Hearing loss in patients with dialysis and renal transplants

Hearing loss in renal dialysis and renal transplant patients occurs quite frequently. An assessment of the likely etiological factors is nearly impossible in a retrospective analysis of any one patient because many factors exist simultaneously. In a prospective study of a large series of patients an identification of factors contributing to the hearing loss was possible in the majority of patients. During the study it became increasingly apparent that what was observed at any one time was the combined effect of many factors. Although one factor seemed to precipitate the hearing loss it was inadvisable to attribute total responsibility to that agent or circumstance. Further, this combined effect was not a simple addition of effects but potentiation. The serious implications of this phenomenon are discussed.