Achados audiológicos em pacientes submetidos ao transplante renal

D'Andrea, Karlin Fabianne Klagenberg; Zeigelboim, Bianca Simone; Liberalesso, Paulo Breno Noronha; Sylvestre, Lucimary de Castro; Jurkiewicz, Ari Leon; Marques, Jair Mendes

Resumos

OBJETIVO: Investigar o comportamento auditivo de pacientes com insuficiência renal crônica submetidos ao transplante renal. MÉTODOS: Foram avaliados 30 pacientes, 10 do gênero feminino e 20 do gênero masculino, na faixa etária de 13 a 26 anos (média de idade 16,97 anos). Os sujeitos foram submetidos a anamnese, avaliação otorrinolaringológica, avaliação audiológica convencional e de altas frequências, medidas de imitância acústica e avaliação do processamento auditivo central. Para os resultados da audiometria de altas frequências foi utilizado um grupo controle. RESULTADOS: Os sujeitos não apresentaram queixas auditivas na anamnese. Os resultados da audiometria convencional demonstraram predomínio da normalidade; na audiometria de altas frequências, os pacientes apresentaram resultados piores do que os sujeitos do grupo controle. Na imitanciometria houve predomínio de curva tipo A bilateral. Na avaliação do processamento auditivo central, 14 sujeitos (46,67%) apresentaram resultados alterados no Staggered Spondaic Word Test (SSW). Houve diferença significativa entre a variável idade e o resultado da audiometria tonal limiar: quanto maior a idade, menor a sensibilidade auditiva nos limiares de 250 Hz a 8 kHz. Houve relação entre o tipo de doador (cadáver ou vivo) e o resultado do teste SSW: os índices de resultados alterados foram maiores quando o doador era cadáver, em comparação com casos de doador vivo. CONCLUSÃO: Houve alterações na avaliação audiológica convencional e de altas frequências e no processamento auditivo central de sujeitos com insuficiência renal crônica submetidos ao transplante renal, sugerindo a necessidade de orientação à equipe envolvida quanto aos cuidados, prevenção e identificação precoce de acometimentos audiológicos.

Insuficiência renal crônica; Transplante de rim; Audiometria; Testes de impedância acústica; Percepção auditiva

PURPOSE: To investigate the auditory behavior of patients with chronic renal failure (CRF) undergoing kidney transplantation. METHODS: Thirty patients were evaluated, 10 (33.33%) females and 20 (66.67%) males, aging from 13 to 26 years (average, 16.97 years; standard deviation, 3.60 years). Patients underwent the following procedures: anamnesis, otolaryngological examination, audiological evaluation (pure tone and high frequency), acoustic impedance measurements and central auditory processing evaluation. A control group was used to compare the high-frequency audiometry results. RESULTS: The following observations were made: absence of auditory complaints at the time of anamnesis; pure-tone audiometry was predominantly normal; patients presented lower hearing levels at the high-frequency audiometry, when compared to the control group, and as for the acoustic impedance measurements, curves of the type A were predominant; there was a change of the central auditory processing for 14 patients (46.67%) in the Staggered Spondaic Word Test (SSW); there was a significant difference between the age variable and the result of the pure-tone audiometry, that is, hearing sensitivity in thresholds from 250Hz to 8,000Hz decreased with advancing age; and the relation between the type of donor and the SSW test result was significant. Rates were higher when the patients had been transplanted from deceased donors compared to living donors. CONCLUSION: There were no changes in conventional audiological and high-frequency evaluation, or in the central auditory processing. Professionals involved in the care of kidney transplantation recipients must be better informed about the care, prevention, and early identification of auditory disorders.

