of 60–89 mL/min/1.73 m² (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.00–1.23) and eGFR < 60 mL/min/1.73 m² (OR: 1.25, 95% CI: 1.04–1.49) showed increased risk of hearing loss after adjusting for potential confounders.

Conclusions

Reduced kidney function is independently associated with hearing loss. Testing for hearing should be included in the integrated management of patients with chronic kidney disease.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana

Background

Chronic kidney disease is a major public health challenge, globally. Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss.

Aim

The study was aimed at determining the prevalence, degrees and types of hearing impairment among Chronic kidney disease patients on haemodialysis in Ghana.

Methods

A case-control study involving 50 Chronic Kidney disease patients and 50 age and gender-matched control group was carried out at the Korle Bu Teaching Hospital (KBTH). A structured questionnaire was administered to obtain basic socio-demographic data and case history of the participants. Audiological assessment was performed using a test battery comprising otoscopy, tympanometry and pure tone audiometry in a soundproof booth.

Results

Higher hearing thresholds were recorded across all the frequencies tested among the case group than the control group (p < 0.05) in both ears. Only sensorineural hearing loss was identified among the cases. The prevalence of hearing loss was 32% among the case group and 12% among the control group. No significant association was observed between hearing loss and duration of Chronic kidney disease (p = 0.16), gender of Chronic kidney disease patient and hearing loss (p = 0.88), and duration of Chronic kidney disease and degree of hearing loss (p=0.31).

Conclusion

Our study showed that Chronic Kidney disease patients on haemodialysis are at higher risk of experiencing hearing loss.

Funding

None declared.

Otorhinolaryngological dysfunctions induced by chronic kidney disease in pre- and post-transplant stages

Purpose

Otorhinolaryngological abnormalities are common complications of chronic kidney disease (CKD) and its treatment. The main aim of this study was to provide a brief and precise review of the current knowledge regarding CKD and its treatment-related influence on head and neck organs.

Methods

The Medline and Web of Science databases were searched using the terms “chronic kidney disease”, “kidney transplantation”, “immunosuppression”, “dialysis” in conjunction with “otorhinolaryngological manifestation”. Articles that did not address the topics, low-quality studies, case reports, and studies based on nonsignificant cohorts were excluded, and the full text of remaining high-quality, novel articles were examined and elaborated on.

Results

Patients with CKD are prone to develop sensorineural hearing loss, tinnitus, recurrent epistaxis, opportunistic infections including oropharyngeal candidiasis or rhino-cerebral mucormycosis, taste and smell changes, phonatory and vestibular dysfunctions, deep neck infections, mucosal abnormalities, gingival hyperplasia, halitosis or xerostomia. Immunosuppressive therapy after kidney transplantation increases the risk of carcinogenesis, both related and not-related to latent viral infection. The most commonly viral-related neoplasms observed in these patients are oral and oropharyngeal cancers, whereas the majority of not-related to viral infection tumors constitute lip and thyroid cancers. CKD-related otorhinolaryngological dysfunctions are often permanent, difficult to control, have a significant negative influence on patient’s quality of life, and can be life threatening.

Conclusion

Patients with CKD suffer from a number of otorhinolaryngological CKD-induced complications. The relationship between several otorhinolaryngological complications and CKD was widely explained, whereas the correlation between the rest of them and CKD remains unclear. Further studies on this subject are necessary.

Hearing Evaluation in Patients with Chronic Renal Failure: A 1 Year Cross-Sectional Study in a Tertiary Care Centre

(1) To study the prevalence of sensorineural hearing loss among chronic renal failure patients. (2) To study the correlation between degree of hearing loss and the duration of chronic renal failure. This cross sectional study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery at KAHER's Jawaharlal Nehru Medical College and KLEs Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2018 to December 2018. 60 ears (30 patients) with chronic renal failure were included in the study. All 60 ears were subjected to ENT examination, pure tone audiometry and measurement of glomerular filtration rate. Patients with type 2 diabetes mellitus, suppurative otitis media, and other known causes of sensorineural hearing loss were excluded. The prevalence of sensorineural hearing loss was calculated among the chronic renal failure patients. The correlation, if any, was studied by statistical analysis between SNHL and duration of chronic renal failure, as well as type and degree of hearing loss. Sensorineural hearing loss was seen in 51.67% of the 60 ears with 18.33% had mixed hearing loss (p < 0.0001). Robust correlation was seen between severity of SNHL and the duration of chronic renal failure. Positive correlation was seen between SNHL and age of the patient. High prevalence of SNHL was seen in the chronic renal failure patients. Long standing cases had tendency of worse hearing levels. Age of the patients also seemed to have a positive correlation with SNHL severity. While evaluating a chronic renal failure patient, auditory impairment should always be kept in mind.

