The correlation between fibroblast growth factor-23 and ESRD patients with hearing impairment

Abstract

Background End-stage renal disease (ESRD) patients often experience hearing impairment, resulting in a high rate of disability and a decline in their quality of life. Fibroblast growth factor-23 (FGF23) is a diagnostic biomarker for chronic kidney disease (CKD) and a pathogenic contributor to CKD progression. However, the correlation between FGF23 level and CKD patients with hearing impairment remains elusive. This study aimed to investigate the relationship between the FGF23 and ESRD accompanied with hearing impairment. Methods A total of 144 ESRD patients, who were admitted to the First Affiliated Hospital of Kunming Medical University from November to December 2020, were enrolled in this study. Firstly, 144 ESRD patients underwent pure-tone audiometry (PTA). Secondly, it was attempted to randomly select 20 ESRD patients with normal hearing, and 20 ESRD patients with hearing impairment (match ratio, 1:1). Age- and gender-matched healthy people (n = 20) were also recruited as controls group. The expression levels of FGF23 was detected by enzyme-linked immunosorbent assay (ELISA). Results The results of pure-tone audiometry showed that the prevalence of hearing impairment in ESRD patients was 80.5%. Male ESRD patients were more likely to develop hearing impairment compared to female patients. The incidence rate of hearing impairment at a high frequency was significantly higher than that at a low frequency (P < 0.01). The serum levels of FGF23, phosphorus, and parathyroid hormone (PTH) in ESRD patients with hearing impairment significantly increased compared with those with normal hearing and healthy controls. Conclusion ESRD patients had a higher risk of hearing loss, especially high-frequency hearing impairment. As FGF23 level increased, the risk of hearing loss was also elevated. The hearing impairment in ESRD patients was associated with the degree of kidney injury, and serum FGF23 level.

Correlation study of FGF23/D-serine in maintenance hemodialysis patients with combined hearing impairment

“…FGF23 neutralization effectively improves bone quality and osseointegration in CKD mice, suggesting FGF23 as a key factor in CKD-related bone diseases [ 24 ]. In addition, the risk of hearing impairment is significantly higher in ESRD patients with higher FGF23 levels than in those with lower FGF23 levels [ 2 ], which is consistent with the results of this study. So, FGF23 not only has an important biomarker in the development of CKD but also has a direct pathological effect on its complications.…”

“…In our previous study, we found that the rate of hearing impairment in ESRD patients was significantly higher than in the general population, and the incidence of non-genetic hearing impairment in maintenance hemodialysis patients was as high as 80.5%. Men had significantly higher hearing impairment than women, and a higher proportion of impairment in both ears than in one ear [ 2 ]; yet, the exact mechanism of action remained unclear. Furthermore, another study indicated that hearing impairment significantly improved in patients with renal failure after successful renal transplantation when the renal failure was eliminated [ 19 ].…”

“…Research shows that Klotho and FGF23 are independently associated with concentric hypertrophy in CKD patients [ 27 ]. Our previous study demonstrated that high levels of FGF23 are associated with hearing impairment in ESRD patients, independently of Klotho [ 2 ]. So, the Klotho’s serum level wasn’t evaluated in this study.…”

“…It is characterized by a possible progressive decline in kidney function leading to renal failure, which can eventually progress to end-stage renal disease (ESRD) or uremia. Moreover, recent studies have found that the incidence of sensorineural deafness in patients with chronic renal failure ranges from 40% to 90%, and the degree of deafness is positively correlated with the degree of renal failure [ 2 , 3 ]. Hearing loss is the fifth leading cause of disability in the world [ 4 ].…”

Predictive value of serum d -serine level for hearing impairment in uremic patients

“…The risk of HI in CKD patients is higher than in normal individuals. The current study also found that the prevalence of HI in uremic patients was 80.5% [ 5 ], but the specific mechanism of CKD leading to HI is unclear. A previous study speculated that uremic toxins inhibit the activity of Na + ,K + -ATPase in the central nervous system and affect the auditory nerve function and ion transport in the inner ear [ 20 , 21 ].…”