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Cochlear function in patients with chronic kidney disease.

S M Govender, C D Govender, G Matthews

    The South African Journal of Communication Disorders = Die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings
    |August 28, 2014
    PubMed
    Summary
    This summary is machine-generated.

    Chronic kidney disease (CKD) patients in later stages show early cochlear dysfunction and subclinical hearing loss. Distortion product otoacoustic emissions (DPOAEs) are more sensitive than pure tone audiometry in detecting this hearing impairment.

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    Area of Science:

    • Otoacoustic Emissions
    • Audiology
    • Nephrology

    Background:

    • Chronic kidney disease (CKD) affects multiple organ systems, including the auditory system.
    • Subclinical cochlear dysfunction may precede overt hearing loss in CKD patients.

    Purpose of the Study:

    • To evaluate cochlear functioning in patients across all five stages of chronic kidney disease (CKD).
    • To compare the efficacy of pure tone audiometry and distortion product otoacoustic emissions (DPOAEs) in detecting early cochlear dysfunction in CKD.

    Main Methods:

    • Fifty participants (18-45 years) with varying stages of CKD were selected using purposive sampling.
    • Participants underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs).
    • Blood test results, drug intake, and concomitant conditions were recorded and analyzed.

    Main Results:

    • Distortion product otoacoustic emissions (DPOAEs) were more sensitive than pure tone audiometry in detecting high-frequency cochlear dysfunction in CKD stages 3, 4, and 5.
    • Patients in CKD stages 1 and 2 exhibited normal pure tone thresholds and DPOAEs.
    • Early cochlear dysfunction, indicating subclinical hearing loss, was identified in later CKD stages by DPOAEs.
    • Reduced cochlear functioning correlated with increased electrolyte levels, specific drug regimens, and co-existing medical conditions.

    Conclusions:

    • Later stages of CKD are associated with early cochlear dysfunction and subclinical hearing loss.
    • Electrolyte imbalances, urea/creatinine levels, ototoxic medications, and co-morbidities likely contribute to hearing impairment in CKD.
    • Audiological monitoring, including DPOAEs, should be integrated into the management of CKD patients to detect and monitor cochlear function.