Otological and Visual Implications of Diabetes Mellitus in North Indian Population

The worldwide population of diabetic patients is increasing alarmingly with India claiming number one position. It causes irreversible damage to cochlear hair cells, vestibular apparatus, visual pathway, nephrons, nerves, if not checked in time. A total of 188 patients of diabetes mellitus were included in this prospective study. The patients underwent routine anamnesis, hearing handicap inventory and dizziness handicap inventory assessment along with clinical examination for audiological, vestibular, neurological and ophthalmological (fundoscopy) status. In our study a sensorineural hearing loss, retinopathy, neuropathy, vestibulopathy was seen in diabetic patients.

Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database

Introduction: The panorama of drug-induced ototoxicity has widened in the last decades; moreover, post-marketing data are necessary to gain a better insight on ototoxic adverse drug reactions (ADRs). The aim of this study was to perform an analysis of ADR reports describing drug-induced ototoxicity from the Italian spontaneous reporting system (SRS).

Methods: As a measure of disproportionality, we calculated the reporting odds ratios (RORs) and 95% confidence intervals (CIs) with a case/non-case methodology. Cases were all suspected ADR reports regarding drug-induced ototoxicity collected into the Italian SRS from 2001 to 2017. Non-cases included all other ADRs reported in the same period.

Results: Of 325,980 reports, 652 included at least one ototoxic ADR, compared with 325,328 non-cases. Statistically significant adjusted RORs were found for drugs for cardiovascular disorders, urologicals, teriparatide, amikacin, prulifloxacin, rifampicin and isoniazid, cisplatin, hormone antagonists, tacrolimus, pomalidomide, tramadol, and antidepressants. Significant adjusted RORs in relation to tinnitus were also observed for doxazosin (ROR 5.55, 95% CI 2.06–14.93), bisoprolol (4.28, 1.59–11.53), nebivolol (8.06, 3.32–19.56), ramipril (3.96, 2.17–7.23), irbesartan (19.60, 9.19–41.80), betamethasone (4.01, 1.28–12.52), moxifloxacin (4.56, 1.71–12.34), ethambutol (12.25, 3.89–38.57), efavirenz (16.82, 5.34–52.96), sofosbuvir/ledipasvir (5.95, 1.90–18.61), etoposide (7.09, 2.63–19.12), abatacept (6.51, 2.42–17.53), indometacin (6.30, 2.02–19.72), etoricoxib (5.00, 2.23–11.23), tapentadol (4.37, 1.09–17.62), and timolol combinations (23.29, 9.53–56.95). Moreover, significant adjusted RORs for hypoacusis regarded clarithromycin (3.95, 1.86–8.40), azithromycin (10.23, 5.03–20.79), vancomycin (6.72, 2.14–21.11), methotrexate (3.13, 1.00–9.81), pemetrexed (4.38, 1.40–13.76), vincristine (5.93, 1.88–18.70), vinorelbine (21.60, 8.83–52.82), paclitaxel (2.34, 1.03–5.30), rituximab (3.20, 1.19–8.63), interferon alfa-2b (17.44, 8.56–35.53), thalidomide (16.92, 6.92–41.38), and deferasirox (41.06, 20.07–84.01).

Conclusions: This study is largely consistent with results from literature. Nevertheless, propafenone, antituberculars, hormone antagonists, teriparatide, tramadol, and pomalidomide are unknown for being ototoxic. Hypoacusis after the use of vinorelbine, methotrexate, and pemetrexed is unexpected, such as tinnitus related with etoposide, nebivolol, betamethasone, abatacept, sofosbuvir/ledipasvir, and tapentadol, but these considerations require further investigation to better define the risk due to the paucity of data. Moreover, physicians should be aware of the clinical significance of ototoxicity and be conscious about the importance of their contribution to spontaneous reporting.

