Wednesday, March 13, 2024

BLOG ON HEARING LOSS AND CHRONIC KIDNEY DISEASE


 THE CONNECTION BETWEEN CKD AND HEARING LOSS



1. INTRODUCTION

In my lifetime I have lost the hearing in my right ear. Recently, I discovered that my hearing loss may be connected to my 42 years of CKD/PKD, so I wanted to share what I have learned.

I did a Broadcast on Friday, March 8, 2024 on Hearing Loss and Kidney Disease.
THE CONNECTION BETWEEN CKD AND HEARING LOSS


1. INTRODUCTION

In my lifetime I have lost the hearing in my right ear. Recently, I discovered that my hearing loss may be connected to my 42 years of CKD/PKD, so I wanted to share what I have learned.

I did a Broadcast on Friday, March 8, 2024 on Hearing Loss and Kidney Disease.
https://www.facebook.com/share/v/UjtBWRctbtTqoF4i/?mibextid=oFDknk

Here are some of my thoughts.



2. IS THERE A CONNECTION BETWEEN  KIDNEY DISEASE AND YOUR LOSS OF HEARING?

According to experts, there is a connection Kidney Disease and a Loss of Hearing. (Nature.com)

There are nearly 1.6 billion people that and suffer from a hearing loss & is the third-leading cause of disability worldwide.
Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. It affects 15% of US adults & 37 million people are estimated to have chronic kidney disease.

The question is whether or not there is a connection between the two.  The answer appears to be yes. According to experts, The kidneys and the hearing organs share a common morphogenetic(same cells, tisue & genetic structure)origin and rely on similar biological structures (for example, cilia) and processes (for example, specialized cellular transport mechanisms) to function.

So the same Genetic Abnormalities that cause CKD can also cause hearing loss, and vice versa.

The NIH states," Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss."

According to Nature.com, "A strong, graded and independent relationship exists between kidney function and the risk of hearing loss; the highest risk is observed in patients on haemodialysis, but kidney transplant recipients and people with mild CKD are also at increased risk."

Because tissue in our ear is substantially similar to the tissue in our kidneys, the toxic build up that damages kidney tissue also is capable of damaging inner ear tissue.

This appears to be confirmed by a 2010 study in Australia, that not just specific Kidney Diseases, but Kidney Disease in general can cause hearing loss in Kidney Patients. "This study examined the medical records of 2,564 people aged 50 and over, 513 of whom had moderate chronic kidney disease. Some 54.4% of all the patients with chronic kidney disease had some degree of hearing loss, as compared to only 28.3% of those who had no kidney problems.” Even more interesting, 30% of the CKD patients had a severe hearing loss compared to just 10% in those patients without CKD."

The study concluded, "The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear." Also, some treatments for kidney ailments are ototoxic, meaning they cause hearing loss."

As stated earlier, this is readily found in patients that are on hemodialysis.

Experts suggest that Infants, children and  adults with malformation or dysfunction of their hearing organs should be evaluated for the presence of malformation or dysfunction of their kidneys, and people with Kidney Disease should have their hearing checked for loss.

3. IN CERTAIN TYPES OF KIDNEY DISEASES HEARING LOSS IS MORE PROMINENT THAN IN OTHERS

Some types of Kidney Diseases are mentioned more prominently than others in the literature as causes of hearing loss and if you have one of these diseases you may wish to have your hearing checked as well as your  kidney function.



These diseases include:

• Alport's Syndrome
• Polycystic Kidney Disease
• Meniere's Disease

Many people with Alport's Syndrome have problems with their ears and eyes. Alport syndrome is a rare inherited disorder that damages the tiny blood vessels in the kidneys. It can also cause hearing loss and eye problems.

Alport syndrome is an inherited form of kidney inflammation (nephritis). It is caused by a defect (mutation) in a gene for a protein in the connective tissue, called collagen.

The disorder is rare. There are three genetic types:

• X-linked Alport syndrome (XLAS) -- This is the most common type. The disease is more severe in males than in females.

• Autosomal recessive Alport syndrome (ARAS) -- Males and females have equally severe disease.

• Autosomal dominant Alport syndrome (ADAS) -- This is the rarest type. Males and females have equally severe disease.

The frequency in which hearing loss appears with Alport's is striking. Studies show that, approximately, 70% of patients with AS suffer from progressive sensorineural hearing loss.  Over time, Alport syndrome also leads to hearing loss in both ears. By the early teens, it is more common in males with XLAS, though in females, hearing loss is not as common and happens when they're adults. With ARAS, boys and girls have hearing loss during childhood. With ADAS, it occurs later in life. Hearing loss usually occurs before kidney failure.

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss With Polycystic Kidney Disease
Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Hearing Loss and Meniere's Disease

Several studies  harmful effects of chronic kidney disease (CKD) on the audiovestibular system. This would include a connection between Chronic Kidney Disease and Meniere's Disease. Patients with CKD had a significantly increased incidence of Ménière’s disease,


According to the Mayo Clinic, Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.

Symptoms of Meniere's disease include:

• Regular dizzy spells. You have a spinning feeling that starts and stops suddenly. Vertigo may start without warning. It usually lasts 20 minutes to 12 hours, but not more than 24 hours. Serious vertigo can cause nausea.

• Hearing loss. Hearing loss in Meniere's disease may come and go, especially early on. Over time, hearing loss can be long-lasting and not get better.

• Ringing in the ear. Ringing in the ear is called tinnitus. Tinnitus is the term for when you have a ringing, buzzing, roaring, whistling or hissing sound in your ear.

• Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the ear. This is called aural fullness.

After a vertigo attack, symptoms get better and might go away for a while. Over time, how many vertigo attacks you have may lessen.

To Diagnose Meniere's, the physician will conduct an exam and asks about your health history. A Meniere's disease diagnosis needs to include:

• Two or more vertigo attacks, each lasting 20 minutes to 12 hours, or up to 24 hours.

• Hearing loss proved by a hearing test.

• Tinnitus or a feeling of fullness or pressure in the ear.
A Balance Assessment will take place.

Between vertigo attacks, balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that study how well the inner ear is working include:

Electronystagmogram or videonystagmography (ENG or VNG). These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your healthcare provider may use warm and cold air or water in the ear for the caloric test.

No cure exists for Meniere's disease. Some treatments can help lessen how bad vertigo attacks are and how long they last. But there are no treatments for permanent hearing loss. Your healthcare provider may be able to suggest treatments that prevent your hearing loss from getting worse.

