Sensorineural Hearing Loss in Chronic Kidney Disease – Outcome of Trial of Steroid Therapy

Abstract

The prevalence of sensorineural hearing loss (SHL) in chronic kidney disease (CKD) patient was between 10% - 67%. However, the outcome of treatment has not been well studied, especially in Nigeria. Our hypothesis is that steroid therapy may achieve improvement in hearing in these patients, hence we report the outcome following a trial of oral steroid. This was a prospective study involving CKD patients with SHL. The subjects were commenced on oral prednisolone 60mg/day tailed over 4 weeks and this was repeated after 1 month and each patient had 3 courses. The pure tone average (PTA) was measured with a computer audiometer BA 20 Kamplex before and after treatment. The study population of 25 subjects involved 14males and 11 females between the ages of 19 and 65 years, (46 + 21.2). The PTA was between 65 - 100dB, mean = 70dB compared with post treatment hearing acuity of 50 – 95dB, mean = 65dB. Comparing the pre- and post- treatment PTA, an improvement of 5dB was seen in 2/25(8%), no change in 4/25(16%) while the PTA was increased by 10 – 30dB in 19/25(76%). Pearson correlation to compare the mean of pre- and post– treatment PTA revealed no significant difference (P =0.08). In conclusion, SHL in CKD patients was not responsive to steroid therapy; this is probably due to various persistent aetiological factors. However, this is an indication for further search for the effective treatment in order to improve quality of life in these patients.