Hearing Status in Children with Idiopathic Nephrotic Syndrome

Document Type : Original Article


1 Department of Pediatrics, Faculty of Medicine, Ain Shams University, Egypt.

2 Department of Pediatrics, Faculty of Medicine, Ain Shams University.

3 General practitioner, Faculty of Medicine, Ain Shams University, Egypt.


The nephrotic syndrome is a glomerular disease, in which the glomerular capillary wall becomes no longer impermeable to proteins. It is characterized by nephrotic range proteinuria and the clinical findings associated with large urinary losses of protein: hypoalbuminemia, edema, and hyperlipidemia. The organs of the inner ear bear a physiological similarity to the kidney, both being concerned with maintaining the electrolyte concentration gradient. There is an association between renal and inner ear disorders, either genetically determined as in Alport syndrome and branchio-oto-renal syndrome or acquired as in acute kidney injury and chronic kidney disease.

Aim of the Work
To evaluate hearing status in children with idiopathic nephrotic syndrome.
Patients and Methods
This case-control study was conducted on 80 patients with nephrotic syndrome (for at least 12 months’ duration) following up at Pediatric Nephrology Clinic, Children’s Hospital, Ain Shams University and 20 (age and sex-matched) apparently healthy children as a control group Patients included were in remission or relapse and none had known ear disease or secondary nephrotic syndrome. Patients were subjected to thorough history taking and clinical examination. Corrected s. calcium, s. albumin and s. sodium was measured in all patients. Pure tone audiometry for all patients and controls was done to assess hearing status.
We found that patients with hearing impairment had lower serum albumin and serum calcium. Presence of proteinuria and the use of cyclophosphamide was significantly more in patients with hearing impairment. We also found that sensorineural hearing loss group had lower serum calcium and as well as serum sodium compared to conductive hearing loss group, with no significant difference in serum albumin between the 2 subgroups. No significant difference was noted in hearing status among patients in remission and those in relapse
Biochemical changes in idiopathic nephrotic syndrome, especially electrolytes, may play a role in hearing impairment in those patients. Drugs- (maybe) perhaps through immunosuppression (and) as well as increasing infection incidence;may also contribute to hearing impairment especially conductive hearing loss.


Main Subjects