O tratamento da doenca renal cronica pode afetar a audicao? / Could the type of treatment for chronic kidney disease affect the auditory system?

RESUMO

Introdução: Doença renal crônica (DRC) é definida pela presença de lesão renal levando à perda lenta e progressiva da função renal. Objetivo: Comparar testes auditivos entre pacientes com DRC submetidos a diferentes método de tratamento. Material e método: Estudo clínico transversal. Os grupos foram divididos de acordo com o método de tratamento hemodiálise (n = 35), diálise peritoneal (n =15), conservador (n = 51) e 27 pacientes saudáveis (controle). Pacientes com idade superior a 60 anos, perda auditiva congênita, síndromes genéticas, infecções de orelha média e transplante renal foram excluídos da pesquisa. A avaliação audiológica incluiu audiometria tonal, emissões otoacústicas evocadas transientes e Potencial Evocado Auditivo de Tronco Encefálico (PEATE); e as variáveis avaliadas foram sexo, idade, diagnóstico de hipertensão arterial e diabetes, estádio da DRC, tempo de diagnóstico do diabetes e da hipertensão arterial, duração da DRC e do tratamento. Resultados: A idade, presença de hipertensão arterial e tempo de DRC foram estatisticamente significantes e controlados. O grupo conservador apresentou piores limiares auditivos na audiometria tonal e o intervalo III-V do PEATE significativamente maior que o da hemodiálise. Conclusão: O tratamento conservador mostrou piores resultados na avaliação auditiva, independente de diabetes e de hipertensão, reforçando que os pacientes submetidos a tratamento para DRC devem realizar avaliação auditiva completa para melhor compreensão da doença e de seus efeitos sobre o sistema auditivo. .

ABSTRACT

Introduction: Chronic kidney disease (CKD) is defined as the presence of renal injury that leads to the slow and progressive loss of kidney function. Aim: To compare audiological tests between patients with CKD receiving different types of treatment. Material and method: This was a clinical and experimental study. Groups were divided according to treatment hemodialysis (n = 35), peritoneal dialysis (n = 15), and conservative (n = 51), and were compared to 27 healthy controls. Patients older than 60 years; those with congenital hearing loss, genetic syndromes, and middle-ear infections; and those who had been submitted to a kidney transplant were excluded. Audiologic evaluation included pure-tone audiometry, transient evoked otoacoustic emissions, and auditory brainstem response (ABR). The variables considered were gender, age, diagnosis of arterial hypertension, time since the diagnosis of diabetes and hypertension, CKD stage, duration of CKD, and duration of treatment. Results: The variables age, presence of arterial hypertension, and time of CKD were statistically significant and controlled. The auditory thresholds measured by pure-tone threshold audiometry were worse for the conservative treatment group, and the III-V interval of the ABR of the conservative treatment group was significantly greater than that of the hemodialysis groups. Conclusion: The conservative treatment group presented worse audiological tests, regardless of hypertension and diabetes, reinforcing that patients need to undergo a complete hearing assessment for better understanding of the disease and its effects on the auditory system. .