ENT 2026

Background.Progressive hearing loss in patients with chronic kidney disease reduces speech intelligibility, aggravates tinnitus, and restricts social participation. An effective preventive strategy should integrate control of nephrological risk factors, regular audiological monitoring, and timely rehabilitation Objective. To evaluate changes in audiological parameters following implementation of a comprehensive prevention and rehabilitation program in patients with chronic kidney disease.Materials and Methods. The study included 180 patients: 50 receiving conservative treatment, 50 undergoing maintenance hemodialysis, 50 undergoing peritoneal dialysis, and 30 enrolled in a comprehensive prevention and rehabilitation program. The control group comprised 30 healthy individuals. Pure-tone audiometry, tympanometry, acoustic reflex testing, and otoacoustic emission testing were performed at baseline and after 6 and 12 months. The program included correction of anemia, blood pressure, and metabolic abnormalities; monitoring of potentially ototoxic medications; antioxidant and neuroprotective therapy when clinically indicated; hearing-aid fitting; and communication rehabilitation.Results. Before rehabilitation, the most severe audiological abnormalities were observed in the hemodialysis group: bilateral sensorineural hearing loss was diagnosed in 76.0% of patients, including moderate hearing loss in 44.0% and severe hearing loss in 16.0%. Preserved otoacoustic emissions were recorded in 40.0% of patients undergoing hemodialysis and in 56.0% of those undergoing peritoneal dialysis,After 12 months of comprehensive follow-up, the mean hearing threshold in the rehabilitation group improved by 6.4 dB at 4000 Hz and by 4.2 dB across the speech-frequency range. The otoacoustic-emission signal-to-noise ratio increased by a mean of 2.1 dB. Otoacoustic emissions were preserved in 76.7% of patients in the rehabilitation group compared with 40.0% in the hemodialysis group; reduced acoustic reflex amplitude was observed in 26.7% and 66.0%, respectively (p < 0.001), Improvements in functional measures were accompanied by reductions in tinnitus severity and difficulties with speech understanding. The greatest benefit was observed when patients entered the program early, before severe sensorineural hearing loss had developed, Conclusions. A comprehensive preventive strategy combined with longitudinal audiological monitoring may help stabilize auditory function and improve otoacoustic-emission parameters. The program should be based on correction of anemia, arterial hypertension, and metabolic abnormalities; avoidance of unjustified use of ototoxic medications; and timely audiological rehabilitation. These findings require confirmation in randomized studies.

Dr. D. M. Nabieva is affiliated with Tashkent State Medical University, Tashkent, Uzbekistan. Her research focuses on the prevention, diagnosis, and rehabilitation of hearing loss, particularly among patients with chronic kidney disease (CKD). Her academic interests include audiological assessment, sensorineural hearing loss, and the relationship between renal disorders and auditory dysfunction, Her research explores comprehensive approaches to preserving auditory function in patients receiving conservative treatment, hemodialysis, and peritoneal dialysis. She emphasizes the importance of early detection, regular audiological monitoring, and individualized rehabilitation strategies to improve hearing outcomes and quality of life.