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Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology
Katijah Khoza-Shangase1, Jennifer Lau1
1Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Chronic kidney disease in children is linked to a high prevalence of hearing loss, particularly mild sensorineural types. Certain treatments, like hemodialysis and ototoxic medications, correlate with hearing impairment severity.
Area of Science:
- Nephrology
- Audiology
- Pediatrics
Background:
- Chronic kidney disease (CKD) is a growing global health concern impacting mortality and morbidity.
- Hearing loss is a significant comorbidity of CKD, affecting patients' quality of life.
- Pediatric CKD presents unique challenges, including potential effects on auditory function.
Purpose of the Study:
- To investigate and describe hearing function in children with chronic renal dysfunction.
- To determine the prevalence and characteristics of hearing loss in this pediatric population.
- To explore potential relationships between hearing impairment and CKD severity, treatment duration, and specific therapies.
Main Methods:
- A cross-sectional, descriptive, quantitative study involving 100 children (ages 5-18) with CKD.
- Comprehensive audiological assessments including otoscopy, immittance testing, pure tone audiometry (up to 16 kHz), and distortion product otoacoustic emissions (DPOAEs).
- Medical record review and statistical analysis of collected data.
Main Results:
- A high prevalence of hearing loss was observed in the studied children.
- The most common type was mild sensorineural hearing loss, affecting low and high to ultrahigh frequencies.
- No correlation was found between hearing loss severity and CKD severity or treatment duration.
- A significant relationship was identified between hearing loss severity and treatments such as hemodialysis and ototoxic medications (loop diuretics, anti-TB, antimalarials).
Conclusions:
- Early detection of hearing impairment in children with CKD is crucial.
- Extended high-frequency audiometry and DPOAE testing are vital for identifying hearing changes.
- Ototoxic monitoring and preventive audiology strategies are recommended for children undergoing specific CKD treatments.
Abstract:
Chronic kidney is being increasingly recognized as a global health problem with effects that have implications for both mortality and morbidity; with hearing loss being one of the effects that has an impact on quality of life. This study aimed to describe hearing function in a group of children with chronic renal dysfunction receiving treatment in an academic hospital in Johannesburg, South Africa. One hundred children between the ages 5 and 18 years (mean age 11.68) were included in the study. A cross-sectional, descriptive, quantitative research design was employed. All participants underwent a case history interview and an audiological examination which included otoscopy, immittance testing, pure tone audiometry including extended high frequency testing up to 16 kHz as well as diagnostic distortion product otoacoustic emission testing. A medical record review was also done. Both descriptive and inferential statistics were used to analyze the collected data. Results revealed that there was a high prevalence of hearing loss in this group. The most common hearing loss was a low and high to ultrahigh frequency mild sensorineural hearing loss. No relationship between the severity of hearing loss and the severity of renal dysfunction, or the duration of renal dysfunction and the duration of treatment was found. However, a relationship between the severity of hearing loss and certain treatments was found. These were v hemodialysis and the use of ototoxic medication such as loop diuretics, tuberculosis medication, and antimalarial medication. Current findings highlight the importance of extended high frequency audiometry as well as diagnostic distortion product otoacoustic emission testing for early detection of hearing impairment, in pursuit of preventive audiology outcomes, in ototoxic monitoring in this population.
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