High-frequency hearing loss in chronic kidney disease: a frequency-specific analysis across renal function stages

Chronic kidney disease (CKD) has been associated with a wide range of neurological complications, yet the onset and pattern of hearing loss, particularly at high frequencies, remain insufficiently characterized. This study aimed to evaluate hearing function across different stages of renal impairment with a focus on frequency-specific thresholds. A total of 97 participants were retrospectively assessed and divided into three groups: preserved estimated glomerular filtration rate (eGFR) (n = 32), CKD without hemodialysis (n = 32), and patients undergoing hemodialysis (n = 33). Pure-tone audiometry was performed to assess both conventional and high-frequency hearing thresholds. Comparative analyses using Kruskal-Wallis and Mann-Whitney U-tests were conducted. Patients with CKD, even those not receiving hemodialysis (HD), exhibited significantly worse high-frequency hearing thresholds compared to controls (p < 0.05). The greatest degree of hearing impairment was observed in the HD group. Receiver operating characteristic analysis indicated that high-frequency audiometry moderately predicted CKD status, with area under the curve values exceeding 0.70. Logistic regression further demonstrated that age and CKD status were significant predictors of hearing loss (p < 0.01) These findings provide novel frequency-specific evidence that compared with controls, patients with non HD CKD already demonstrate poorer high-frequency thresholds, suggesting possible early involvement even prior to the initiation of HD. The results underscore the importance of routine high-frequency audiological screening for CKD patients, as early detection may help to prevent or mitigate further deterioration in auditory function. This study is among the first to demonstrate frequency-specific differences in hearing loss across distinct renal function groups.