Renal insufficiency; Chronic; Kidney transplantation; Audiometry; Acoustic impedance tests; Auditory perception

Referências bibliográficas

¹ Alport AC. Hereditary familial congenital haemorrhagic nefhritis. Br Med J. 1927;1(3454):504-6.
² Romão Jr JE. Doença renal crônica: definição, epidemiologia e classificação. J Bras Nefrol. 2004;26(Supl.1)(3):1-3.
³ SBN - Sociedade Brasileira de Nefrologia. (2011) [Internet]. Censo dos centros de diálise no Brasil 2011. [cited 2011 out 5] Available from: http://www.sbn.org.br/pdf/censo_2011_publico.pdf
⁴ Oda M, Preeciado MC, Quick CA, Paparella MM. Labyrinthine pathology of chronic renal failure patients treated with hemodialysis and kidney transplantation. Laryngoscope. 1974;84(9):1489-506.
⁵ Matz GJ, Naunton RF. Ototoxic drugs and poor renal function. JAMA.1968;206(9): 2119.
⁶ Thomsen J, Bech P, Szpirt W. Otologic symptoms in chronic renal failure. The possible role of aminoglycoside - furosemide interaction. Arch. Otorhinolaryngol. 1976;214(1):71-9.
⁷ Zeigelboim BS, Mangabeira-Albernaz PL, Fukuda Y. High frequency audiometry and chronic renal failure. Acta Otolaryngol. 2001;121(2):245-8.
⁸ Davis H, Silverman RS. Hearing and deafness. 3ª ed. New York: Holt, Rinehart & Wilson; 1970. p. 253-79.
⁹ Bitencourt RF. Avaliação audiológica em indivíduos expostos a agentes quimioterápicos [dissertação]. Curitiba: Mestrado em Distúrbios da Comunicação, Universidade Tuiuti do Paraná; 2003.
¹⁰ Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24.
¹¹ Borges ACLC. Dissílabos alternados - SSW. In: Pereira LD, Schochat E. Processamento auditivo central: manual de avaliação. São Paulo: Lovise, 1997. p. 169-78.
¹² Keith RW. Random gap detection test.St. Missouri (USA): Auditec of Saint Louis, 2000.
¹³ Yassin A, Badry A, Fatt-Hi A. The relationship between electrolyte balance and cochlear disturbances in cases of renal failure. J Laryngol Otol. 1970;84(4):429-35.
¹⁴ Bergstrom L, Jenkins P, Sando I, English GM. Hearing loss in renal disease: clinical and pathological studies. Ann Otol Rhinol Laryngol. 1973;82(4):555-76.
¹⁵ Pérez Garrigues H, Clemente J M. Chronic renal insufficiency and auditory system. An Otorrinolaringol Ibero Am. 1987;14(6):635-44.
¹⁶ Morton LP, Reynolds L, Zent R, Rayner BL. Hearing thresholds in CAPD patients. Adv Perit Dial. 1992;8:150-2.
¹⁷ Nikolopoulos TP, Kandiloros DC, Segas JV, Nomicos PN, Ferekidis EA, Michelis KE, et al. Auditory function in young patients with chronic renal failure. Clin Otolaryngol Allied Sci. 1997;22(3):222-5.
¹⁸ Henrich WL, Thompson P, Bergstrom LV, Lum GM. Effect of dialysis on hearing acuity. Nephron. 1977;18(6):348-51.
¹⁹ Jakic M, Mihaljevic D, Zibar L, Jakic M, Kotromanovic Z, Roguljic H. Sensorineural hearing loss in hemodialysis patients. Coll Antropol. 2010;34(1):165-71.
²⁰ Alder D, Ritz E. Terminal renal failure and hearing loss. Arch Otorhinolaringol. 1982;235(2-3):587-90.
²¹ Tilki HE, Akpolat T, Tunali G, Kara A, Onar MK. Effects of haemodialysis and continous ambulatory peritoneal dialysis on P300 cognitive potentials in uraemic patients. Ups J Med Sci. 2004;109(1):43-8.
²² Bains KS, Chopra H, Sandhu JS, Aulakh BS. Cochlear function in chronic kidney disease and renal transplantation: a longitudinal study. Transplant Proc. 2007;39(5):1465-8.
²³ Bonaldi LV, Angelis MAA, Smith RL. Hodologia do sistema auditivo. In: Pereira LD, Schochat E. Processamento auditivo central: manual de avaliação. São Paulo: Lovise, 1997. p. 19-25.
²⁴ Diveyi PL, Haupt KM. Audiological correlates of speech understanding deficits in elderly listeners with mild to moderate hearing loss. Ear Hear. 1995;18:19-32.
²⁵ Thodi C, Thodis E, Danielides V, Pasadakis P, Vargemezis V. Hearing in renal failure. Nephrol Dial Transplant. 2006;21(11):3023-30.
²⁶ Bazzi C, Venturini C, Pagani C, Arrigo G, D'Amico G. Hearing loss in short and long-term haemodialyzed patients. Nephrol Dial Transplant. 1995;10(10):1865-8.
²⁷ Lasisi AO, Salako BL, Kadiri S, Arije A, Oko-Jaja R, Ipadeola A, et. al. Sudden sensorineural hearing loss and hemodialysis. Ear Nose Throat J. 2006;85(12):819-21.
²⁸ Mitschke H, Schmidt P, Kopsa H, Zazgornik J. Reversible uremic deafness after successful renal transplantation. N Eng J Med. 1975;292(20):1062-3.
²⁹ Sefer S, Trotic R, Lacmanovic V, Degoricija V, Ratkovic-Gusic I, Kes, P. Effects of renal transplantation on hearing and ocular changes in a monozygotic twin with Alport´s syndrome: comparasion with other twin on hemodialysis. Croat Med J. 2000;41(2):203-6.
³⁰ Alves FRA, Ribeiro FAQ. Revisão sobre a perda auditiva na síndrome de Alport, analisando os aspectos clínicos, genéticos e biomoleculares. Rev Bras Otorrinolaringol. 2005;71(6):813-9.

