Skip to main content
SpringerLink
Log in

Hearing status in children with frequently relapsing and steroid resistant nephrotic syndrome

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Children with idiopathic nephrotic syndrome (INS) are at risk of hearing impairment due to nephrotoxic drugs and biochemical impairments.

Methods

Forty children with INS aged 5–16 years [20 patients with frequently relapsing nephrotic syndrome (FRNS)/steroid dependent nephrotic syndrome (SDNS) and 20 with steroid resistant nephrotic syndrome (SRNS)] and 20 normal healthy controls were enrolled in this study. Pure tone audiometry was done using the ALPS AD 2000 audiometer. Sensorineural hearing loss was diagnosed when the bone conduction level was >20 dB and the difference in air to bone gap was ≤15 dB. Based on the air conduction (AC) threshold, deafness was graded into the following categories: mild (26–40 dB), moderate (41–55 dB), moderately severe (56-70 dB), severe (71–91 dB) and profound (>91 dB).

Results

Children with FRNS/SDNS had a higher threshold for hearing at frequencies of 250 and 500 Hz, respectively, than the controls. Of the children in the FRNS/SDNS category, three (15 %) had mild sensorineural hearing impairment. These children had a low serum calcium level (P < 0.03) and received higher cumulative doses of furosemide (P < 0.04). Children with SRNS had a higher threshold for hearing at frequencies of 250, 500, 1,000, and 2,000 Hz, respectively, than the controls. Of the 20 children with SRNS, ten (50 %) had sensoineural hearing impairment (8 mild, 2 moderate). Children with SRNS with a hearing defect had received a higher cumulative dose of furosemide (P < 0.03).

Conclusions

Children with FRNS/SDNS and SRNS are at risk of sensorineural hearing impairment. The risk factors associated with this impairment were higher cumulative doses of furosemide and hypocalcemia. Larger prospective cohort studies are required to evaluate this association.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Eddy AA, Symons JM (2003) Nephrotic syndrome in childhood. Lancet 362:629–639

    Article  PubMed  Google Scholar 

  2. Indian Pediatrics Nephrology Group, Indian Academy of Pediatrics (2008) Management of steroid sensitive nephrotic syndrome: Revised guidelines. Indian Pediatr 45:203–214

    Google Scholar 

  3. Bergstrom L, Thompson P, Wood RP (1979) New patterns in genetic and congenital nephropathies. Laryngoscope 2:309–322

    Google Scholar 

  4. Cremer CW, Flikkers-Van Noord M (1980) The ear pits-deafness syndrome. Clinical and genetic aspects. Int J Pediatr Otorhinolaryngol 2:309–322

    Article  Google Scholar 

  5. Saito R, Takata N, Matsumoto N, Koide I, Fujita A, Ogura Y, Murakami M, Yanagida K, Komazawa M (1982) Anomalies of the auditory organ in Potter’s syndrome. Histopathological findings in the temporal bone. Arch Otolaryngol 108:484–488

    Article  PubMed  CAS  Google Scholar 

  6. Quick CA, Fish A, Brown C (1973) The relationship between cochlea and kidney. Laryngoscope 83(9):1469–1482

    Article  PubMed  CAS  Google Scholar 

  7. Kumar S, Chakravarti A, Sahni J, Dubey NK, Rathore R (2004) Auditory brain stem evoked response (ABR) study in patients with pediatric chronic renal failure undergoing peritoneal dialysis. Indian J Otol 9:24–27

    Google Scholar 

  8. Aryan CE, Clapp WL, Redman RS, Dharnidharka VR (2006) Hearing loss in renal failure differential diagnosis. Am J Kidney Dis 47(3):553–558

    Article  Google Scholar 

  9. Thodi C, Thodis E, Danielides V, Pasadakis P, Vargemezis V (2006) Hearing in renal failure. Nephrol Dial Transplant 21:3023–3030

    Article  PubMed  Google Scholar 

  10. Sato KA, Gray RW, Lemann J Jr (1982) Urinary excretion of 25-hydroxyvitamin D in health and the nephrotic syndrome. J Lab Clin Med 99(3):325–330

    PubMed  CAS  Google Scholar 

  11. Freundlich M, Bourgoignie JJ, Zilleruelo G, Abitbol C, Canterbury JM, Strauss J (1986) Calcium and vitamin D metabolism in children with nephrotic syndrome. J Pediatr 108(3):383–387

    Article  PubMed  CAS  Google Scholar 

  12. Baxter JH, Goodman HC, Havel RJ (1960) Serum lipid and lipoprotein alteration in nephrosis. J Clin Invest 39:455–465

    Article  PubMed  CAS  Google Scholar 

  13. Kaysen GA (1991) Hyperlipidemia of the nephrotic syndrome. Kidney Int 31[Suppl]:S8–S15

    CAS  Google Scholar 

  14. Bayazit YA, Balat A, Pakir HI, Güler E, Kanlikama M (2005) Influence of relapse and remission periods on hearing status in children with minimal change nephrotic syndrome. Rev Laryngol Otol Rhinol 126(3):171–173

