Risk of sudden sensorineural hearing loss in patients with end‐stage renal disease undergoing dialysis

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Excerpt

End‐stage renal disease (ESRD) is a systemic disease that affects functions of various organs, leading to complications because of the disease itself and the response to disturbed homeostasis.
The prevalence of sensorineural hearing loss (SHL; mainly high frequency) in patients with chronic kidney disease (CKD) or ESRD can be up to 85% higher than that in the general population.1 The cochlea and kidney have numerous anatomic, physiological, pharmacological and pathological similarities.2 With common antigenicity, the development of the cochlea and kidney are regulated by similar genetic factors.2 Both are influenced by similar immunological factors. Dialysis may sometimes result in deteriorated auditory function.3 The aforementioned reasons may explain the association of hearing loss with kidney diseases.
Sudden sensorineural hearing loss (SSHL) has been defined as an unexplained loss of more than 30 dB in three contiguous frequencies, nearly always unilateral, in less than 72 h.4 Most cases are idiopathic. The suggested causes of idiopathic SSHL include viral cochleitis, microvascular events, and autoimmune disorders.5 The risk of SSHL is significantly higher in patients with CKD than in patients without CKD (adjusted hazard ratio (HR) = 1.46).6 Few case reports have demonstrated the occurrence of SSHL in patients with ESRD.3 Whether patients with ESRD receiving different dialysis modalities exhibit different degrees of risk is unclear. In this study, we used Taiwan National Health Insurance claims data to conduct a retrospective cohort analysis and adopted a propensity score‐matching method to evaluate the risks of SSHL in patients on HD and PD.

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