The Japanese Journal of Clinical Dialysis Vol.27 No.2(5)

Theme Working in Cooperation with Other Departments for Dialysis Treatment -- Centered Mainly on Easily Overlooked Conditions
Title Balance and hearing disorders in elderly dialysis patients
Publish Date 2011/02
Author Yasutaka Kojima Department of Otolaryngology, Mitsui Memorial Hospital
Author Taeko Okuno Department of Otolaryngology, Mitsui Memorial Hospital
Author Yu Matsumoto Department of Otolaryngology, Mitsui Memorial Hospital
[ Summary ] It is widely accepted that patients receiving hemodialysis have higher incidences of dizziness, vertigo and hearing loss. Hemodialysis has contributed to the survival of elderly patients with chronic kidney disease. As a result, the elderly dialysis population is steadily growing. Therefore, an understanding of a wide variety of comorbidities is critical in effectively formulating patient care. Balance disorders in elderly dialysis patients arise from a combination of factors. Age, as well as hemodialysis-induced hypotension influences several types of balance disorders including orthostatic disturbances, cerebellar and brainstem conditions, as well as cochlear vascular disorders. Benign paroxysmal positional vertigo, labyrinthitis, and drug-induced balance disorders are highlighted in this article. Sensorineural hearing loss is frequently reported in elderly hemodialysis patients. However, the etiology of this condition remains controversial. Hemodialysis also appears to have an ototoxic effect, although it is difficult to distinguish between its effects and the effects of aging. Higher frequency ranges are most affected in sustained hearing loss. Sudden hearing loss can be bilateral or unilateral. Fluctuation in low frequency perception during and shortly after dialysis session is common. The association between hearing loss and duration of hemodialysis remains unclear.
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