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儿童期起病的慢性肾脏病常伴有肾性综合征相关听力损失。

Renal Syndromic Hearing Loss Is Common in Childhood-onset Chronic Kidney Disease.

机构信息

Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2020 Nov 16;35(44):e364. doi: 10.3346/jkms.2020.35.e364.

Abstract

BACKGROUND

Hearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population. This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD.

METHODS

In this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2-5, age at onset of renal symptom < 18 years) were recruited. We referred to the "renal" syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD.

RESULTS

A total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL.

CONCLUSION

One-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.

摘要

背景

儿童听力损失(HL)可能对其发育产生不利影响。与普通人群相比,慢性肾脏病(CKD)患者的 HL 更为常见。本研究评估了儿童期 CKD 患者 HL 及其潜在疾病的患病率。

方法

在这项对三级转诊中心的回顾性研究中,招募了儿童期 CKD 患者(2-5 期,肾症状发病年龄<18 岁)。我们将“肾”综合征性 HL 定义为除 HL 和 CKD 外还伴有遗传或综合征疾病或肾外异常的病例。

结果

根据 CKD 的病因,共对 421 名患者(男:女=279:142)进行了回顾性分析:先天性肾和尿路畸形(CAKUT;n=184,43.7%)、肾小球疾病(GP;n=105,24.9%)、囊性肾病(CYST;n=39,9.3%)、围产期问题(PP;n=29,6.9%)和其他(n=64,15.2%)。82 名(19.5%)患者检测到 HL,包括 51 名(12.1%)感音神经性听力损失(SNHL)患者、30 名(7.1%)传导性听力损失(CHL)患者和 1 名混合性 HL 患者。各亚组 HL 的患病率如下:CAKUT 组 16.8%、GP 组 28.6%、CYST 组 12.8%、PP 组 24.1%和其他组 14.1%。CKD 分期越高,HL 越常见,尤其是终末期肾病的 CHL。SNHL 更常见于由 GP 引起的 CKD。82 名 HL 患者中,有 50%(41 例)为肾综合征性 HL:58.8%的 SNHL 和三分之一的 CHL 为肾综合征性 HL。

结论

五分之一的儿童期 CKD 患者存在 HL。总的来说,肾综合征性 HL 占本研究 HL 的一半。为了提高儿童期 CKD 患者的生活质量,我们建议考虑 HL,需要进行监测,如有必要,应进行早期干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b1/7669456/77db2bb0a40b/jkms-35-e364-g001.jpg

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