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Otorhinolaryngological dysfunctions induced by chronic kidney disease in pre- and post-transplant stages
Joanna Krajewska Wojciechowska1, Wojciech Krajewski2, Tomasz Zatoński3
1Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland. krajewska.jm@gmail.com.
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.
Insights
Chronic kidney disease (CKD) and its treatments cause numerous head and neck issues, including hearing loss and infections. Many CKD-related ear, nose, and throat complications significantly impact quality of life and can be life-threatening.
Area of Science:
- Nephrology
- Otorhinolaryngology
- Oncology
Background:
- Chronic kidney disease (CKD) and its treatments are associated with various head and neck complications.
- These manifestations can significantly affect patient well-being and require careful management.
Purpose of the Study:
- To review current knowledge on the influence of CKD and its treatments on head and neck organs.
- To provide a concise overview of associated otorhinolaryngological abnormalities.
Main Methods:
- A systematic literature search was conducted on Medline and Web of Science.
- Keywords included "chronic kidney disease," "kidney transplantation," "immunosuppression," "dialysis," and "otorhinolaryngological manifestation."
- High-quality, novel articles were selected and analyzed, excluding case reports and low-quality studies.
Main Results:
- CKD patients exhibit increased risks of sensorineural hearing loss, tinnitus, epistaxis, opportunistic infections (e.g., candidiasis, mucormycosis), and taste/smell dysfunction.
- Immunosuppression post-kidney transplant elevates cancer risk, including oral, oropharyngeal, lip, and thyroid cancers.
- These complications are often permanent, difficult to manage, reduce quality of life, and can be life-threatening.
Conclusions:
- CKD induces a range of otorhinolaryngological complications.
- The link between some complications and CKD is well-established, while others require further investigation.
- Additional research is needed to fully elucidate the complex relationship between CKD and head and neck disorders.
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