Treatment Methods include:

Medicines for vertigo

Your healthcare provider may prescribe medicines to take during a vertigo attack so that it's less severe:

• Motion sickness medicines. Medicines such as meclizine (Antivert) or diazepam (Valium) may lessen the spinning feeling and help control nausea and vomiting.

• Anti-nausea medicines. Medicines such as promethazine might control nausea and vomiting during a vertigo attack.

• Diuretics and betahistine. These medicines can be used together or alone to improve vertigo. Diuretics lower how much fluid is in the body, which may lower the amount of extra fluid in the inner ear. Betahistines ease vertigo symptoms by improving blood flow to the inner ear.

Long-term medicine use

Your healthcare provider may prescribe a medicine to reduce fluid retention and suggest limiting your salt intake. This helps control the intensity and amount of Meniere's disease symptoms in some people.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from procedures that don't include surgery, such as:

• Rehabilitation. If you have balance problems between vertigo attacks, vestibular rehabilitation therapy might improve your balance.

• Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your healthcare provider can refer you to an ear doctor, also called an audiologist, to talk about the best hearing aids for you.

If conservative treatments aren't successful, your care provider might suggest more-intense treatments.

Middle ear injections

Medicines injected and absorbed in the middle ear may help vertigo symptoms get better. This treatment is done in a care provider's office. Injections can include:

• Gentamicin. This is an antibiotic that's toxic to your inner ear. It works by damaging the sick part of your ear that's causing vertigo. Your healthy ear then takes on the job for balance. But there is a risk of further hearing loss.

• Steroids. Steroids such as dexamethasone also may help control vertigo attacks in some people. Dexamethasone may not work as well as gentamicin. But it's less likely to cause further hearing loss.

Surgery

If vertigo attacks from Meniere's disease are severe and hard to bear and other treatments don't help, surgery might be an option. Procedures include:

• Endolymphatic sac surgery. The endolymphatic sac helps control inner ear fluid levels. This procedure relieves pressure around the endolymphatic sac, which can improve fluid levels. Sometimes, a care provider places a tube inside your ear to drain any extra fluid.

• Labyrinthectomy. With this procedure, the surgeon removes the parts of your ear causing vertigo, which causes complete hearing loss in that ear. This allows your healthy ear to be in charge of sending information about balance and hearing to your brain. Care providers only suggest this procedure if you have poor hearing or total hearing loss in the diseased ear.

• Vestibular nerve section. This procedure involves cutting the vestibular nerve to prevent information about movement from getting to the brain. The vestibular nerve sends balance and movement information from your inner ear to the brain. This procedure usually improves vertigo and keeps hearing in the diseased ear. Most people need medicine that puts them in a sleep-like state, called general anesthesia, and an overnight hospital stay.


What illness causes hearing damage?

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

4. CONCLUSIONS

There is a significant relationship between CKD and Hearing Loss. One recent article states, "Patients with CKD are predisposed to several otorhinolaryngological issues especially SNHL, and the link between SNHL (sensorineural hearing loss)
and CKD has both been extensively explained, but the relationship between the remaining complications and CKD is still unknown."

In plain English, if you suffer from CKD, you should get your hearing checked, and if you have any symptoms that we have discussed today, you may wish to consult with an otolaryngologist.

5. REFERENCES

A.. Can Kidney Disease Lead to Hearing Loss?

The multifaceted links between hearing loss and chronic kidney disease
https://www.nature.com/articles/s41581-024-00808-2#:~:text=A%20strong%2C%20graded%20and%20independent,are%20also%20at%20increased%20risk.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/#:~:text=Chronic%20kidney%20disease%20is%20a,can%20lead%20to%20hearing%20loss.

What is the relationship between the kidneys and the ears?
Tissues of the kidney and the inner ear are similar and share a common metabolic function, therefore problems that affect kidney function can also damage the inner ear. High blood pressure, diabetes and a family history of CKD can increase your risk of developing kidney problems and hearing problems.
https://yvdwaudiology.co.za/blog/your-kidneys-and-your-ears/#:~:text=Tissues%20of%20the%20kidney%20and,kidney%20problems%20and%20hearing%20problems.

Hearing Loss  in Patients on Hemodialysis

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/

Hearing loss causes
https://www.healthyhearing.com/help/hearing-loss/causes

The Link Between Kidneys and Your Hearing
https://hearinghealthfoundation.org/blogs/the-link-between-your-kidneys-and-your-hearing

Kidney Disease a Surprising Reason For Hearing Loss
https://www.hearingunlimited.net/kidney-disease-a-surprising-reason-for-hearing-loss/
(a specific part of our ears shares functional and structural characteristics with our kidneys. Research has confirmed that physiological mechanisms of fluid and electrolyte balance are present in both organs. This matters because it means that when a health issue affects the functionality of one (i.e. the kidneys or the ears), it’s likely to affect the other. So while hearing loss doesn’t cause CKD – or vice versa – patients with certain types of hearing loss are likely to experience problems with their kidneys (and vice versa).


The Relationship Between Cochlea and Kidney
https://www.researchgate.net/publication/227808405_The_Relationship_Between_Cochlea_and_Kidney

B. Other Kidney Diseases That Can Cause Hearing Loss:

• Alport's Syndrome
From the NKF:
Alport's Syndrome
https://www.kidney.org/atoz/content/alport (General Description);

Alport's Syndrome; Symptoms and Causes
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/alport-syndrome

Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766141/

How often does Alport syndrome cause hearing loss?

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss in Alport syndrome
https://alportsyndrome.org/hearing-loss-in-alport-syndrome/

Alport syndrome
https://medlineplus.gov/genetics/condition/alport-syndrome/#frequency

Deafblind Fact Sheet: Alport Syndrome
https://www.cde.state.co.us/cdesped/sd-db_factsheetwp_alport#:~:text=Approximately%2080%25%20of%20young%20males,often%20by%20their%20teenage%20years.




• Polycystic Kidney Disease

Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Autosomal Dominant Polycystic Kidney Disease Associated with Familial Sensorineural Deafness
https://www.tandfonline.com/doi/pdf/10.1080/003655999750016302

Polycystic kidney disease and sensorineural deafness
https://www.researchgate.net/publication/283581697_Polycystic_kidney_disease_and_sensorineural_deafness
Hearing Loss and Meniere's Disease

Connection Between Meniere's Disease and CKD

Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière’s disease: a nationwide cohort study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511089/



Meniere's Disease
https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910
(Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.)

