National Assessment of Ear Abnormalities as Predictors for Renal Abnormalities

Abstract

PURPOSE: Ear malformations and renal abnormalities are established to have some level of association. However, there is still ongoing debate regarding the utility, cost-effectiveness, and overall need to screen children with ear malformations for renal abnormalities. Herein, we utilized the 2016 Kids’ Inpatient Database (KID) to examine the association and relationship between different types of ear abnormalities commonly seen in children and renal abnormalities. METHODS: KID is a large national inpatient database that compiles admissions and data regarding diagnosis, race, procedures etc. Patients who had ICD-10 diagnoses of ear abnormalities (Q17) were identified. Those without ear abnormalities served as the control group. Patients with renal malformations (Q60 and Q63) were identified. Logistic regression was then conducted to analyze if patients with ear malformations had significantly different odds of having renal malformations. Statistical analyses were conducted in STATA using an α<0.05 for determining significance of predictors. RESULTS: 8324 patients were identified with ear abnormalities. 5321 patients were identified with congenital renal abnormalities. Those with microtia were found to be 8.83 times more likely to have congenital renal abnormalities compared to those without. Those with an accessory auricle were 3.5 times more likely to have renal abnormalities compared to those without. Those with a diagnosis of other specified ear abnormalities and other unspecified were found to be 5.92 and 7.75 times more likely to have renal abnormalities compared to those without respectively. Those patients with a congenital misplaced ear were 9.66 times more likely to have renal malformations compared to those without. Figure 1 Additionally, we examined renal agenesis as in relation to ear abnormalities. 4784 patients were identified with renal agenesis. Patients with microtia were found to be 18.17 times more likely to have renal agenesis compared to those without. Those with an accessory auricle were 4.01 times more likely to have renal agenesis compared to those without. Patients with a misplaced ear were 14.40 times more likely to have renal agenesis compared to those without. Those with other specified and unspecified ear abnormalities were found to be 8.11 and 8.48 times more likely to have renal agenesis compared to those without respectively. Patients an other mishappen ear were 4.68 times more likely to have renal agenesis compared to those without. Figure 2 CONCLUSIONS: Our results indicate a clear association between specific ear abnormalities and renal abnormalities. As such, there may be clinical value and supportive evidence for conducting screening tests such as renal ultrasounds on pediatric patients who present for ear abnormalities. To our knowledge, this is the first study to evaluate the association of specific ear abnormalities and renal abnormalities using a national database. These associations may aid clinicians in pursuing screening regimens for patients with congenital ear anomalies.