Alterações funcionais cocleovestibulares em pacientes com doença renal crônica em hemodiálise

Abstract

Introduction: Chronic kidney disease is characterized by progressive and irreversible reduction of renal function and can be classified according to glomerular filtration rate. When this rate reaches very low values, we find what is called renal functional failure, when it is necessary some kind of renal replacement therapy. Hemodialysis, one kind of these therapy can induce electrolyte, biochemical, immunological, osmotic and vascular changes that are capable of leading to changes in the functioning of the inner ear. Such changes can cause symptoms such as hearing loss and vestibular alterations. Objective: To determine which cochleovestibular alterations affect patients diagnosed with chronic kidney disease before and after hemodialysis. Method: Cross-sectional clinical study developed in the nephrology sector of the University Hospital of the Federal University of Maranhão. The sample consisted of 30 individuals aged between 18 and 59 years diagnosed with chronic kidney disease under hemodialysis treatment. The video head impulse test (vHIT) was performed for vestibular evaluation and the research of distortion product otoacoustic emissions (OAE-DP) and transient otoacoustic emissions (OAE-TE) for cochlear evaluation. All tests were performed before and after the hemodialysis session. Results: When analyzing the vestibulo-ocular reflex before and after hemodialysis through vHIT, no statistically significant changes were observed, regardless of gender, age group and treatment time on hemodialysis. Similarly, no alterations were observed in relation to asymmetry. Regarding the analysis of DPOAE, there was an increase in the number of patients who failed at the highest frequencies (4 and 5 KHz) in the post hemodialysis test, but no statistically significant change was observed after hemodialysis (p> 0.05). In relation to THEAE, when comfacing the pre and post HD tests there was an increase in patients who failed at frequencies of 2 and 4KHz, also without statistically significant alteration after hemodialysis (p> 0.05). Conclusion: There were no significant cochleovestibular alterations, assessed through vHIT and OAE, after a single hemodialysis session for the studied sample.