What is Meniere's Disease?
https://www.nidcd.nih.gov/health/menieres-disease

Meniere Disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/menieres-disease


C. Diseases In General That Can Cause Hearing Loss :

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

Deafness - a range of causes
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/deafness-a-range-of-causes

D. Conclusion
Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review
https://www.cureus.com/articles/169480-sensorineural-hearing-loss-in-patients-with-chronic-kidney-disease-a-comprehensive-review#!/





















THE CONNECTION BETWEEN CKD AND HEARING LOSS


1. INTRODUCTION

In my lifetime I have lost the hearing in my right ear. Recently, I discovered that my hearing loss may be connected to my 42 years of CKD/PKD, so I wanted to share what I have learned.

I did a Broadcast on Friday, March 8, 2024 on Hearing Loss and Kidney Disease.
https://www.facebook.com/share/v/UjtBWRctbtTqoF4i/?mibextid=oFDknk

Here are some of my thoughts.



2. IS THERE A CONNECTION BETWEEN  KIDNEY DISEASE AND YOUR LOSS OF HEARING?

According to experts, there is a connection Kidney Disease and a Loss of Hearing. (Nature.com)

There are nearly 1.6 billion people that and suffer from a hearing loss & is the third-leading cause of disability worldwide.
Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. It affects 15% of US adults & 37 million people are estimated to have chronic kidney disease.

The question is whether or not there is a connection between the two.  The answer appears to be yes. According to experts, The kidneys and the hearing organs share a common morphogenetic(same cells, tisue & genetic structure)origin and rely on similar biological structures (for example, cilia) and processes (for example, specialized cellular transport mechanisms) to function.

So the same Genetic Abnormalities that cause CKD can also cause hearing loss, and vice versa.

The NIH states," Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss."

According to Nature.com, "A strong, graded and independent relationship exists between kidney function and the risk of hearing loss; the highest risk is observed in patients on haemodialysis, but kidney transplant recipients and people with mild CKD are also at increased risk."

Because tissue in our ear is substantially similar to the tissue in our kidneys, the toxic build up that damages kidney tissue also is capable of damaging inner ear tissue.

This appears to be confirmed by a 2010 study in Australia, that not just specific Kidney Diseases, but Kidney Disease in general can cause hearing loss in Kidney Patients. "This study examined the medical records of 2,564 people aged 50 and over, 513 of whom had moderate chronic kidney disease. Some 54.4% of all the patients with chronic kidney disease had some degree of hearing loss, as compared to only 28.3% of those who had no kidney problems.” Even more interesting, 30% of the CKD patients had a severe hearing loss compared to just 10% in those patients without CKD."

The study concluded, "The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear." Also, some treatments for kidney ailments are ototoxic, meaning they cause hearing loss."

As stated earlier, this is readily found in patients that are on hemodialysis.

Experts suggest that Infants, children and  adults with malformation or dysfunction of their hearing organs should be evaluated for the presence of malformation or dysfunction of their kidneys, and people with Kidney Disease should have their hearing checked for loss.

3. IN CERTAIN TYPES OF KIDNEY DISEASES HEARING LOSS IS MORE PROMINENT THAN IN OTHERS

Some types of Kidney Diseases are mentioned more prominently than others in the literature as causes of hearing loss and if you have one of these diseases you may wish to have your hearing checked as well as your  kidney function.



These diseases include:

• Alport's Syndrome
• Polycystic Kidney Disease
• Meniere's Disease

Many people with Alport's Syndrome have problems with their ears and eyes. Alport syndrome is a rare inherited disorder that damages the tiny blood vessels in the kidneys. It can also cause hearing loss and eye problems.

Alport syndrome is an inherited form of kidney inflammation (nephritis). It is caused by a defect (mutation) in a gene for a protein in the connective tissue, called collagen.

The disorder is rare. There are three genetic types:

• X-linked Alport syndrome (XLAS) -- This is the most common type. The disease is more severe in males than in females.

• Autosomal recessive Alport syndrome (ARAS) -- Males and females have equally severe disease.

• Autosomal dominant Alport syndrome (ADAS) -- This is the rarest type. Males and females have equally severe disease.

The frequency in which hearing loss appears with Alport's is striking. Studies show that, approximately, 70% of patients with AS suffer from progressive sensorineural hearing loss.  Over time, Alport syndrome also leads to hearing loss in both ears. By the early teens, it is more common in males with XLAS, though in females, hearing loss is not as common and happens when they're adults. With ARAS, boys and girls have hearing loss during childhood. With ADAS, it occurs later in life. Hearing loss usually occurs before kidney failure.

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss With Polycystic Kidney Disease
Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Hearing Loss and Meniere's Disease

Several studies  harmful effects of chronic kidney disease (CKD) on the audiovestibular system. This would include a connection between Chronic Kidney Disease and Meniere's Disease. Patients with CKD had a significantly increased incidence of Ménière’s disease,


According to the Mayo Clinic, Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.

Symptoms of Meniere's disease include:

• Regular dizzy spells. You have a spinning feeling that starts and stops suddenly. Vertigo may start without warning. It usually lasts 20 minutes to 12 hours, but not more than 24 hours. Serious vertigo can cause nausea.

• Hearing loss. Hearing loss in Meniere's disease may come and go, especially early on. Over time, hearing loss can be long-lasting and not get better.

• Ringing in the ear. Ringing in the ear is called tinnitus. Tinnitus is the term for when you have a ringing, buzzing, roaring, whistling or hissing sound in your ear.

• Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the ear. This is called aural fullness.

After a vertigo attack, symptoms get better and might go away for a while. Over time, how many vertigo attacks you have may lessen.

To Diagnose Meniere's, the physician will conduct an exam and asks about your health history. A Meniere's disease diagnosis needs to include:

• Two or more vertigo attacks, each lasting 20 minutes to 12 hours, or up to 24 hours.

• Hearing loss proved by a hearing test.

• Tinnitus or a feeling of fullness or pressure in the ear.
A Balance Assessment will take place.

Between vertigo attacks, balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that study how well the inner ear is working include:

Electronystagmogram or videonystagmography (ENG or VNG). These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your healthcare provider may use warm and cold air or water in the ear for the caloric test.

No cure exists for Meniere's disease. Some treatments can help lessen how bad vertigo attacks are and how long they last. But there are no treatments for permanent hearing loss. Your healthcare provider may be able to suggest treatments that prevent your hearing loss from getting worse.

Treatment Methods include:

Medicines for vertigo

Your healthcare provider may prescribe medicines to take during a vertigo attack so that it's less severe:

• Motion sickness medicines. Medicines such as meclizine (Antivert) or diazepam (Valium) may lessen the spinning feeling and help control nausea and vomiting.

