Abstract
Abstract Background and Aims Idiopathic sudden sensorineural hearing loss (ISSNHL) is one of the most challenging complications nephrologists encounter when treating dialysis patients (pts). Since no previous study has compared the treatment response of dialysis pts to that of non-dialysis pts, physicians have difficulty managing these pts. This study aimed to investigate the treatment outcome of dialysis pts with ISSNHL. Method In this single-center, retrospective, observational study, 700 pts diagnosed with ISSNHL between January 2005 and December 2021 at Asan Medical Center, Korea were enrolled. Among them, 47 were dialysis pts and 653 were non-dialysis pts. Non-dialysis pts were compared using a 5:1 propensity score matching (PSM) analysis to balance pre-existing clinical characteristics. High-dose systemic steroid therapy or intra-tympanic (IT) steroid injections were administered according to the standard protocol. The pure tone average (PTA) of the two groups was compared before initiating the treatment, and after 2 weeks and 2 months of treatment. The degree of improvement in the hearing was evaluated using Siegel's criteria. Results Without PSM, the age, prevalence of diabetes or hypertension, initial hearing threshold by each frequency level (0.5, 1, 2, and 4 kHz), and treatment strategies were statistically different between the two groups. In the PS-matched cohort, none of the measured confounding variables were statistically different between the two groups (Table 1). Two months after steroid treatment, the average improvement in pure tone audiometry (p = 0.025) and the percentage of complete response according to Siegel's criteria were significantly higher in the non-dialysis pts group than the dialysis pts group (27.2% vs. 6.4%) (Table 2). Conclusion This study suggests that dialysis pts have significantly worse treatment outcomes for ISSNHL compared to non-dialysis pts.
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