Audiological Profile of Adult Patients Awaiting Kidney and Liver Transplantation

Hearing loss is an underrecognized comorbidity in patients with chronic kidney disease (CKD) and chronic liver disease (CLD), particularly among those awaiting solid organ transplantation. Early identification of auditory dysfunction is essential to optimize communication, treatment adherence, and post-transplant care. To describe the prevalence, severity, and audiometric patterns of hearing loss in adult candidates for kidney or liver transplantation.

A cross-sectional study was conducted in 36 adult patients with advanced CKD or CLD evaluated for kidney or liver transplantation at a tertiary academic center. All participants underwent otomicroscopy, tympanometry, pure-tone audiometry, distortion product otoacoustic emissions (DPOAEs), and tinnitus assessment using the Tinnitus Handicap Inventory. Hearing loss was defined as a pure-tone average >20 dB HL across 0.5-4 kHz in either ear.

Hearing loss was identified in 30.6% of patients (CLD: 31.6%; CKD: 29.4%), predominantly mild to moderate, with symmetrical high-frequency sensorineural patterns. Distortion product otoacoustic emissions abnormalities were observed in 56.9% of ears, suggesting subclinical cochlear dysfunction. Tinnitus was reported in 38.2% of participants, with no significant differences between groups. All cases of tinnitus were classified as slight or mild handicap. Use of acetylsalicylic acid was significantly associated with hearing loss among CKD patients (P=.003).

Hearing loss and tinnitus are common in patients with advanced CKD or CLD awaiting transplantation. Comprehensive audiological assessment, including DPOAEs, may improve pre-transplant evaluation by identifying patients at risk for auditory impairment and informing ototoxic medication decisions.