• Anti-nausea medicines. Medicines such as promethazine might control nausea and vomiting during a vertigo attack.

• Diuretics and betahistine. These medicines can be used together or alone to improve vertigo. Diuretics lower how much fluid is in the body, which may lower the amount of extra fluid in the inner ear. Betahistines ease vertigo symptoms by improving blood flow to the inner ear.

Long-term medicine use

Your healthcare provider may prescribe a medicine to reduce fluid retention and suggest limiting your salt intake. This helps control the intensity and amount of Meniere's disease symptoms in some people.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from procedures that don't include surgery, such as:

• Rehabilitation. If you have balance problems between vertigo attacks, vestibular rehabilitation therapy might improve your balance.

• Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your healthcare provider can refer you to an ear doctor, also called an audiologist, to talk about the best hearing aids for you.

If conservative treatments aren't successful, your care provider might suggest more-intense treatments.

Middle ear injections

Medicines injected and absorbed in the middle ear may help vertigo symptoms get better. This treatment is done in a care provider's office. Injections can include:

• Gentamicin. This is an antibiotic that's toxic to your inner ear. It works by damaging the sick part of your ear that's causing vertigo. Your healthy ear then takes on the job for balance. But there is a risk of further hearing loss.

• Steroids. Steroids such as dexamethasone also may help control vertigo attacks in some people. Dexamethasone may not work as well as gentamicin. But it's less likely to cause further hearing loss.

Surgery

If vertigo attacks from Meniere's disease are severe and hard to bear and other treatments don't help, surgery might be an option. Procedures include:

• Endolymphatic sac surgery. The endolymphatic sac helps control inner ear fluid levels. This procedure relieves pressure around the endolymphatic sac, which can improve fluid levels. Sometimes, a care provider places a tube inside your ear to drain any extra fluid.

• Labyrinthectomy. With this procedure, the surgeon removes the parts of your ear causing vertigo, which causes complete hearing loss in that ear. This allows your healthy ear to be in charge of sending information about balance and hearing to your brain. Care providers only suggest this procedure if you have poor hearing or total hearing loss in the diseased ear.

• Vestibular nerve section. This procedure involves cutting the vestibular nerve to prevent information about movement from getting to the brain. The vestibular nerve sends balance and movement information from your inner ear to the brain. This procedure usually improves vertigo and keeps hearing in the diseased ear. Most people need medicine that puts them in a sleep-like state, called general anesthesia, and an overnight hospital stay.


What illness causes hearing damage?

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

4. CONCLUSIONS

There is a significant relationship between CKD and Hearing Loss. One recent article states, "Patients with CKD are predisposed to several otorhinolaryngological issues especially SNHL, and the link between SNHL (sensorineural hearing loss)
and CKD has both been extensively explained, but the relationship between the remaining complications and CKD is still unknown."

In plain English, if you suffer from CKD, you should get your hearing checked, and if you have any symptoms that we have discussed today, you may wish to consult with an otolaryngologist.

5. REFERENCES

A.. Can Kidney Disease Lead to Hearing Loss?

The multifaceted links between hearing loss and chronic kidney disease
https://www.nature.com/articles/s41581-024-00808-2#:~:text=A%20strong%2C%20graded%20and%20independent,are%20also%20at%20increased%20risk.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/#:~:text=Chronic%20kidney%20disease%20is%20a,can%20lead%20to%20hearing%20loss.

What is the relationship between the kidneys and the ears?
Tissues of the kidney and the inner ear are similar and share a common metabolic function, therefore problems that affect kidney function can also damage the inner ear. High blood pressure, diabetes and a family history of CKD can increase your risk of developing kidney problems and hearing problems.
https://yvdwaudiology.co.za/blog/your-kidneys-and-your-ears/#:~:text=Tissues%20of%20the%20kidney%20and,kidney%20problems%20and%20hearing%20problems.

Hearing Loss  in Patients on Hemodialysis

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/

Hearing loss causes
https://www.healthyhearing.com/help/hearing-loss/causes

The Link Between Kidneys and Your Hearing
https://hearinghealthfoundation.org/blogs/the-link-between-your-kidneys-and-your-hearing

Kidney Disease a Surprising Reason For Hearing Loss
https://www.hearingunlimited.net/kidney-disease-a-surprising-reason-for-hearing-loss/
(a specific part of our ears shares functional and structural characteristics with our kidneys. Research has confirmed that physiological mechanisms of fluid and electrolyte balance are present in both organs. This matters because it means that when a health issue affects the functionality of one (i.e. the kidneys or the ears), it’s likely to affect the other. So while hearing loss doesn’t cause CKD – or vice versa – patients with certain types of hearing loss are likely to experience problems with their kidneys (and vice versa).


The Relationship Between Cochlea and Kidney
https://www.researchgate.net/publication/227808405_The_Relationship_Between_Cochlea_and_Kidney

B. Other Kidney Diseases That Can Cause Hearing Loss:

• Alport's Syndrome
From the NKF:
Alport's Syndrome
https://www.kidney.org/atoz/content/alport (General Description);

Alport's Syndrome; Symptoms and Causes
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/alport-syndrome

Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766141/

How often does Alport syndrome cause hearing loss?

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss in Alport syndrome
https://alportsyndrome.org/hearing-loss-in-alport-syndrome/

Alport syndrome
https://medlineplus.gov/genetics/condition/alport-syndrome/#frequency

Deafblind Fact Sheet: Alport Syndrome
https://www.cde.state.co.us/cdesped/sd-db_factsheetwp_alport#:~:text=Approximately%2080%25%20of%20young%20males,often%20by%20their%20teenage%20years.




• Polycystic Kidney Disease

Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Autosomal Dominant Polycystic Kidney Disease Associated with Familial Sensorineural Deafness
https://www.tandfonline.com/doi/pdf/10.1080/003655999750016302

Polycystic kidney disease and sensorineural deafness
https://www.researchgate.net/publication/283581697_Polycystic_kidney_disease_and_sensorineural_deafness
Hearing Loss and Meniere's Disease

Connection Between Meniere's Disease and CKD

Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière’s disease: a nationwide cohort study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511089/



Meniere's Disease
https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910
(Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.)

What is Meniere's Disease?
https://www.nidcd.nih.gov/health/menieres-disease

Meniere Disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/menieres-disease


C. Diseases In General That Can Cause Hearing Loss :

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

Deafness - a range of causes
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/deafness-a-range-of-causes

D. Conclusion
Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review
https://www.cureus.com/articles/169480-sensorineural-hearing-loss-in-patients-with-chronic-kidney-disease-a-comprehensive-review#!/




































Here are some of my thoughts.