Idiopathic sudden sensorineural hearing loss in dialysis patients

Although sudden sensorineural hearing loss (SSNHL) affects chronic kidney disease (CKD) patients more frequently than non-CKD patients, few reports have described SSNHL in dialysis patients. We aimed to review the characteristics of SSNHL in chronic dialysis patients and evaluate treatment responses to steroid therapy. We retrospectively reviewed the records of dialysis patients diagnosed with idiopathic SSNHL at Asan Medical Center between January 2000 and December 2014. Pure tone and speech audiometry analyzes were performed before and 2 weeks and 2 months after treatment onset to evaluate outcomes. Twenty-two patients (11 men, 11 women; mean age: 49.9 ± 11.7 years) were included; 16 (72%) and 6 (28%) had undergone hemodialysis and peritoneal dialysis, respectively, for a median of 49.2 ± 41.4 (1–144) months. End-stage renal disease was most frequently caused by diabetic nephropathy (11 cases), chronic glomerulonephritis (1 case) and unknown factors (7 cases). Common accompanying symptoms included tinnitus (68.2%), ear fullness (45.5%) and vertigo (27.3%). The mean pure tone audiometry threshold at the initial presentation was 82.6 ± 22.4 dB. At 2 months post-steroid treatment, 4 (18.2%), 4 (18.2%) and 6 (27.3%) patients exhibited a complete, partial, or slight recovery, respectively; 8 patients (36.3%) showed no improvement. Although we could not identify the specific cause of SSNHL in this population, our relatively large case series elucidates the precise clinical features of SSNHL in this population and demonstrates the outcomes of steroid treatment.

Sensorineural hearing loss in patients with chronic renal failure on hemodialysis in Basrah, Iraq

Objectives:

The objective of this study is to determine the effect of hemodialysis on the hearing threshold in patients with chronic renal failure (CRF).

Materials and Methods:

Fifty-nine patients with CRF on regular hemodialysis were followed up for 1 year with a pure-tone audiometric examination every 6 months.

Results:

The mean age of the patients was 41.8 ± 9.2 years (range: 17–50 years). At the beginning of the study, 39 patients (66.1%) had sensorineural hearing loss (SNHL). During the 12-month follow-up, 6 more patients developed SNHL giving a point prevalence rate of 76.3% at the end of the study. The hearing loss was more evident in the higher frequencies. Of the studied patients, 64.4% showed deterioration of the hearing threshold. The mean hearing threshold at the beginning of the study was 29.2 ± 21.1 dB versus 36.9 ± 17.3 dB at the end of the study (P < 0.001). No significant relation was found between age, sex, serum electrolytes, blood urea, and duration of CRF and hearing loss. Multivariate analysis showed that the duration of hemodialysis was the only significant independent predictor of SNHL.

Conclusion:

SNHL is common in patients with CRF on hemodialysis. It was mild to moderate in the majority of patients. Hearing impairment was most obvious at the high frequencies. Most of the patients showed further deterioration in the hearing threshold with the duration of dialysis.

Audiological Profile in Primary Sjögren's Syndrome in a Tertiary Care Setting and its Clinical Implications

This study aims to assess the frequency and the profile of hearing loss among patients with primary Sjögren's syndrome in a tertiary care hospital in India and to look for an association between hearing loss and immunological parameters (anti-SSA antibody, anti-SSB antibody, anticardiolipin antibodies, complements C3 and C4). This prospective observational study was done from January 2011 to October 2011 on consecutive patients diagnosed with primary Sjögren's syndrome in our tertiary care hospital. All patients underwent a puretone audiogram, tympanogram and acoustic reflex testing. The results of the tests were correlated with clinical and immunological findings. The frequency of audiometrically confirmed hearing loss in primary Sjögren's syndrome was estimated to be 78.38 %, though only 17.24 % complained of hearing loss; minimal to mild sensorineural hearing loss were the most common varieties. The commonest finding on tympanometry was 'A' type curve and acoustic reflex was absent in 18.92 % of cases. There was no association between hearing loss and age, sicca symptoms, systemic symptoms or immunological test results in primary Sjögren's syndrome. There was a high prevalence of hearing loss among patients with primary Sjögren's syndrome, but most patients were unaware of this. Hearing assessment and regular monitoring of hearing thresholds is advisable for all patients with primary Sjögren's syndrome.