Datas de Publicação

Publicação nesta coleção
19 Jul 2013
Data do Fascículo
2013

Histórico

Recebido
15 Maio 2012
Aceito
05 Out 2012

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹ Alport AC. Hereditary familial congenital haemorrhagic nefhritis. Br Med J. 1927;1(3454):504-6.

[2] ² Romão Jr JE. Doença renal crônica: definição, epidemiologia e classificação. J Bras Nefrol. 2004;26(Supl.1)(3):1-3.

[3] ³ SBN - Sociedade Brasileira de Nefrologia. (2011) [Internet]. Censo dos centros de diálise no Brasil 2011. [cited 2011 out 5] Available from: http://www.sbn.org.br/pdf/censo_2011_publico.pdf

[4] ⁴ Oda M, Preeciado MC, Quick CA, Paparella MM. Labyrinthine pathology of chronic renal failure patients treated with hemodialysis and kidney transplantation. Laryngoscope. 1974;84(9):1489-506.

[5] ⁵ Matz GJ, Naunton RF. Ototoxic drugs and poor renal function. JAMA.1968;206(9): 2119.

[6] ⁶ Thomsen J, Bech P, Szpirt W. Otologic symptoms in chronic renal failure. The possible role of aminoglycoside - furosemide interaction. Arch. Otorhinolaryngol. 1976;214(1):71-9.

[7] ⁷ Zeigelboim BS, Mangabeira-Albernaz PL, Fukuda Y. High frequency audiometry and chronic renal failure. Acta Otolaryngol. 2001;121(2):245-8.

[8] ⁸ Davis H, Silverman RS. Hearing and deafness. 3ª ed. New York: Holt, Rinehart & Wilson; 1970. p. 253-79.

[9] ⁹ Bitencourt RF. Avaliação audiológica em indivíduos expostos a agentes quimioterápicos [dissertação]. Curitiba: Mestrado em Distúrbios da Comunicação, Universidade Tuiuti do Paraná; 2003.

[10] ¹⁰ Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24.

[11] ¹¹ Borges ACLC. Dissílabos alternados - SSW. In: Pereira LD, Schochat E. Processamento auditivo central: manual de avaliação. São Paulo: Lovise, 1997. p. 169-78.

[12] ¹² Keith RW. Random gap detection test.St. Missouri (USA): Auditec of Saint Louis, 2000.

[13] ¹³ Yassin A, Badry A, Fatt-Hi A. The relationship between electrolyte balance and cochlear disturbances in cases of renal failure. J Laryngol Otol. 1970;84(4):429-35.

