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慢性肾脏病与听力损失风险的关系。

Chronic kidney disease and the risk of incident hearing loss.

机构信息

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Madison, Wisconsin, U.S.A.

Renal Division, Department of Medicine, Brigham and Women's Hospital, Madison, Wisconsin, U.S.A.

出版信息

Laryngoscope. 2020 Apr;130(4):E213-E219. doi: 10.1002/lary.28088. Epub 2019 May 28.

Abstract

OBJECTIVES

There is a strikingly high prevalence of sensorineural hearing loss among patients with chronic kidney disease, with estimates ranging from 36% to 77%; however, longitudinal data are limited. We assessed whether lower baseline estimated glomerular filtration rate calculated using creatinine (eGFR ), as well as decline in eGFR over time, were associated with incident hearing loss.

METHODS

Serum creatinine was measured in 1,843 individuals aged 48 to 80 years without hearing loss at the start of the Epidemiology of Hearing Loss Study in 1993. Follow-up creatinine assessments were conducted at 5 (n = 1,526) and 10 (n = 1,095) years. Hearing tests were conducted at baseline and at 5-, 10-, and 15-year follow-up visits. The risk of hearing loss was assessed as a function of baseline eGFR as well as a function of a 20% decline in eGFR between baseline and 5 years and between 5 and 10 years. Cox proportional hazards regression was used to examine the risk of incident speech-frequency hearing loss, defined as pure tone average (PTA) > 25 decibels hearing loss for thresholds at 0.5, 1, 2, and 4 kHz (PTA ) in either ear.

RESULTS

During 15,676 person-years of follow up, there were 802 cases of incident hearing loss. There was no statistically significant association between lower baseline eGFR and risk of incident hearing loss. Decline in eGFR was also not associated with incident hearing loss at speech frequencies.

CONCLUSION

Overall, there was no significant association between eGFR or decline in eGFR using the serum creatinine-based equation and risk of incident hearing loss.

LEVEL OF EVIDENCE

2 Laryngoscope, 130:E213-E219, 2020.

摘要

目的

慢性肾脏病患者的感音神经性听力损失患病率极高,估计范围为 36%至 77%;然而,纵向数据有限。我们评估了基线时使用肌酐(eGFR)计算的肾小球滤过率估计值(eGFR)以及随时间的下降是否与听力损失的发生有关。

方法

1993 年开始的听力损失流行病学研究中,在无听力损失的 48 至 80 岁的 1843 名个体中测量了血清肌酐。在 5 年(n=1526)和 10 年(n=1095)时进行了后续肌酐评估。在基线以及 5 年、10 年和 15 年随访时进行了听力测试。听力损失的风险评估了基线 eGFR 的功能以及基线至 5 年和 5 年至 10 年之间 eGFR 下降 20%的功能。使用 Cox 比例风险回归检查了事件性言语频率听力损失的风险,该风险定义为在 0.5、1、2 和 4 kHz(PTA)的阈值处纯音平均(PTA)>25 分贝听力损失在任一只耳朵。

结果

在 15676 人年的随访期间,有 802 例发生听力损失。较低的基线 eGFR 与听力损失的发生风险之间没有统计学上的显著关联。eGFR 的下降也与言语频率的听力损失无关。

结论

总体而言,使用基于血清肌酐的方程的 eGFR 或 eGFR 下降与事件性听力损失的风险之间没有显著关联。

证据水平

2 Laryngoscope,130:E213-E219,2020。

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