Abstract: TH-PO1140
CKD and Incident Hearing Loss
Session Information
- CKD: Clinical, Outcomes, Trials - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Gupta, Shruti, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Cruickshanks, Karen J., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Curhan, Gary C., Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Curhan, Sharon, Brigham and Women''s Hospital/Harvard Medical School, Boston, Massachusetts, United States
Background
There is a strikingly high prevalence of sensorineural hearing loss among patients with chronic kidney disease (CKD), with estimates ranging from 36 to 77%. However, the etiology of hearing loss in CKD is not well-understood. In the only prior longitudinal study, estimated glomerular filtration rate (eGFRCysC) <60 mL/min/1.73 m2 was significantly associated with a 50% higher 20-year cumulative incidence of hearing impairment. We assessed whether lower baseline eGFR calculated using serum creatinine (SCr) was associated with incident hearing loss, and whether rapid decline in eGFR over time was associated with an evenhigher risk.
Methods
SCr was measured in 1843 individuals without hearing loss at the start of the Epidemiology of Hearing Loss Study in 1993. Follow-up SCr assessments were conducted at 5 (n=1500) and 10 (n=1086) years. The eGFRCr was estimated using the CKD-EPI equation. Hearing tests were conducted at baseline, and at 5, 10, and 15 year follow-up visits. The risk of hearing loss was assessed as a function of baseline eGFRCr, as well as a function of a 20% decline in eGFRCr between baseline and 5 years, and between 5 and 10 years. Incident hearing loss was defined as pure-tone average >25 dB for thresholds at 0.5, 1, 2, and 4 kHz. Cox proportional hazards regression was used to adjust for sex, cholesterol, smoking, waist circumference, schooling, NSAIDs, loop diuretics, hypertension, and diabetes.
Results
During 15,676 person-years of follow up, there were 802 cases of incident hearing loss (Table 1). There was no significant association between lower baseline eGFRCr and incident hearing loss. There was also no association after stratifying by sex or age. Decline in eGFRCr was not associated with incident hearing loss.
Conclusion
There were no significant associations between baseline eGFRCr or decline in eGFRCr and risk of incident hearing loss.
Table 1: Multivariate-Adjusted Hazard Ratios for Risk of Hearing Loss by Baseline eGFR and eGFR Decline, EHLS 1993-2010
| Baseline eGFRCr (ml/min/1.73 m2) | |||
| 0 to <60 | 60 to <90 | 90+ | |
| Cases(n) | 86 | 495 | 221 |
| Person-years | 1060 | 8674 | 5942 |
| HR(95%CI) | 1.06 (0.83-1.35) | 1.00 (ref) | 1.09 (0.91-1.29) |
| eGFRCr Decline ≥20% | |||
| No | Yes | ||
| Cases(n) | 328 | 52 | |
| Person-years | 6853 | 854 | |
| HR(95%CI) | 1.00 (ref) | 1.12 (0.82-1.54) | |
Funding
- NIDDK Support