Evaluation of hearing and balance system in chronic renal failure patients receiving hemodialysis treatment

Aim: The purpose of this study is to evaluate the changes in the hearing and balance system in adult patients with the diagnosis of Chronic Kidney Failure (CRF) who are treated with hemodialysis, compared to the healthy individuals without CRF. Materials and Methods: This study consists of 35 patients diagnosed with CRF and receiving hemodialysis treatment three days a week, aged between 18 and 50, 35 healthy individuals. Pure tone audiometry, Video Head Impulse test (vHIT), Post Head Shake Nystagmus test and dizziness disability questionnaire (DHI) were applied to all participants to evaluate the integrity of the audiovestibular system. The data were evaluated with appropriate statistical methods. Results: The mean age of the patient group in the study was 33.09 ±6.8; of the patient group, 16 (45.5%) were male and 19 (51.4%) were female. In the control group, 17 people (51.5%) were men and 18 people (48.6%) were women. Pure tone averages were found to be significantly higher in both speech frequencies and high frequencies in hemodialysis patients compared to normal individuals (p=0,001). In terms of DHI score, the scores of the patient groups are higher than the control groups (p=0,001). In the vHIT test, there is no statistically significant difference between the patient and control groups in terms of gain asymmetry for the semicircular canals on both sides(p<0,05). The presence of saccades in the left and right lateral canals between the study and control groups were examined separately by Chi-Square test, and a statistically significant difference was found (ᵪ²=6.56, p=0,03). While 17.1% of the patients had both left and right lateral saccades; Saccades were not observed in the lateral canals in the control group. A statistically significant difference was found in the Chi-square test results of the patient and control groups in terms of the presence of nystagmus after the post-head shake test (p=0,025). The relationship between the measured blood parameters of hemodialysis patients and the presence of saccades was investigated. Inverse relationship between the presence of LARP (left anterior right posterior) saccade and BUN/creatinine ratio; A correct correlation was determined between the presence of RALP (right anterior left posterior) saccade and creatinine elevation. It was also observed that the presence of saccades in the vHIT test increased significantly as the disease duration of hemodialysis patients increased. Conclusion: The vHIT test is an important test that can be easily used in the evaluation of the vestibular system in CRF patients receiving hemodialysis treatment. In this study, it was determined that the overt and covert saccades in the vHIT test increased significantly as the creatinine increased and the duration of the disease increased. Expanding its clinical use in monitoring the vestibular side effects of creatinine elevation and disease duration in CRF patients with vHIT may be possible with future studies.