Hearing Loss in Renal Disease: Clinical and Pathological Studies

Abstract

Ninety-one of 224 chronic renal patients, most of them hemodialysis and/or transplant patients, had sensorineural loss: 11% noise exposure; 7% genetic; 22% due to multiple factors, including ototoxicity; 41% with hearing loss and ototoxic drug exposure, (but one-fourth had had insufficient drugs to cause hearing loss) and 11% were of unknown etiology. Hearing loss and normal hearing patients exposed to ototoxicity or multiple factors were similar in all parameters but hearing loss. Ten temporal bone cases are described, two from patients with hearing loss of unknown origin. One showed cochlear hydrops, fibrous tissue proliferation in cochlear perilymphatic spaces, Corti's organ degeneration, displaced tectorial membrane and probable metastatic calcification in the stria vascularis. The other case showed hair cell loss. Three patients had had ototoxic drugs; one bad hair cell loss and tectorial membrane abnormalities; one had hair cell loss and metastatic strial calcification; one was normal. One patient had pus in both internal auditory canals. Another bad otosclerotic focus without stapes fixation. Three were normal. We do not yet recognize pathology typical of hearing loss of severe renal disease. Findings seem to fall into two broad categories: those of known entities and those of obscure etiology.