Abstract
Hearing impairment was observed in patients with chronic kidney disease (CKD). Our purpose was to investigate the relationship between sensorineural hearing loss (SNHL) and associated comorbidities in the CKD population. We conducted a retrospective, population-based study to examine the risk of developing SNHL in patients with CKD. Population-based data from 2000-2010 from the Longitudinal Health Insurance Database of the Taiwan National Health Insurance Research Database was used in this study. The population sample comprised 185,430 patients who were diagnosed with CKD, and 556,290 without CKD to determine SNHL risk factors. Cox proportional hazard regression analysis demonstrated the CKD group had a significantly increased risk of SNHL compared with the non-CKD group [adjusted hazard ratio (HR), 3.42; 95% confidence interval (CI), 3.01-3.90, p < 0.001]. In the CKD group, the risk of SNHL (adjusted HR, 5.92) was higher among patients undergoing hemodialysis than among those not undergoing hemodialysis (adjusted HR, 1.40). Furthermore, subgroup analysis revealed an increased risk of SNHL in patients with CKD and comorbidities, including heart failure (adjusted HR, 7.48), liver cirrhosis (adjusted HR, 4.12), type 2 diabetes mellitus (adjusted HR, 3.98), hypertension (adjusted HR, 3.67), and chronic obstructive pulmonary disease (adjusted HR, 3.45). CKD is an independent risk of developing SNHL. Additionally, hemodialysis for uremia can increase the risk of SNHL. Cardiovascular, lung, liver, and metabolic comorbidities in CKD patients may further aggravate the risk of SNHL by inter-organ crosstalk. We should pay attention to SNHL in this high-risk population.
Highlights
Chronic kidney disease (CKD) is characterized by a progressive reduction in the renal function and can affect several organs
185,430 patients with CKD and 556,290 participants without CKD were enrolled in the study (Fig 1)
After adjusting for variables like age, gender, comorbidities, and drug intake, the highest hazard ratio (HR) of sensorineural hearing loss (SNHL) was 3.42 times in patients with CKD, followed by that for stroke (HR, 1.52; 95% confidence interval (CI), 1.31–1.77), chronic obstructive pulmonary disease (COPD) (HR, 1.21; 95% CI, 1.04–1.53), and liver cirrhosis (HR, 1.19; 95% CI, 0.94–1.55)
Summary
Chronic kidney disease (CKD) is characterized by a progressive reduction in the renal function and can affect several organs. CKD is continually becoming more prevalent and a public health issue of global concern [1]. Problems associated with the auditory system are common in patients with CKD and can negatively affect the quality of life [2]. The nephron shares anatomical, physiological, immunological, and pharmacological similarities with the stria vascularis. Epithelial cells of nephron and stria vascularis are in close contact with their vascular supply [3]. Common antigenicity testing has demonstrated antibody deposition in both nephron and stria vascularis [3, 7]. Various drugs act on both organs such as aminoglycosides associated with both nephrotoxic and ototoxic effects [3, 4]
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