Hearing loss in short- and long-term haemodialysed patients

BACKGROUND.: Hearing loss has been described in patients with chronic renalfailure on regular dialysis treatment (RDT) with very differentfrequency, ranging from 20 to 75%; RDT does not seem to worsenhearing function for at least the first 5 years of treatment;no studies are available on patients on RDT for more than 10years. METHODS.: We performed an audiometric evaluation in 91 patients on RDTfor various periods: group I (34 patients), <5 years; groupII (32 patients), 5–10 years; group III (25 patients),> 10 years; patients with histories of chronic otitis, ototoxicdrug treatment, and chronic auditory trauma were excluded; thepossible correlations with some biochemical parameters (urea,creatinine, PTH) were also looked for. RESULTS.: Hearing loss was present in 77% of patients and 69.2% of ears;the percentage of patients with hypoacusia was higher in groupIII (84%) than in group I (76.3%) and II (71.7%), but the differenceswere not statistically significant. Hypoacusia was cochlearneurosensory in 61.5%, conductive in 6.5%, and mixed in 9.0%of patients; the percentage of patients with cochlear neurosensoryhypoacousia was similar in the three groups (I, 61.7%; II, 59.3%;III, 64%). Hearing loss was of slight to moderate degree andnot different in the three groups (I, 22.7±15 dB; II,26.9±6.0 dB; III, 29.1±8.9 dB). There were nocorrelations between hearing loss and plasma creatinine andPTH values; patients with plasma urea >200 mg/dl had higherpercentage of hypoacousia (86%) than patients with plasma urea<200 mg/dl (69%) (P=0.06). CONCLUSIONS.: Hearing loss, mainly cochlear neurosensory in type, is presentin a high percentage of patients on RDT even at the beginningof treatment, but no negative effects on hearing can be correlatedwith the duration of dialysis.