Sanjani Fadillah-Akbar, Haryuna Tengku-Siti-Hajar, Farhat Farhat, Nasution Syafrizal, Harahap Juliandi, Lubis Yuliani M, Asroel Harry-Agustaf, Khalid Khalisanni
Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Jl. Dr. Mansur No. 5, Medan, 20155, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jl. Dr. Mansur No. 5, Medan 20155, Indonesia.
Iran J Otorhinolaryngol. 2025;37(4):197-204. doi: 10.22038/ijorl.2025.77733.3633.
Chronic Kidney Disease (CKD) is considered a public health issue because its frequency is increasing in adults. When a person experiences renal failure, one of the most researched solutes that builds up in plasma is indoxyl sulfate. This toxin can attach to proteins, and it is a byproduct of the tryptophan metabolism in the diet, which provides pro-oxidative and pro-inflammatory activity. In CKD, the redox imbalance associated with oxidative stress is associated with pathophysiological issues brought on by the buildup of uremic toxins. The cochlea is highly susceptible to oxidative stress, which consequently causes permanent cochlear degeneration. To better understand the connection between Indoxyl sulfate levels and hearing loss in CKD patients, we examined the results of pure tone audiometry and OAE examinations.
This research was conducted on 27 people with stage 5 CKD who had their blood plasma levels of indoxyl sulfate measured before having their hearing ability assessed by OAE and pure tone audiometry. Next, a correlation test was carried out between the results of Indoxyl sulfate levels and the results of hearing function tests in CKD patients.
The indoxyl sulfate value and degree of auditory impairment had a strong positive correlation, according to the Spearman correlation test. (r = 0.881; p = 0.001) and an inverse relationship between the Indoxyl sulfate value and SNR (r = -0.761; p = 0.001).
CKD patients have impaired hearing, which is correlated with the amount of uremic toxin Indoxyl Sulfate that has accumulated.
慢性肾脏病(CKD)被视为一个公共卫生问题,因为其在成年人中的发病率正在上升。当一个人出现肾衰竭时,血浆中积累的研究最多的溶质之一是硫酸吲哚酚。这种毒素可以附着在蛋白质上,它是饮食中色氨酸代谢的副产物,具有促氧化和促炎活性。在CKD中,与氧化应激相关的氧化还原失衡与尿毒症毒素积累所引发的病理生理问题有关。耳蜗对氧化应激高度敏感,进而导致永久性耳蜗退变。为了更好地理解CKD患者硫酸吲哚酚水平与听力损失之间的联系,我们检查了纯音听力测定和耳声发射(OAE)检查的结果。
本研究对27例5期CKD患者进行,在通过OAE和纯音听力测定评估其听力能力之前,先测量他们血浆中硫酸吲哚酚的水平。接下来,对CKD患者硫酸吲哚酚水平的结果与听力功能测试的结果进行相关性测试。
根据Spearman相关性测试,硫酸吲哚酚值与听觉损伤程度呈强正相关(r = 0.881;p = 0.001),且硫酸吲哚酚值与信噪比呈负相关(r = -0.761;p = 0.001)。
CKD患者存在听力受损,这与积累的尿毒症毒素硫酸吲哚酚的量相关。