Sudden profound sensorineural hearing loss following initiation of haemodialysis in a patient with end-stage renal disease

Abstract

Background: The population of patients receiving haemodialysis is on the increase in Nigeria. Various complications are associated with this life-saving procedure. Reports of sudden profound sensorineural hearing loss, following initiation of haemodialysis, are rare in the literature. Aim: The aim of this report is to highlight the unusual occurrence of sudden hearing loss after a common life-saving procedure. Methods: This is a case report of a 31year old military officer who had an end-stage renal disease due to a chronic glomerulonephritis and with a baseline good social hearing. He developed profound hearing loss immediately after the first session of haemodialysis. Clinical evaluation of the ear was done. Pure tone audiometry and full audiological evaluation was conducted. This was repeated nine months later. Findings: Ear examination revealed unremarkable outer ear/otoscopic findings. Tuning fork test showed no perception to both Rinne's and Weber's test. Pure tone audiometry (PTA) revealed profound bilateral sensorineural hearing loss (SNHL) with pure tone average (at 500, 1000. 2000. 4000Hz) of 93dBHL and 88dBHL in the right and left ear respectively. Repeat audiometry revealed no significant change. Conclusion: The patient developed irreversible bilateral profound sensorineural hearing loss following initiation of haemodialysis. We recommend pre-haemodialysis otologic and audiometric evaluation for patients. This can be repeated at intervals to identify patients who may develop hearing impairment in the course of treatment of the disease. Also medical personnel offering dialytic therapies should be vigilant for this rare complication.

The effect of hemodialysis on hearing in chronic kidney disease patients – A systematic review

“…The earliest case report dates back to 1973 [47] while the latest was in 2017. [6] The majority of these articles demonstrated a significant association between hemodialysis and SSNHL. [6,18,26,28,46,48] Cross-sectional studies formed 16.7% of the selected articles from 1996 [30] to 2020 [9] with a sample population of 363.…”

“…[6] The majority of these articles demonstrated a significant association between hemodialysis and SSNHL. [6,18,26,28,46,48] Cross-sectional studies formed 16.7% of the selected articles from 1996 [30] to 2020 [9] with a sample population of 363. Similar to case reports, cross-sectional studies linked hemodialysis to the occurrence of SSNHL.…”

“…[2] However, there have been many reports of CKD patients developing complications such as cardiovascular accidents, infection, protein anabolism, anorexia, fatigue, breathlessness, as well as sensorineural hearing loss (SNHL) which compromise the quality of life of these patients. [5,6] Any pathology in the cochlea, vestibular cochlear nerve, or central auditory pathways can lead to SNHL. [7] A SNHL of more than 30 dB at three sequential frequencies occurring within a period of 72 h is called sudden SNHL (SSNHL).…”