Association Between Hearing Impairment and Albuminuria in the Korean Adults: The 2011-2012 Korea National Health and Nutrition Examination Survey

Although the associations between albuminuria and renal and cardiovascular diseases, including diabetes and hypertension, have been extensively studied, few studies have investigated the association between albuminuria and hearing impairment. In this study, we assessed the relationship between albuminuria and hearing impairment in 9786 adult Korean subjects, using data from the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2011-2012. The range of urinary albumin-to-creatinine ratio (UACR) was divided into 4 grades: grade 1 (first tertile of low-grade albuminuria [LGA]), 0.00 to 1.99 mg/g Cr; grade 2 (second tertile of LGA), 2.00 to 5.49 mg/g Cr; grade 3 (third tertile of LGA), 5.50 to 29.99 mg/g Cr; grade 4 (albuminuria), ≥30.00 mg/g Cr.The age- and sex-adjusted weighted UACR was higher in subjects with hearing impairment compared with those without hearing impairment (26.2 ± 4.7 mg/g Cr vs 14.1 ± 1.5 mg/g Cr, P = 0.020). The age- and sex-adjusted weighted prevalence of albuminuria was also higher in subjects with hearing impairment compared with subjects without hearing impairment. (8.3 ± 0.9% vs 5.8 ± 0.4%, P = 0.013) The age- and sex-adjusted weighted percentage of hearing impairment increased as UACR increased (18.0% ± 0.6%, 20.0% ± 0.8%, 22.2% ± 0.9%, 25.3% ± 2.0%, respectively; P < 0.001). Logistic regression analyses were performed for hearing impairment by albuminuria, with age, sex, tobacco use, heavy alcohol use, educational background, occupational noise exposure, obesity, hypertension, diabetes, total serum cholesterol, and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m as covariates. Using grade 1 of UACR as the control, grade 3 (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.05-1.53, P = 0.005) and grade 4 (OR 1.41, 95% CI 1.04-1.90, P = 0.026) of UACR were correlated with hearing impairment, respectively. When the level of hearing impairment (dB) was analyzed as a continuous variable, it was positively correlated with log UACR (Spearman correlation, unadjusted r = 0.226, adjusted r = 0.076, P < 0.001).In conclusion, we are the first to demonstrate that albuminuria is associated with hearing impairment in the Korean general population, using nationally representative data. Screening for albuminuria would allow for interventions for the prevention of hearing impairment.

The prevalence and factors associated with hearing impairment in the Korean adults: the 2010-2012 Korea National Health and Nutrition Examination Survey (observational study)

There are few studies that have used audiometric testing to gauge the demographic characteristics and associated risk factors for hearing loss at the national-level. Here, we investigated the weighted prevalence and associated factors of hearing impairment in 16,040 Korean adult population. Subjects completed audiometric test and laboratory examination as part of the data from The 2010-2012 Korea National Health and Nutrition Examination Survey (KNHANES). In our respective study, the overall weighted (n = 33,762,584) prevalence of mild hearing impairment among the Korean adult population was 20.5% (95% clearance [CI], 19.6-21.6), whereas moderate-to-profound hearing impairment was 9.2% (95% CI, 8.6-9.9). The weighted prevalence of mild hearing impairment in younger adults (19-39 years' old) was 4.4% (3.5-5.5), in middle-age adults (40-64 years), it was 21.1% (19.8-22.5), and in older adults (≥65 years' old), it was 69.7% (67.8-71.6). Logistic regression analyses were performed for low/mid frequency or high-frequency mild hearing impairment with age, sex, tobacco use, heavy alcohol use, educational background, occupational noise exposure, obesity, hypertension, diabetes, total serum cholesterol, and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m² as covariates. The analyses revealed independent correlations between increased age, tobacco use, education, hypertension, and eGFR <60 mL/min/1.73m², and low/mid frequency and high frequency mild hearing impairment. High frequency mild hearing impairment was positively correlated with male sex, diabetes, and an increase in total serum cholesterol. Taken together, hearing impairment in Korea is highly prevalent with approximately one-fifth of Korean adult reporting mild hearing impairment. This study suggests that individuals with cardiovascular risk factors such as hypertension, diabetes, smoking, increased serum cholesterol, or decreased eGFR are at particular risk of developing hearing impairment. As such, these groups may benefit from hearing loss screening in addition to those groups typically considered to be of elevated risk including geriatrics, those of low socioeconomic status, and those with considerable occupational noise exposure.

Prevalence and patterns of hearing loss among chronic kidney disease patients undergoing haemodialysis

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.