2. IS THERE A CONNECTION BETWEEN  KIDNEY DISEASE AND YOUR LOSS OF HEARING?

According to experts, there is a connection Kidney Disease and a Loss of Hearing. (Nature.com)

There are nearly 1.6 billion people that and suffer from a hearing loss & is the third-leading cause of disability worldwide.
Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. It affects 15% of US adults & 37 million people are estimated to have chronic kidney disease.

The question is whether or not there is a connection between the two.  The answer appears to be yes. According to experts, The kidneys and the hearing organs share a common morphogenetic(same cells, tisue & genetic structure)origin and rely on similar biological structures (for example, cilia) and processes (for example, specialized cellular transport mechanisms) to function.

So the same Genetic Abnormalities that cause CKD can also cause hearing loss, and vice versa.

The NIH states," Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss."

According to Nature.com, "A strong, graded and independent relationship exists between kidney function and the risk of hearing loss; the highest risk is observed in patients on haemodialysis, but kidney transplant recipients and people with mild CKD are also at increased risk."

Because tissue in our ear is substantially similar to the tissue in our kidneys, the toxic build up that damages kidney tissue also is capable of damaging inner ear tissue.

This appears to be confirmed by a 2010 study in Australia, that not just specific Kidney Diseases, but Kidney Disease in general can cause hearing loss in Kidney Patients. "This study examined the medical records of 2,564 people aged 50 and over, 513 of whom had moderate chronic kidney disease. Some 54.4% of all the patients with chronic kidney disease had some degree of hearing loss, as compared to only 28.3% of those who had no kidney problems.” Even more interesting, 30% of the CKD patients had a severe hearing loss compared to just 10% in those patients without CKD."

The study concluded, "The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear." Also, some treatments for kidney ailments are ototoxic, meaning they cause hearing loss."

As stated earlier, this is readily found in patients that are on hemodialysis.

Experts suggest that Infants, children and  adults with malformation or dysfunction of their hearing organs should be evaluated for the presence of malformation or dysfunction of their kidneys, and people with Kidney Disease should have their hearing checked for loss.

3. IN CERTAIN TYPES OF KIDNEY DISEASES HEARING LOSS IS MORE PROMINENT THAN IN OTHERS

Some types of Kidney Diseases are mentioned more prominently than others in the literature as causes of hearing loss and if you have one of these diseases you may wish to have your hearing checked as well as your  kidney function.



These diseases include:

• Alport's Syndrome
• Polycystic Kidney Disease
• Meniere's Disease

Many people with Alport's Syndrome have problems with their ears and eyes. Alport syndrome is a rare inherited disorder that damages the tiny blood vessels in the kidneys. It can also cause hearing loss and eye problems.

Alport syndrome is an inherited form of kidney inflammation (nephritis). It is caused by a defect (mutation) in a gene for a protein in the connective tissue, called collagen.

The disorder is rare. There are three genetic types:

• X-linked Alport syndrome (XLAS) -- This is the most common type. The disease is more severe in males than in females.

• Autosomal recessive Alport syndrome (ARAS) -- Males and females have equally severe disease.

• Autosomal dominant Alport syndrome (ADAS) -- This is the rarest type. Males and females have equally severe disease.

The frequency in which hearing loss appears with Alport's is striking. Studies show that, approximately, 70% of patients with AS suffer from progressive sensorineural hearing loss.  Over time, Alport syndrome also leads to hearing loss in both ears. By the early teens, it is more common in males with XLAS, though in females, hearing loss is not as common and happens when they're adults. With ARAS, boys and girls have hearing loss during childhood. With ADAS, it occurs later in life. Hearing loss usually occurs before kidney failure.

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss With Polycystic Kidney Disease
Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Hearing Loss and Meniere's Disease

Several studies  harmful effects of chronic kidney disease (CKD) on the audiovestibular system. This would include a connection between Chronic Kidney Disease and Meniere's Disease. Patients with CKD had a significantly increased incidence of Ménière’s disease,


According to the Mayo Clinic, Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.

Symptoms of Meniere's disease include:

• Regular dizzy spells. You have a spinning feeling that starts and stops suddenly. Vertigo may start without warning. It usually lasts 20 minutes to 12 hours, but not more than 24 hours. Serious vertigo can cause nausea.

• Hearing loss. Hearing loss in Meniere's disease may come and go, especially early on. Over time, hearing loss can be long-lasting and not get better.

• Ringing in the ear. Ringing in the ear is called tinnitus. Tinnitus is the term for when you have a ringing, buzzing, roaring, whistling or hissing sound in your ear.

• Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the ear. This is called aural fullness.

After a vertigo attack, symptoms get better and might go away for a while. Over time, how many vertigo attacks you have may lessen.

To Diagnose Meniere's, the physician will conduct an exam and asks about your health history. A Meniere's disease diagnosis needs to include:

• Two or more vertigo attacks, each lasting 20 minutes to 12 hours, or up to 24 hours.

• Hearing loss proved by a hearing test.

• Tinnitus or a feeling of fullness or pressure in the ear.
A Balance Assessment will take place.

Between vertigo attacks, balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that study how well the inner ear is working include:

Electronystagmogram or videonystagmography (ENG or VNG). These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your healthcare provider may use warm and cold air or water in the ear for the caloric test.

No cure exists for Meniere's disease. Some treatments can help lessen how bad vertigo attacks are and how long they last. But there are no treatments for permanent hearing loss. Your healthcare provider may be able to suggest treatments that prevent your hearing loss from getting worse.

Treatment Methods include:

Medicines for vertigo

Your healthcare provider may prescribe medicines to take during a vertigo attack so that it's less severe:

• Motion sickness medicines. Medicines such as meclizine (Antivert) or diazepam (Valium) may lessen the spinning feeling and help control nausea and vomiting.

• Anti-nausea medicines. Medicines such as promethazine might control nausea and vomiting during a vertigo attack.

• Diuretics and betahistine. These medicines can be used together or alone to improve vertigo. Diuretics lower how much fluid is in the body, which may lower the amount of extra fluid in the inner ear. Betahistines ease vertigo symptoms by improving blood flow to the inner ear.

Long-term medicine use

Your healthcare provider may prescribe a medicine to reduce fluid retention and suggest limiting your salt intake. This helps control the intensity and amount of Meniere's disease symptoms in some people.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from procedures that don't include surgery, such as:

• Rehabilitation. If you have balance problems between vertigo attacks, vestibular rehabilitation therapy might improve your balance.

• Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your healthcare provider can refer you to an ear doctor, also called an audiologist, to talk about the best hearing aids for you.

If conservative treatments aren't successful, your care provider might suggest more-intense treatments.

Middle ear injections

Medicines injected and absorbed in the middle ear may help vertigo symptoms get better. This treatment is done in a care provider's office. Injections can include:

• Gentamicin. This is an antibiotic that's toxic to your inner ear. It works by damaging the sick part of your ear that's causing vertigo. Your healthy ear then takes on the job for balance. But there is a risk of further hearing loss.

• Steroids. Steroids such as dexamethasone also may help control vertigo attacks in some people. Dexamethasone may not work as well as gentamicin. But it's less likely to cause further hearing loss.

Surgery

If vertigo attacks from Meniere's disease are severe and hard to bear and other treatments don't help, surgery might be an option. Procedures include:

• Endolymphatic sac surgery. The endolymphatic sac helps control inner ear fluid levels. This procedure relieves pressure around the endolymphatic sac, which can improve fluid levels. Sometimes, a care provider places a tube inside your ear to drain any extra fluid.

• Labyrinthectomy. With this procedure, the surgeon removes the parts of your ear causing vertigo, which causes complete hearing loss in that ear. This allows your healthy ear to be in charge of sending information about balance and hearing to your brain. Care providers only suggest this procedure if you have poor hearing or total hearing loss in the diseased ear.

• Vestibular nerve section. This procedure involves cutting the vestibular nerve to prevent information about movement from getting to the brain. The vestibular nerve sends balance and movement information from your inner ear to the brain. This procedure usually improves vertigo and keeps hearing in the diseased ear. Most people need medicine that puts them in a sleep-like state, called general anesthesia, and an overnight hospital stay.


What illness causes hearing damage?

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

4. CONCLUSIONS

There is a significant relationship between CKD and Hearing Loss. One recent article states, "Patients with CKD are predisposed to several otorhinolaryngological issues especially SNHL, and the link between SNHL (sensorineural hearing loss)
and CKD has both been extensively explained, but the relationship between the remaining complications and CKD is still unknown."

In plain English, if you suffer from CKD, you should get your hearing checked, and if you have any symptoms that we have discussed today, you may wish to consult with an otolaryngologist.

5. REFERENCES

A.. Can Kidney Disease Lead to Hearing Loss?

The multifaceted links between hearing loss and chronic kidney disease
https://www.nature.com/articles/s41581-024-00808-2#:~:text=A%20strong%2C%20graded%20and%20independent,are%20also%20at%20increased%20risk.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/#:~:text=Chronic%20kidney%20disease%20is%20a,can%20lead%20to%20hearing%20loss.

What is the relationship between the kidneys and the ears?
Tissues of the kidney and the inner ear are similar and share a common metabolic function, therefore problems that affect kidney function can also damage the inner ear. High blood pressure, diabetes and a family history of CKD can increase your risk of developing kidney problems and hearing problems.
https://yvdwaudiology.co.za/blog/your-kidneys-and-your-ears/#:~:text=Tissues%20of%20the%20kidney%20and,kidney%20problems%20and%20hearing%20problems.

Hearing Loss  in Patients on Hemodialysis

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/

Hearing loss causes
https://www.healthyhearing.com/help/hearing-loss/causes

The Link Between Kidneys and Your Hearing
https://hearinghealthfoundation.org/blogs/the-link-between-your-kidneys-and-your-hearing

Kidney Disease a Surprising Reason For Hearing Loss
https://www.hearingunlimited.net/kidney-disease-a-surprising-reason-for-hearing-loss/
(a specific part of our ears shares functional and structural characteristics with our kidneys. Research has confirmed that physiological mechanisms of fluid and electrolyte balance are present in both organs. This matters because it means that when a health issue affects the functionality of one (i.e. the kidneys or the ears), it’s likely to affect the other. So while hearing loss doesn’t cause CKD – or vice versa – patients with certain types of hearing loss are likely to experience problems with their kidneys (and vice versa).


The Relationship Between Cochlea and Kidney
https://www.researchgate.net/publication/227808405_The_Relationship_Between_Cochlea_and_Kidney

B. Other Kidney Diseases That Can Cause Hearing Loss:

• Alport's Syndrome
From the NKF:
Alport's Syndrome
https://www.kidney.org/atoz/content/alport (General Description);

Alport's Syndrome; Symptoms and Causes
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/alport-syndrome

Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766141/

How often does Alport syndrome cause hearing loss?

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss in Alport syndrome
https://alportsyndrome.org/hearing-loss-in-alport-syndrome/

Alport syndrome
https://medlineplus.gov/genetics/condition/alport-syndrome/#frequency

Deafblind Fact Sheet: Alport Syndrome
https://www.cde.state.co.us/cdesped/sd-db_factsheetwp_alport#:~:text=Approximately%2080%25%20of%20young%20males,often%20by%20their%20teenage%20years.




• Polycystic Kidney Disease

Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Autosomal Dominant Polycystic Kidney Disease Associated with Familial Sensorineural Deafness
https://www.tandfonline.com/doi/pdf/10.1080/003655999750016302

Polycystic kidney disease and sensorineural deafness
https://www.researchgate.net/publication/283581697_Polycystic_kidney_disease_and_sensorineural_deafness
Hearing Loss and Meniere's Disease

Connection Between Meniere's Disease and CKD

Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière’s disease: a nationwide cohort study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511089/



Meniere's Disease
https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910
(Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.)

What is Meniere's Disease?
https://www.nidcd.nih.gov/health/menieres-disease

Meniere Disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/menieres-disease


C. Diseases In General That Can Cause Hearing Loss :

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

Deafness - a range of causes
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/deafness-a-range-of-causes

D. Conclusion
Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review
https://www.cureus.com/articles/169480-sensorineural-hearing-loss-in-patients-with-chronic-kidney-disease-a-comprehensive-review#!/





















THE CONNECTION BETWEEN CKD AND HEARING LOSS


1. INTRODUCTION

In my lifetime I have lost the hearing in my right ear. Recently, I discovered that my hearing loss may be connected to my 42 years of CKD/PKD, so I wanted to share what I have learned.

I did a Broadcast on Friday, March 8, 2024 on Hearing Loss and Kidney Disease.
https://www.facebook.com/share/v/UjtBWRctbtTqoF4i/?mibextid=oFDknk

Here are some of my thoughts.



