STUDY OF PREVELANCE AND PATTERN OF SENSERINEURAL HEARING IMPAIRMENT IN STAGE 5 CHRONIC KIDNEY DISEASE PATIENTS ON HAEMODIALYSIS- AT A TERTIARY HEALTH CARE SETUP IN INDIA.
Background: In patients with established CKD, multiple risk factors have been hypothesized to cause senserineural hearing loss. There is high rise in the prevalence of CKD in India due to rise in conditions such as diabetes and hypertension.
Aim of the study: To identify the pattern of sensorineural hearing loss (SNHL) in stage 5 CKD patients on haemodialysis and to study the association between haemodialysis and degree of hearing changes.
Case control, observational, analytical study.
Method: In case control study 500 stage-5 CKD on haemodialysis patients and 500 age and gender-matched healthy individuals were included in this study over the period of 3 years. All patients were aged 18 to 50 years to exclude presence of presbycusis. After base line investigations,they were subjected for all cases and controls were subjected otoscopic examination and hearing assessment using standard pure tone audiometry. Descriptive statistical analysis has been carried out in this study.
Result: In CKD group, 96.5 % patients (5 patients had natural death) suffered from hearing loss and 3.5 %(17) patients had normal hearing. In control group, 31.2% suffered from SN hearing loss and 68.2 %(343) have no hearing loss . Among the Stage 5 CKD group, 11.9% had mild SN hearing loss, 14.2% had moderate SNHL (sensori-neural hearing loss), 14.8 %(71 patients) had moderately severe SNHL , 25.7% had severe SNHL, and 33.2%had profound SNHL. In the control group, 9% had mild SNHL, 7.6% had moderate SNHL, 7.1% had moderately severe SNHL, 5.4% had severe SNHL and 2.2% had profound SNHL. Deterioration of hearing acuity occurred in 62% of the patients at the end of follow-up and 12.4% of the participants showed improvement in hearing acuity.25.6% patients showed no improvement.
Conclusion: Our finding in present study is that CKD patients with hearing loss received significantly lesser haemodialysis sessions is interesting as it suggests a possible beneficial association between increasing number of dialysis sessions and hearing loss.
Keywords: Haemodialysis, Hearing loss, Sensori-neural hearing loss.