Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland.
Department and Clinic of Urology and Urological Oncology, Medical University in Wroclaw, Borowska 213, 50556, Wroclaw, Poland.
Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1575-1591. doi: 10.1007/s00405-020-05925-9. Epub 2020 Mar 28.
Otorhinolaryngological abnormalities are common complications of chronic kidney disease (CKD) and its treatment. The main aim of this study was to provide a brief and precise review of the current knowledge regarding CKD and its treatment-related influence on head and neck organs.
The Medline and Web of Science databases were searched using the terms "chronic kidney disease", "kidney transplantation", "immunosuppression", "dialysis" in conjunction with "otorhinolaryngological manifestation". Articles that did not address the topics, low-quality studies, case reports, and studies based on nonsignificant cohorts were excluded, and the full text of remaining high-quality, novel articles were examined and elaborated on.
Patients with CKD are prone to develop sensorineural hearing loss, tinnitus, recurrent epistaxis, opportunistic infections including oropharyngeal candidiasis or rhino-cerebral mucormycosis, taste and smell changes, phonatory and vestibular dysfunctions, deep neck infections, mucosal abnormalities, gingival hyperplasia, halitosis or xerostomia. Immunosuppressive therapy after kidney transplantation increases the risk of carcinogenesis, both related and not-related to latent viral infection. The most commonly viral-related neoplasms observed in these patients are oral and oropharyngeal cancers, whereas the majority of not-related to viral infection tumors constitute lip and thyroid cancers. CKD-related otorhinolaryngological dysfunctions are often permanent, difficult to control, have a significant negative influence on patient's quality of life, and can be life threatening.
Patients with CKD suffer from a number of otorhinolaryngological CKD-induced complications. The relationship between several otorhinolaryngological complications and CKD was widely explained, whereas the correlation between the rest of them and CKD remains unclear. Further studies on this subject are necessary.
耳鼻喉异常是慢性肾脏病（CKD）及其治疗的常见并发症。本研究的主要目的是简要而精确地综述目前关于 CKD 及其治疗对头颈部器官影响的相关知识。
使用“慢性肾脏病”、“肾移植”、“免疫抑制”、“透析”与“耳鼻喉表现”等术语在 Medline 和 Web of Science 数据库中进行检索。排除未涉及主题的文章、低质量的研究、病例报告和基于非显著队列的研究，然后检查并详细阐述剩余高质量的新文章的全文。
CKD 患者易发生感音神经性听力损失、耳鸣、复发性鼻出血、机会性感染（包括口咽念珠菌病或鼻-脑毛霉菌病）、味觉和嗅觉改变、发音和前庭功能障碍、深部颈部感染、黏膜异常、牙龈增生、口臭或口干。肾移植后的免疫抑制治疗会增加致癌风险，包括与潜伏病毒感染相关和不相关的风险。这些患者中观察到的最常见的病毒相关肿瘤是口腔和口咽癌，而大多数与病毒感染无关的肿瘤构成唇癌和甲状腺癌。CKD 相关的耳鼻喉功能障碍通常是永久性的、难以控制的，对患者的生活质量有重大负面影响，并且可能危及生命。
CKD 患者患有多种耳鼻喉科 CKD 引起的并发症。已广泛解释了几种耳鼻喉并发症与 CKD 之间的关系，而其余并发症与 CKD 之间的相关性尚不清楚。有必要对此主题进行进一步研究。
