Characterization of Hearing Loss in Adult Patients With Nondialysis Chronic Kidney Disease.

OBJECTIVE: To confirm the association between chronic kidney disease and sensorineural hearing loss in non-dialysis non-diabetic patients and to establish the audiological profile of these patients indicating the possible location of the auditory damage. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary referral center. PATIENTS: Patients between 18 and 60 years old with chronic kidney disease, without diabetes mellitus and without personal history of otology disease, were compared with a healthy control group pared by sex and age to establish differences between their audiological profile. INTERVENTIONS: Pure tone audiometry (PTA), transient evoked otoacoustic emissions (TEOAEs), distortion products otoacoustic emissions (DPOAEs), and auditory brainstem responses (ABR) were performed in both groups. MAIN OUTCOME MEASURES: Mean and standard deviation of PTA auditory thresholds, TEOAEs reproducibility, DPOAEs level/noise, and ABR absolute latency and interwave latency were measured, and compared using linear mixed models. RESULTS: Fifty one cases were included and compared with 51 healthy volunteers. The audiometric profile found in patients with chronic kidney disease was a sensorineural hearing loss in 4 to 8 kHz frequencies in the PTA, a decrease in the TEOAEs reproducibility and a decrease in the DPOAEs level. An enlargement in the V wave absolute latency and III to V and I to V interwave latency in the ABR were also found but within normal range. CONCLUSIONS: There is an association between chronic kidney disease in non-dialysis non diabetic adults patients and sensorineural hearing loss, affecting high frequencies and having the cochlea as the main site of auditory damage.

Prediction of the bone conduction gain curve after partial posterior stapedectomy: the frequency shift concept.

INTRODUCTION: In this article, we present a method able to reasonably predict the bone conduction (BC) gain curve. It provides the advantage of advising patients who will receive little benefit from surgery. MATERIALS AND METHOD: A group of 284 cases is studied in an attempt to verify the poststapedectomy predictability of their characteristic gain curve (CGC) to define a pattern, which indicates the outcome of surgery. For that purpose, the postoperative BC curve has been modeled by fitting a linear regression curve (LRC), which I refer to here as "baseline," into the average audiogram of the 284 cases. RESULTS: Using the average baseline as the predicted postoperative BC audiogram, in 77% of the cases, the predicted CGC is qualitatively comparable to the measured one. DISCUSSIONS: The postoperative baseline can be modeled as a shifting of the average frequency of the preoperative baseline toward higher frequencies. This method is useful to predict the probabilities of having a negative slope in the gain curve after stapes surgery and, therefore, will help in the decision-making process for the indication of surgery and to advise patients on the results they can expect to have. A description of the steps to follow for the application of this method is made available.