Acute sensorineural hearing loss in hemodialysis patients

Abstract

Background: Approximately, 30–40% of patients experienced hearing loss under regular hemodialysis.

Objective: This study reviewed our experience on treating acute hearing loss in patients under regular hemodialysis over the past two decades.

Methods: Twenty-six patients having acute hearing loss under hemodialysis were divided into two groups based on their etiologies. Sixteen patients (16 ears) with sudden sensorineural hearing loss (SSHL) were assigned to Group A and 10 patients (13 ears) with endolymphatic hydrops (EH) were assigned to Group B.

Results: No significant difference was noted between Groups A and B, regardless of hemodialysis duration, clinical manifestation, underlying systemic diseases, blood examination, and vestibular test battery. In contrast, serum osmolality was significantly lower in Group B (292 ± 11 mOsm/kg) than in Group A (310 ± 11 mOsm/kg). Furthermore, Group B (40 ± 14 dB) had better mean hearing level than Group A (87 ± 21 dB) in the initial audiogram, and a higher hearing improvement rate (69%) than Group A (19%).

Conclusions and significance: Both SSHL and EH are major causes for precipitating acute hearing loss in hemodialysis patients. Compared to SSHL, the less deteriorated MHL and lower serum osmolality in EH provide two clues for differentiating acute hearing loss in hemodialysis patients.

Chinese abstract

背景：定期血液透析时, 有大约30–40％的患者出现听力下降。

目的：本研究回顾了过去二十年来我们治疗定期血液透析患者的急性听力损失的验。

方法：根据血液病的病因, 将26例血液透析急性听力损失患者分为两组。 A组16例（16耳）突然发生感音神经性听力丧失（SSHL）；B组10例（13耳）内淋巴积水（EH）。

结果：无论血液透析持续时间、临床表现、潜在的全身性疾病、血液检查和前庭测试电池如何, A组与B组之间无显著差异。相反, B组（292±11 mOsm / kg）的血清渗透压显著低于A组（310±11 mOsm / kg）。此外, 在初始听力图中, B组（40±14dB）的平均听力水平比A组（87±21 dB）更好, 并且听力改善率（69％）比A组（19％）高。

结论和意义：SSHL和EH都是导致血液透析患者急性听力损失的主要原因。与SSHL相比, 恶化程度较小的MHL和EH的较低血清渗透压, 为区分血液透析患者的急性听力损失提供了两个线索。

Keywords:

• Acute hearing loss
• chronic kidney disease
• endolymphatic hydrops
• end-stage renal disease (ESRD)
• hemodialysis
• sudden deafness
• sudden sensorineural hearing loss

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the National Science Council, Taiwan (Grant no. Most 108-2314-B-002-178-MY3).