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Kohansal B, fathollahzadeh S, Ghezeljeh AB, Najafi S, Saeidi N. A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis. Indian J Otolaryngol Head Neck Surg 2024; 76:2939-2947. [PMID: 39130234 PMCID: PMC11306716 DOI: 10.1007/s12070-024-04586-y] [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: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 08/13/2024] Open
Abstract
Objective Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Methods Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Results Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. Conclusion CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.
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Affiliation(s)
- Behieh Kohansal
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | - Saba fathollahzadeh
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | | | - Sirvan Najafi
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | - Nasser Saeidi
- Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Zou Y, Tang X, Rao K, Zhong Y, Chen X, Liang Y, Pi Y. Association between hearing loss, tinnitus, and chronic kidney disease: the NHANES 2015-2018. Front Med (Lausanne) 2024; 11:1426609. [PMID: 39099598 PMCID: PMC11294234 DOI: 10.3389/fmed.2024.1426609] [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: 05/01/2024] [Accepted: 07/10/2024] [Indexed: 08/06/2024] Open
Abstract
Background Previous studies suggested that chronic kidney disease (CKD) might contribute to hearing loss and tinnitus. Patients with CKD are often at risk of sudden onset hearing loss and tinnitus; however, few epidemiological investigations have been conducted on this topic. The purpose of this investigation was to analyze the correlation between hearing loss, tinnitus, and CKD based on information obtained from the National Health and Nutrition Examination Survey (NHANES). Methods Using data from the NHANES 2015-2018, a cross-sectional analysis was conducted, which included 5,131 participants, and used multivariate logistic regression analyses and subgroup analysis to investigate the association between hearing loss, tinnitus, and CKD. Results CKD was associated independently with hearing loss, with the CKD group being more at risk of hearing loss than the non-CKD group [age-adjusted 95% confidence interval (CI): 1.54 (1.31-1.8), p < 0.001]; multivariable-adjusted 95% CI: 1.31 (1.1-1.55), p = 0.002. Multifactorial logistic regression analysis did not find an association between CKD and tinnitus, however, further subgroup analyses showed a relationship in some populations. Conclusion The results suggested that CKD is associated with hearing loss and tinnitus. The complexity of the relationship between CKD and hearing loss requires further research.
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Affiliation(s)
| | | | | | | | | | - Yuyan Liang
- Seventh Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Ying Pi
- Seventh Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
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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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Kumar K, Sengolraj L, Kalaiah MK. The Effect of Hemodialysis on Spectral and Temporal Processing Abilities and Speech Perception in Noise among Individuals with Chronic Kidney Disease. Audiol Neurootol 2023; 29:60-66. [PMID: 37586357 DOI: 10.1159/000533165] [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: 04/10/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION The effect of chronic kidney disease (CKD) on hearing is well documented in the literature. Several studies have investigated the effect of hemodialysis on the peripheral auditory system among individuals with CKD. However, studies investigating the effect of hemodialysis on speech perception and auditory processing abilities are limited. The present study investigated the effect of hemodialysis on few auditory processing abilities and speech perception in noise among adults with CKD. METHODS A total of 25 adults with CKD undergoing hemodialysis regularly participated in the study. Spectral ripple discrimination threshold (SRDT), gap detection threshold (GDT), amplitude-modulation detection threshold (AMDT), and speech recognition threshold in noise (SRTn) were measured before and after hemodialysis. Paired samples "t" test was carried out to investigate the effect of hemodialysis on thresholds. RESULTS Results showed a significant improvement for SRDT, GDT, AMDT, and SRTn after hemodialysis among individuals with CKD. DISCUSSION Hemodialysis showed a positive effect on speech perception in noise and auditory processing abilities among individuals with CKD.
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Affiliation(s)
- Kaushlendra Kumar
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Livingston Sengolraj
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Mohan Kumar Kalaiah
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Assessment of hearing levels in children with nephrotic syndrome. Int J Pediatr Otorhinolaryngol 2022; 160:111230. [PMID: 35835030 DOI: 10.1016/j.ijporl.2022.111230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 06/12/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Due to the similarities in the physiological mechanisms and antigenicity of the kidney and cochlea, they are simultaneously affected by certain diseases and drugs. Therefore, the purpose of this study was to investigate whether the hearing functions of patients with nephrotic syndrome (NS) were affected by the severity of the disease and the cyclosporine treatment. METHODS The sample of this study consisted of 87 participants, including 65 patients (130 ears) with NS and 22 age- and sex-matched normal hearing children (44 ears). Based on the severity of the disease, the patients were divided into two groups: infrequently relapsing nephrotic syndrome (IRNS) and steroid-dependent or frequently relapsing nephrotic syndrome (SD/FRNS). Their audiologic tests, including Pure-tone Audiometry and Distortion-Product Otoacoustic Emission (DPOAE), were compared with the tests of the control group. In addition, the audiologic tests of the NS patients who received cyclosporine were compared with those who did not. RESULTS In the pure-tone audiometry, there were statistically significant differences between the IRNS, SD/FRNS, and control groups at 2000, 4000 Hz, and pure-tone average (PTA). Hearing levels of the SD/FRNS group at 2000, 4000 Hz, and PTA were higher than those of the control group. At 6000 Hz in pure-tone audiometry, there was a very weak positive correlation between the hearing level and the number of relapses. At 250 Hz and PTA, hearing levels of the group that received cyclosporine were higher compared to the group that did not receive it. In DPOAE, there was no significant difference between the groups according to the severity of the disease and the use of cyclosporine. CONCLUSION During the follow-up of the patients with NS, their hearing functions should be questioned, especially in patients with SD/FRNS and receiving cyclosporine treatment.
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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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Kumar K, Sengolraj L, Kalaiah MK. Temporal processing, spectral processing, and speech perception in noise abilities among individuals with chronic kidney disease undergoing hemodialysis. Acta Otolaryngol 2021; 141:768-772. [PMID: 34289322 DOI: 10.1080/00016489.2021.1948100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In the literature, the effect of chronic kidney disease on the peripheral auditory system has been well documented. But studies investigating the effect of chronic kidney disease on speech perception and auditory processing abilities are limited. AIMS/OBJECTIVES The present study investigated the effect of chronic kidney disease on different auditory processing tasks and speech perception in noise among adults. MATERIAL AND METHODS A total of 28 adults participated in the study. Group 1 included 14 individuals with chronic kidney disease undergoing hemodialysis, and Group 2 included 14 individuals with no known kidney complications. Amplitude modulation detection threshold, gap detection threshold, spectral ripple discrimination threshold, and speech recognition threshold in noise were measured. Independent samples t-test was carried out to investigate whether mean thresholds are significantly different between groups. RESULTS Results showed poorer gap detection threshold, amplitude modulation detection threshold, spectral ripple discrimination threshold, and speech recognition threshold in noise among individuals with chronic kidney disease compared to individuals with no known kidney complications. CONCLUSIONS The present study showed poorer auditory processing and speech perception abilities in individuals with chronic kidney disease.
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Affiliation(s)
- Kaushlendra Kumar
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Livingston Sengolraj
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Mohan Kumar Kalaiah
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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