Shih Cheng-Ping, Lin Hung-Che, Chung Chi-Hsiang, Hsiao Po-Jen, Wang Chih-Hung, Lee Jih-Chin, Chien Wu-Chien
Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
PLoS One. 2017 Aug 15;12(8):e0183192. doi: 10.1371/journal.pone.0183192. eCollection 2017.
Tinnitus mostly results from central and peripheral auditory pathology. Chronic kidney disease (CKD) is a major risk factor for cerebrovascular disease. However, no studies have evaluated the association between tinnitus and CKD. The aim of this study is to investigate the risk of tinnitus in patients with CKD. This retrospective cohort study was conducted using Taiwan National Health Insurance Research Database from 2000 to 2010. We established a CKD group (n = 185,430) and a non-CKD comparison group (n = 556,290) to investigate the incidence of tinnitus. Cox proportional hazard regression analysis was used to evaluate the effects of CKD on tinnitus risk. The results showed CKD significantly increased the risk of tinnitus (adjusted hazard ratio, 3.02; 95% CI, 2.655-3.456, P<0.001). A subgroup analysis revealed the increase in risk of tinnitus is more in CKD patients with heart failure (adjusted hazard ratio, 9.975; 95% CI, 5.001-18.752) and diabetes mellitus (adjusted hazard ratio, 3.712; 95% CI, 2.856-5.007). Furthermore, compared to non-CKD patients, the risk of tinnitus was increased 4.586-fold (95% CI, 2.399-6.7) in CKD patients with dialysis and 2.461-fold (95% CI, 1.033-3.454) in CKD patients without dialysis. This study is the first to report that CKD is associated with an increased risk of tinnitus. Among CKD cohort, patients with dialysis are at a higher risk of tinnitus than those without dialysis.
耳鸣大多源于中枢和外周听觉病理状况。慢性肾脏病（CKD）是脑血管疾病的主要危险因素。然而，尚无研究评估耳鸣与CKD之间的关联。本研究旨在调查CKD患者发生耳鸣的风险。本回顾性队列研究使用了2000年至2010年的台湾国民健康保险研究数据库。我们设立了一个CKD组（n = 185,430）和一个非CKD对照组（n = 556,290）来调查耳鸣的发生率。采用Cox比例风险回归分析来评估CKD对耳鸣风险的影响。结果显示，CKD显著增加了耳鸣风险（调整后的风险比为3.02；95%置信区间为2.655 - 3.456，P<0.001）。亚组分析显示，合并心力衰竭的CKD患者（调整后的风险比为9.975；95%置信区间为5.001 - 18.752）和合并糖尿病的CKD患者（调整后的风险比为3.712；95%置信区间为2.856 - 5.007）耳鸣风险增加更为明显。此外，与非CKD患者相比，接受透析的CKD患者耳鸣风险增加了4.586倍（95%置信区间为2.399 - 6.7），未接受透析的CKD患者耳鸣风险增加了2.461倍（95%置信区间为1.033 - 3.454）。本研究首次报告CKD与耳鸣风险增加有关。在CKD队列中，接受透析的患者耳鸣风险高于未接受透析的患者。
