Bains K S, Chopra H, Sandhu J S, Aulakh B S
Department of Nephrology, Dayanand Medical College, 1101/1 Tagore Nagar, Ludhiana, Punjab 141001, India.
Transplant Proc. 2007 Jun;39(5):1465-8. doi: 10.1016/j.transproceed.2007.02.085.
Hearing loss on pure-tone and brainstem-evoked response audiometry is well documented in chronic kidney disease patients, but there are only scant data in renal allograft recipients. The aim of this study was to evaluate cochlear function on pure-tone and brainstem-evoked response audiometry among patients of chronic kidney disease to document changes after renal transplantation. The study included 20 healthy controls and 40 patients: 10 each at stage 3 and 4 and 20 with stage 5 chronic kidney disease. Patients with known causes for hearing loss were not included. Patients with stage 5 chronic kidney disease were reevaluated 1 year after renal transplantation. Compared with healthy controls, chronic kidney disease patients showed a highly significant bilateral sensorineural hearing loss at all frequencies of 0.25 to 8.0 kHz, which was more marked in higher frequencies. A highly significant delay in the latencies of waves I, III, and V and interpeak latencies of I to III and I to V was also noted on brainstem-evoked response audiometry. Compared with their pretransplant values, there was a significant improvement in the delay in absolute latencies of I, III, and V among renal allograft recipients. There was no correlation of audiometry findings with gender, degree of renal failure, and serum sodium. Hearing loss was seen in 70% of stage 3 and 4 chronic kidney disease and 60% in stage 5. The intensity of hearing loss was variable. In conclusion, chronic kidney disease patients shows definitive audiologic dysfunction with some improvement in hearing and wave latencies after successful renal transplantation.
慢性肾病患者纯音听力测定和脑干诱发电位听力测定显示听力损失已有充分记录，但肾移植受者的数据却很少。本研究的目的是评估慢性肾病患者纯音听力测定和脑干诱发电位听力测定的耳蜗功能，以记录肾移植后的变化。该研究纳入了20名健康对照者和40名患者：3期和4期各10名，5期慢性肾病患者20名。排除已知有听力损失原因的患者。5期慢性肾病患者在肾移植1年后进行重新评估。与健康对照者相比，慢性肾病患者在0.25至8.0kHz的所有频率上均表现出高度显著的双侧感音神经性听力损失，在高频更为明显。脑干诱发电位听力测定还显示I波、III波和V波潜伏期以及I至III波和I至V波的峰间潜伏期有高度显著延迟。与移植前的值相比，肾移植受者I波、III波和V波绝对潜伏期的延迟有显著改善。听力测定结果与性别、肾衰竭程度和血清钠无关。3期和4期慢性肾病患者中70%有听力损失，5期患者中60%有听力损失。听力损失的程度各不相同。总之，慢性肾病患者存在明确的听觉功能障碍，肾移植成功后听力和波潜伏期有一定改善。
