Audiological Findings in Hemodialysis Patients

Area of Science:

• Nephrology
• Audiology
• Otolaryngology

Background:

• End-stage chronic renal failure (CRF) is associated with a higher incidence of hearing loss compared to the general population.
• Potential causes include ototoxic medications, hypertension, electrolyte imbalances, and hemodialysis-related factors like hypotension and immunological reactions.

Purpose of the Study:

• To assess auditory function in patients with end-stage CRF.
• To determine the prevalence of hearing loss and associated factors in these patients.
• To evaluate the impact of a single hemodialysis session on hearing parameters.

Main Methods:

• A descriptive and analytical cross-sectional study was conducted on 30 hemodialysis patients under 65 years old without otologic pathology or history of ototoxicity.
• Data collected included demographics, clinical information, and laboratory results. All patients underwent otologic examination and pure-tone audiometry before hemodialysis; a subset had audiometry post-dialysis.

Main Results:

• 13.3% of patients exhibited hearing loss across all tested frequencies. Severe high-frequency (4000-8000 Hz) hearing loss was observed in 10%. Low frequencies (125-200 Hz) were affected in 61.67%, and high frequencies in 63.33%.
• Speech frequencies (500-4000 Hz) were affected in 33.3% of cases (mild in 20%, moderate in 13.33%). Sensorineural hearing loss was present in 16.6%, conductive in 10%, and mixed in 6.67%.
• No significant correlation was found between hearing impairment and age, gender, dialysis duration, BMI, ototoxic drug history, hypertension, or biochemical parameters. Peridialytic cramps showed a significant correlation with hearing loss. No significant change in hearing thresholds was observed before and after hemodialysis.

Conclusions:

• The prevalence of hearing impairment remains high in patients undergoing hemodialysis.
• This study did not demonstrate a significant effect of a single hemodialysis session on hearing parameters.
• Hearing loss can negatively impact the quality of life for CRF patients, suggesting the need for routine audiological evaluations to facilitate early intervention and mitigate social consequences.