Hearing status in children with frequently relapsing and steroid resistant nephrotic syndrome
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ORIGINAL ARTICLE
Hearing status in children with frequently relapsing and steroid resistant nephrotic syndrome Abhijeet Saha & Vivek Gupta & Kanika Kapoor & N. K. Dubey & Priti Lal & T. S. Sidhu & V. V. Batra & A. D. Upadhyay
Received: 1 June 2012 / Revised: 3 October 2012 / Accepted: 15 October 2012 / Published online: 12 December 2012 # IPNA 2012
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 A. Saha : V. Gupta : K. Kapoor : N. K. Dubey 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 P. Lal : T. S. Sidhu Department of ENT, PGIMER and Dr Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, India 110001 V. V. Batra Department of Pathology, GB Pant Hospital, New Delhi, India A. D. Upadhyay Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India A. Saha (*) Division of Pediatric Nephrology, PGIMER and Ram Manohar Lohia Hospital, Room no 406, PGIMER Building, Baba Kharak Singh Marg, New Delhi 201010, India e-mail: [email protected]
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 (P15 dB. Quantitative information on the air conduction (AC) threshold allowed deafness to be graded into mild (26–40 dB), moderate (41–55 dB), moderately severe
Table 4 Characteristics of patients with FRNS/SDNS with a hearing defecta and with normal hearing Character
Hearing defecta (n03)
Normal hearing (n017)
P valueb
Weight (kg) Height (cm) Systolic blood pressure (mm Hg) Diastolic blood pressure (mmHg) Serum total protein (gm/dl) Serum albumin (gm/dl)
31.333±12.055 118±11.533 100.667±4.619 68±10.583 4.167±0.288 1.867±0.115
26.41176±10.546 118±15.479 105.647±9.956 68.118±7.857 4.324±0.814 1.741±0.449
0.37 0.87 0.75 0.91 0.96 0.36
Serum cholesterol (mg/dl) Serum sodium (mEq/l) Serum potassium (mEq/l) Serum calcium (mg/dl) Corrected calcium (mg/dl) Cumulative dose of furosemide (mg/kg)c Duration of illness (years) Number o
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