[14] ¹⁴ Bergstrom L, Jenkins P, Sando I, English GM. Hearing loss in renal disease: clinical and pathological studies. Ann Otol Rhinol Laryngol. 1973;82(4):555-76.

[15] ¹⁵ Pérez Garrigues H, Clemente J M. Chronic renal insufficiency and auditory system. An Otorrinolaringol Ibero Am. 1987;14(6):635-44.

[16] ¹⁶ Morton LP, Reynolds L, Zent R, Rayner BL. Hearing thresholds in CAPD patients. Adv Perit Dial. 1992;8:150-2.

[17] ¹⁷ Nikolopoulos TP, Kandiloros DC, Segas JV, Nomicos PN, Ferekidis EA, Michelis KE, et al. Auditory function in young patients with chronic renal failure. Clin Otolaryngol Allied Sci. 1997;22(3):222-5.

[18] ¹⁸ Henrich WL, Thompson P, Bergstrom LV, Lum GM. Effect of dialysis on hearing acuity. Nephron. 1977;18(6):348-51.

[19] ¹⁹ Jakic M, Mihaljevic D, Zibar L, Jakic M, Kotromanovic Z, Roguljic H. Sensorineural hearing loss in hemodialysis patients. Coll Antropol. 2010;34(1):165-71.

[20] ²⁰ Alder D, Ritz E. Terminal renal failure and hearing loss. Arch Otorhinolaringol. 1982;235(2-3):587-90.

[21] ²¹ Tilki HE, Akpolat T, Tunali G, Kara A, Onar MK. Effects of haemodialysis and continous ambulatory peritoneal dialysis on P300 cognitive potentials in uraemic patients. Ups J Med Sci. 2004;109(1):43-8.

[22] ²² Bains KS, Chopra H, Sandhu JS, Aulakh BS. Cochlear function in chronic kidney disease and renal transplantation: a longitudinal study. Transplant Proc. 2007;39(5):1465-8.

[23] ²³ Bonaldi LV, Angelis MAA, Smith RL. Hodologia do sistema auditivo. In: Pereira LD, Schochat E. Processamento auditivo central: manual de avaliação. São Paulo: Lovise, 1997. p. 19-25.

[24] ²⁴ Diveyi PL, Haupt KM. Audiological correlates of speech understanding deficits in elderly listeners with mild to moderate hearing loss. Ear Hear. 1995;18:19-32.

[25] ²⁵ Thodi C, Thodis E, Danielides V, Pasadakis P, Vargemezis V. Hearing in renal failure. Nephrol Dial Transplant. 2006;21(11):3023-30.

[26] ²⁶ Bazzi C, Venturini C, Pagani C, Arrigo G, D'Amico G. Hearing loss in short and long-term haemodialyzed patients. Nephrol Dial Transplant. 1995;10(10):1865-8.

[27] ²⁷ Lasisi AO, Salako BL, Kadiri S, Arije A, Oko-Jaja R, Ipadeola A, et. al. Sudden sensorineural hearing loss and hemodialysis. Ear Nose Throat J. 2006;85(12):819-21.

[28] ²⁸ Mitschke H, Schmidt P, Kopsa H, Zazgornik J. Reversible uremic deafness after successful renal transplantation. N Eng J Med. 1975;292(20):1062-3.

[29] ²⁹ Sefer S, Trotic R, Lacmanovic V, Degoricija V, Ratkovic-Gusic I, Kes, P. Effects of renal transplantation on hearing and ocular changes in a monozygotic twin with Alport´s syndrome: comparasion with other twin on hemodialysis. Croat Med J. 2000;41(2):203-6.

[30] ³⁰ Alves FRA, Ribeiro FAQ. Revisão sobre a perda auditiva na síndrome de Alport, analisando os aspectos clínicos, genéticos e biomoleculares. Rev Bras Otorrinolaringol. 2005;71(6):813-9.

Achados audiológicos em pacientes submetidos ao transplante renal

Audiological findings in patients submitted to kidney transplant

Resumos

Referências bibliográficas

Datas de Publicação

Histórico