2. IS THERE A CONNECTION BETWEEN  KIDNEY DISEASE AND YOUR LOSS OF HEARING?

According to experts, there is a connection Kidney Disease and a Loss of Hearing. (Nature.com)

There are nearly 1.6 billion people that and suffer from a hearing loss & is the third-leading cause of disability worldwide.
Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. It affects 15% of US adults & 37 million people are estimated to have chronic kidney disease.

The question is whether or not there is a connection between the two.  The answer appears to be yes. According to experts, The kidneys and the hearing organs share a common morphogenetic(same cells, tisue & genetic structure)origin and rely on similar biological structures (for example, cilia) and processes (for example, specialized cellular transport mechanisms) to function.

So the same Genetic Abnormalities that cause CKD can also cause hearing loss, and vice versa.

The NIH states," Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss."

According to Nature.com, "A strong, graded and independent relationship exists between kidney function and the risk of hearing loss; the highest risk is observed in patients on haemodialysis, but kidney transplant recipients and people with mild CKD are also at increased risk."

Because tissue in our ear is substantially similar to the tissue in our kidneys, the toxic build up that damages kidney tissue also is capable of damaging inner ear tissue.

This appears to be confirmed by a 2010 study in Australia, that not just specific Kidney Diseases, but Kidney Disease in general can cause hearing loss in Kidney Patients. "This study examined the medical records of 2,564 people aged 50 and over, 513 of whom had moderate chronic kidney disease. Some 54.4% of all the patients with chronic kidney disease had some degree of hearing loss, as compared to only 28.3% of those who had no kidney problems.” Even more interesting, 30% of the CKD patients had a severe hearing loss compared to just 10% in those patients without CKD."

The study concluded, "The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear." Also, some treatments for kidney ailments are ototoxic, meaning they cause hearing loss."

As stated earlier, this is readily found in patients that are on hemodialysis.

Experts suggest that Infants, children and  adults with malformation or dysfunction of their hearing organs should be evaluated for the presence of malformation or dysfunction of their kidneys, and people with Kidney Disease should have their hearing checked for loss.

3. IN CERTAIN TYPES OF KIDNEY DISEASES HEARING LOSS IS MORE PROMINENT THAN IN OTHERS

Some types of Kidney Diseases are mentioned more prominently than others in the literature as causes of hearing loss and if you have one of these diseases you may wish to have your hearing checked as well as your  kidney function.



These diseases include:

• Alport's Syndrome
• Polycystic Kidney Disease
• Meniere's Disease

Many people with Alport's Syndrome have problems with their ears and eyes. Alport syndrome is a rare inherited disorder that damages the tiny blood vessels in the kidneys. It can also cause hearing loss and eye problems.

Alport syndrome is an inherited form of kidney inflammation (nephritis). It is caused by a defect (mutation) in a gene for a protein in the connective tissue, called collagen.

The disorder is rare. There are three genetic types:

• X-linked Alport syndrome (XLAS) -- This is the most common type. The disease is more severe in males than in females.

• Autosomal recessive Alport syndrome (ARAS) -- Males and females have equally severe disease.

• Autosomal dominant Alport syndrome (ADAS) -- This is the rarest type. Males and females have equally severe disease.

The frequency in which hearing loss appears with Alport's is striking. Studies show that, approximately, 70% of patients with AS suffer from progressive sensorineural hearing loss.  Over time, Alport syndrome also leads to hearing loss in both ears. By the early teens, it is more common in males with XLAS, though in females, hearing loss is not as common and happens when they're adults. With ARAS, boys and girls have hearing loss during childhood. With ADAS, it occurs later in life. Hearing loss usually occurs before kidney failure.

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss With Polycystic Kidney Disease
Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Hearing Loss and Meniere's Disease

Several studies  harmful effects of chronic kidney disease (CKD) on the audiovestibular system. This would include a connection between Chronic Kidney Disease and Meniere's Disease. Patients with CKD had a significantly increased incidence of Ménière’s disease,


According to the Mayo Clinic, Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.

Symptoms of Meniere's disease include:

• Regular dizzy spells. You have a spinning feeling that starts and stops suddenly. Vertigo may start without warning. It usually lasts 20 minutes to 12 hours, but not more than 24 hours. Serious vertigo can cause nausea.

• Hearing loss. Hearing loss in Meniere's disease may come and go, especially early on. Over time, hearing loss can be long-lasting and not get better.

• Ringing in the ear. Ringing in the ear is called tinnitus. Tinnitus is the term for when you have a ringing, buzzing, roaring, whistling or hissing sound in your ear.

• Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the ear. This is called aural fullness.

After a vertigo attack, symptoms get better and might go away for a while. Over time, how many vertigo attacks you have may lessen.

To Diagnose Meniere's, the physician will conduct an exam and asks about your health history. A Meniere's disease diagnosis needs to include:

• Two or more vertigo attacks, each lasting 20 minutes to 12 hours, or up to 24 hours.

• Hearing loss proved by a hearing test.

• Tinnitus or a feeling of fullness or pressure in the ear.
A Balance Assessment will take place.

Between vertigo attacks, balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that study how well the inner ear is working include:

Electronystagmogram or videonystagmography (ENG or VNG). These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your healthcare provider may use warm and cold air or water in the ear for the caloric test.

No cure exists for Meniere's disease. Some treatments can help lessen how bad vertigo attacks are and how long they last. But there are no treatments for permanent hearing loss. Your healthcare provider may be able to suggest treatments that prevent your hearing loss from getting worse.

Treatment Methods include:

Medicines for vertigo

Your healthcare provider may prescribe medicines to take during a vertigo attack so that it's less severe:

• Motion sickness medicines. Medicines such as meclizine (Antivert) or diazepam (Valium) may lessen the spinning feeling and help control nausea and vomiting.

• Anti-nausea medicines. Medicines such as promethazine might control nausea and vomiting during a vertigo attack.

• Diuretics and betahistine. These medicines can be used together or alone to improve vertigo. Diuretics lower how much fluid is in the body, which may lower the amount of extra fluid in the inner ear. Betahistines ease vertigo symptoms by improving blood flow to the inner ear.

Long-term medicine use

Your healthcare provider may prescribe a medicine to reduce fluid retention and suggest limiting your salt intake. This helps control the intensity and amount of Meniere's disease symptoms in some people.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from procedures that don't include surgery, such as:

• Rehabilitation. If you have balance problems between vertigo attacks, vestibular rehabilitation therapy might improve your balance.

• Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your healthcare provider can refer you to an ear doctor, also called an audiologist, to talk about the best hearing aids for you.

If conservative treatments aren't successful, your care provider might suggest more-intense treatments.

Middle ear injections

Medicines injected and absorbed in the middle ear may help vertigo symptoms get better. This treatment is done in a care provider's office. Injections can include:

• Gentamicin. This is an antibiotic that's toxic to your inner ear. It works by damaging the sick part of your ear that's causing vertigo. Your healthy ear then takes on the job for balance. But there is a risk of further hearing loss.

• Steroids. Steroids such as dexamethasone also may help control vertigo attacks in some people. Dexamethasone may not work as well as gentamicin. But it's less likely to cause further hearing loss.

Surgery

If vertigo attacks from Meniere's disease are severe and hard to bear and other treatments don't help, surgery might be an option. Procedures include:

• Endolymphatic sac surgery. The endolymphatic sac helps control inner ear fluid levels. This procedure relieves pressure around the endolymphatic sac, which can improve fluid levels. Sometimes, a care provider places a tube inside your ear to drain any extra fluid.

• Labyrinthectomy. With this procedure, the surgeon removes the parts of your ear causing vertigo, which causes complete hearing loss in that ear. This allows your healthy ear to be in charge of sending information about balance and hearing to your brain. Care providers only suggest this procedure if you have poor hearing or total hearing loss in the diseased ear.

• Vestibular nerve section. This procedure involves cutting the vestibular nerve to prevent information about movement from getting to the brain. The vestibular nerve sends balance and movement information from your inner ear to the brain. This procedure usually improves vertigo and keeps hearing in the diseased ear. Most people need medicine that puts them in a sleep-like state, called general anesthesia, and an overnight hospital stay.


What illness causes hearing damage?

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

4. CONCLUSIONS

There is a significant relationship between CKD and Hearing Loss. One recent article states, "Patients with CKD are predisposed to several otorhinolaryngological issues especially SNHL, and the link between SNHL (sensorineural hearing loss)
and CKD has both been extensively explained, but the relationship between the remaining complications and CKD is still unknown."

In plain English, if you suffer from CKD, you should get your hearing checked, and if you have any symptoms that we have discussed today, you may wish to consult with an otolaryngologist.

5. REFERENCES

A.. Can Kidney Disease Lead to Hearing Loss?

The multifaceted links between hearing loss and chronic kidney disease
https://www.nature.com/articles/s41581-024-00808-2#:~:text=A%20strong%2C%20graded%20and%20independent,are%20also%20at%20increased%20risk.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/#:~:text=Chronic%20kidney%20disease%20is%20a,can%20lead%20to%20hearing%20loss.

What is the relationship between the kidneys and the ears?
Tissues of the kidney and the inner ear are similar and share a common metabolic function, therefore problems that affect kidney function can also damage the inner ear. High blood pressure, diabetes and a family history of CKD can increase your risk of developing kidney problems and hearing problems.
https://yvdwaudiology.co.za/blog/your-kidneys-and-your-ears/#:~:text=Tissues%20of%20the%20kidney%20and,kidney%20problems%20and%20hearing%20problems.

Hearing Loss  in Patients on Hemodialysis

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842730/

Hearing loss causes
https://www.healthyhearing.com/help/hearing-loss/causes

The Link Between Kidneys and Your Hearing
https://hearinghealthfoundation.org/blogs/the-link-between-your-kidneys-and-your-hearing

Kidney Disease a Surprising Reason For Hearing Loss
https://www.hearingunlimited.net/kidney-disease-a-surprising-reason-for-hearing-loss/
(a specific part of our ears shares functional and structural characteristics with our kidneys. Research has confirmed that physiological mechanisms of fluid and electrolyte balance are present in both organs. This matters because it means that when a health issue affects the functionality of one (i.e. the kidneys or the ears), it’s likely to affect the other. So while hearing loss doesn’t cause CKD – or vice versa – patients with certain types of hearing loss are likely to experience problems with their kidneys (and vice versa).


The Relationship Between Cochlea and Kidney
https://www.researchgate.net/publication/227808405_The_Relationship_Between_Cochlea_and_Kidney

B. Other Kidney Diseases That Can Cause Hearing Loss:

• Alport's Syndrome
From the NKF:
Alport's Syndrome
https://www.kidney.org/atoz/content/alport (General Description);

Alport's Syndrome; Symptoms and Causes
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/alport-syndrome

Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766141/

How often does Alport syndrome cause hearing loss?

Approximately 80% of males with X-linked Alport syndrome (XLAS) develop hearing loss during their lifetime, often by their teens. Hearing loss in females with XLAS is less frequent and occurs later in life, although about 40% will experience hearing loss.

Hearing Loss in Alport syndrome
https://alportsyndrome.org/hearing-loss-in-alport-syndrome/

Alport syndrome
https://medlineplus.gov/genetics/condition/alport-syndrome/#frequency

Deafblind Fact Sheet: Alport Syndrome
https://www.cde.state.co.us/cdesped/sd-db_factsheetwp_alport#:~:text=Approximately%2080%25%20of%20young%20males,often%20by%20their%20teenage%20years.




• Polycystic Kidney Disease

Studies have shown that Polycystic Kidney Disease can cause hearing loss. One study in particular found a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.

Autosomal Dominant Polycystic Kidney Disease Associated with Familial Sensorineural Deafness
https://www.tandfonline.com/doi/pdf/10.1080/003655999750016302

Polycystic kidney disease and sensorineural deafness
https://www.researchgate.net/publication/283581697_Polycystic_kidney_disease_and_sensorineural_deafness
Hearing Loss and Meniere's Disease

Connection Between Meniere's Disease and CKD

Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière’s disease: a nationwide cohort study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511089/



Meniere's Disease
https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910
(Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear.

Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60. It's thought to be a lifelong condition. But some treatments can help ease symptoms and lessen how it affects your life long term.)

What is Meniere's Disease?
https://www.nidcd.nih.gov/health/menieres-disease

Meniere Disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/menieres-disease


C. Diseases In General That Can Cause Hearing Loss :

Certain diseases can cause hearing loss, including meningitis, mumps, cytomegalovirus and chickenpox. Severe cases of jaundice can also cause hearing loss. other causes – other causes of deafness include Meniere's disease and exposure to certain chemicals.

Deafness - a range of causes
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/deafness-a-range-of-causes

D. Conclusion
Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review
https://www.cureus.com/articles/169480-sensorineural-hearing-loss-in-patients-with-chronic-kidney-disease-a-comprehensive-review#!/



































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