A study of otorhinolaryngological manifestations in patients of chronic renal failure

Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review

This article aims to ascertain the prevalence of loss of hearing in patients with chronic kidney disease (CKD) and also to examine potential causes of sensorineural hearing loss (SNHL) in patients suffering from CKD. It has been discovered in recent years that there is a relationship between the occurrence of SNHL and CKD. Nowadays many people are suffering from CKD. These patients deal with several otorhinolaryngological issues, such as SNHL, candidiasis, epistaxis, halitosis, dysgeusia, xerostomia, and lip and thyroid malignancies. One of the most frequent otorhinolaryngological complications is audiovestibular system impairment. There are various proposed mechanisms for the appearance of loss of hearing in people suffering from CKD. The kidney and the inner ear have multiple functional and structural similarities, which may be the cause of these problems in CKD patients. In addition, changes in the homeostasis of water and electrolytes can affect the endolymphatic fluid and result in endolymphatic hydrops. Finally, some medications, like aminoglycosides and loop diuretics, are well known for their ototoxicity and are utilized to treat patients with CKD. Only a small number of population-based research have so far been able to show a connection between CKD and audiovestibular system impairment. Some investigation has shown that CKD patients are more likely than healthy people to experience vestibular impairment. The quality of life of a patient can be reduced by hearing loss. People with hearing loss experience communication issues in daily life, which negatively affects their cognitive and psychosocial functioning. Social isolation and a poor quality of life in terms of health can all result from hearing loss. In addition, decreased renal function has also been linked to poor quality of life, hospitalization, and cognitive dysfunction.

Otorhinolaryngologic, head and neck presentations among patients with chronic renal disease in a developing country

Background:

Data on otorhinolaryngology and head and neck diseases in patient with chronic renal disease are rare in developing African countries. This study was aimed to determine the epidemiology and management of otorhinolaryngology and head and neck diseases among chronic renal disease patient seen in our tertiary health-care facility.

Materials and Methods:

This was a prospective, hospital-based study that was conducted in the ear, nose, and throat department in a Nigerian University Teaching Hospital. Informed consent was obtained, and pretested interviewers-assisted questionnaires were administered to each patient. Otoscopy, indirect laryngoscopy, and rhinoscopy were carried out. Renal functions were assessed by routine urine analysis and biochemical tests. Audiological tests were carried out for hearing assessment. Data collected were collated and analyzed using the SPSS software version 20.0.

Results:

The prevalence of chronic renal disease in otorhinolaryngology practice was 1.1%. There were 67.9% male with a male-to-female ratio of 2.1:1. The duration of illness was more than 1 year in 39.6% of our patients. The most common presentation was 58.5% tinnitus, 34.0% neck pain, 28.3% nasal blockage, 28.3% sore throat, 26.4% rhinorrhea/epistaxis, 18.9%% pharyngeal wall nodularity, and 15.1% enlarged neck lymph node. The most common affected organ was the ear in 90.6%. Major diagnosis was sensorineural hearing loss, rhinosinusitis, pharyngitis, and cervical adenitis in 58.5%, 30.2%, 20.8%, and 7.5%, respectively. Hearing impairment occurred in 69.8% of the patients, out of which 43.4% were found to be mild hearing loss. Only 19 (35.8%) had dialysis, while 34 (64.2%) of them had conservatively treated.

Conclusion:

The prevalence of chronic renal disease in otorhinolaryngological practice was 1.1%, otological presentation was the most common in 90.6% of patients and 64.2% did well on conservative treatment. Avoidable otorhinolaryngologic complications among patients with chronic renal disease were noted. Periodic otorhinolaryngology referral for review and prompt management of this complication is advised.

Sensorineural hearing loss in patients with chronic renal failure on hemodialysis in Basrah, Iraq

Objectives:

The objective of this study is to determine the effect of hemodialysis on the hearing threshold in patients with chronic renal failure (CRF).

Materials and Methods:

Fifty-nine patients with CRF on regular hemodialysis were followed up for 1 year with a pure-tone audiometric examination every 6 months.

Results:

The mean age of the patients was 41.8 ± 9.2 years (range: 17–50 years). At the beginning of the study, 39 patients (66.1%) had sensorineural hearing loss (SNHL). During the 12-month follow-up, 6 more patients developed SNHL giving a point prevalence rate of 76.3% at the end of the study. The hearing loss was more evident in the higher frequencies. Of the studied patients, 64.4% showed deterioration of the hearing threshold. The mean hearing threshold at the beginning of the study was 29.2 ± 21.1 dB versus 36.9 ± 17.3 dB at the end of the study (P < 0.001). No significant relation was found between age, sex, serum electrolytes, blood urea, and duration of CRF and hearing loss. Multivariate analysis showed that the duration of hemodialysis was the only significant independent predictor of SNHL.

Conclusion:

SNHL is common in patients with CRF on hemodialysis. It was mild to moderate in the majority of patients. Hearing impairment was most obvious at the high frequencies. Most of the patients showed further deterioration in the hearing threshold with the duration of dialysis.