    CAS  Google Scholar 

  15. Orendorz-Frqczkowska K, Medynska A, Jablonka A, Gawron W (2008) Hearing organ function in children with nephrotic syndrome in course of primary glomerulopathy. Otolaryngologia Polska 12:182–187

    Article  Google Scholar 

  16. Bushinsky DA, Monk RD (1998) Electrolyte quintet: calcium. Lancet 352:306–311

    Article  PubMed  CAS  Google Scholar 

  17. Carhart R, Jerger J (1959) Preferred method for clinical determination of pure tone thresholds. J Speech Hear Res 24:330–345

    Google Scholar 

  18. Clark JG (1981) Uses and abuses of hearing loss classification. ASHA 23(7):493–500

    PubMed  CAS  Google Scholar 

  19. Indian Pediatric Nephrology Group, Indian Academy of Pediatrics (2009) Management of steroid resistant nephrotic syndrome: guidelines. Indian Pediatr 46:35–47

    Google Scholar 

  20. Brookes GB (1983) Vitamin D deficiency- a new cause of cochlear deafness. J Laryngol Otol 97(5):405–420

    Article  PubMed  CAS  Google Scholar 

  21. Ikeda K, Kusakari J, Kobayashi T, Saito Y (1987) The effect of vitamin D deficiency on the cochlear potentials and the perilymphatic ionized calcium concentration of rats. Acta Otolaryngol Suppl 435:64–72

    Article  PubMed  CAS  Google Scholar 

  22. Ikeda K, Kobayashi T, Kusakari J, Takasaka T, Yumita S, Furukawa Y (1987) Sensorineural hearing loss associated with hypoparathyroidism. Laryngoscope 97(9):1075–1079

    Article  PubMed  CAS  Google Scholar 

  23. Iwanaga M, Yamamoto E, Yamauchi M (1983) Effect of calcium on AP (N1) and ABR in thyroid and parathyroid dysfunction. Audiology 26:171–177

    Article  Google Scholar 

  24. Chodynicki S, Kostrzewska A (1974) Effect of furosemide and ethacrynic acid on endolymph potential in guinea pigs. Otolaryngol Pol 28:5–8

    PubMed  CAS  Google Scholar 

  25. Green TP, Rybak LP, Mirkin BL, Juhn SK, Morizono T (1981) Pharmacologic determinants of ototoxicity of furosemide in the chinchilla. J Pharmacol Exp Ther 216:537–542

    PubMed  CAS  Google Scholar 

  26. Sewell WF (1984) The relation between the endocochlear potential and spontaneous activity in auditory nerve fibres of the cat. J Physiol 347:685–696

    PubMed  CAS  Google Scholar 

  27. Koch T, Gloddek B (1991) Inhibition of adenylate-cyclase-coupled G protein complex by ototoxic diuretics and cis-platinum in the inner ear of the guinea pig. Eur Arch Otorhinolaryngol 248:459–464

    Article  PubMed  CAS  Google Scholar 

  28. Quick CA, Hoppe W (1975) Permanent deafness associated with furosemide administration. Ann Otol Rhinol Laryngol 84:94–101

    PubMed  CAS  Google Scholar 

  29. Forge A (1976) Observations on the stria vascularis of the guinea pig cochlea and the changes resulting from the administration of the diuretic furosemide. Clin Otolaryngol Allied Sci 1:211–219

    Article  PubMed  CAS  Google Scholar 

  30. Rarey KE, Ross MD (1982) A survey of the effects of loop diuretics on the zonulae occludentes of the perilymph-endolymph barrier by freeze fracture. Acta Otolaryngol 94:307–316

    Article  PubMed  CAS  Google Scholar 

  31. Rybak LP (1993) Ototoxicity of loop diuretics. Otolaryngol Clin North Am 26:829–844

    PubMed  CAS  Google Scholar 

  32. Rybak LP, Whitworth C, Scott V (1993) Furosemide ototoxicity is enhanced in analbuminemic rats. Arch Otolaryngol Head Neck Surg 119:758–761

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Postgraduate Institute of Medical Education & Research (PGIMER) and Dr Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, India, 110001

    Abhijeet Saha, Vivek Gupta, Kanika Kapoor & N. K. Dubey

  2. Department of ENT, PGIMER and Dr Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, India, 110001

    Priti Lal & T. S. Sidhu

  3. Department of Pathology, GB Pant Hospital, New Delhi, India

    V. V. Batra

  4. Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    A. D. Upadhyay

  5. Division of Pediatric Nephrology, PGIMER and Ram Manohar Lohia Hospital, Room no 406, PGIMER Building, Baba Kharak Singh Marg, New Delhi, 201010, India

    Abhijeet Saha

Authors
  1. Abhijeet Saha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vivek Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kanika Kapoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. K. Dubey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Priti Lal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. S. Sidhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. V. V. Batra
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. D. Upadhyay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abhijeet Saha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saha, A., Gupta, V., Kapoor, K. et al. Hearing status in children with frequently relapsing and steroid resistant nephrotic syndrome. Pediatr Nephrol 28, 439–445 (2013). https://doi.org/10.1007/s00467-012-2358-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-012-2358-7

Keywords

Search

Navigation