الفهرس 
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Abstract
H
earing loss especially high frequency SNHL is not uncommon in CKD pediatric patients in both predialysis and dialysis groups. There was also a high prevalence of low IQ especially in pre-dialysis stages. IQ level was the only factor correlated with impaired hearing negatively, where a low IQ result is associated with a higher hearing impairment level, which confirms the importance of hearing to get a better IQ value. Age, Weight, Height, BMI, Blood pressure, The duration of the disease & The duration of the dialysis were not significantly different between patients with hearing impairment and those with normal hearing. It is important to keep in mind the auditory complications of CKD. Evaluating CKD patients with routine audiological evaluation & regular follow-up may help in early diagnosis and treatment of hearing loss and achieving a better quality of life for them and their families.
SUMMARY
C
hronic kidney disease (CKD) is a major health problem worldwide with an increasing incidence and prevalence.
In the past 2 decades, the incidence of chronic kidney disease in children has steadily increased too.
Chronic kidney disease (CKD) also is a major risk factor for many morbidities, including cardiovascular disease, cerebrovascular disease and bleeding, and hence cardiovascular mortality.
Many anatomical, physiological, pharmacological, and pathological similarities exist between the nephron and stria vascularis of the cochlea, and there are many similarities at the ultrastructural level. Both contain epithelial structures in close contact with their vascular supply. In addition to this basement membrane-lined intercellular channels exist both in the glomerulus and the stria vascularis.
Idiopathic sensory neural hearing loss (ISNHL) frequently occurs in patients with chronic kidney disease (CKD), which not only influences the child’s health, but also has a long-term impact on his life.
We aimed in this cross-sectional study to determine the prevalence, type & degree of hearing impairment in pediatric patients with CKD & to evaluate the relationships of various possible related factors with hearing impairment.
This study was carried out at pediatric dialysis, nephrology unit children’s hospital and Audiology unit, otolaryngology department faculty of medicine, Ain Shams University and included 90 CKD pediatric patients & 90 age & gender-matched controls. CKD patients were divided into two groups: group 1: forty-five CKD patients not on dialysis (CKD 2 to 4) & group 2: forty-five CKD patients on regular hemodialysis (CKD 5d).
All patients were subjected to the following: detailed history, physical examination, complete otological examination and basic audiological assessment in the form of Pure tone audiometry, Speech audiometry &tympanometry.
Some laboratory investigations were done including hemoglobin level, iron, lipid, metabolic bone profile, sodium, and potassium. Oral & informed consent was taken from the patients & caregivers and the work was approved by the Research Ethics Committee.
In our study, the most common aetiology of CKD among our patients was congenital anomalies of Kidney & urinary tract (CAKUT). The baseline weight, height, & body mass index (BMI) of the patients’ groups were significantly lower than the control group. Both systolic (SBP) &diastolic blood pressures (DBP) were significantly higher among patients in comparison to the control group.
The present study findings revealed that a positive association exists between CKD and hearing loss where 16.6% of our patients had hearing loss. Mild degree high frequency SNHL was the most common between our patients with hearing loss. Hence this study revealed that hearing loss especially high frequency SNHL is not uncommon in CKD paediatric patients, so the early diagnosis of hearing loss can prevent further progression and achieving a better quality of life.
IQ level was the only factor correlated with impaired hearing negatively, where a low IQ result is associated with a higher hearing impairment level. Age, gender, CKD stage, disease duration were all of no significant differences between the two groups, with normal hearing or without hearing loss