Monday, 27 February 2012

What The Heck Does Hearing Have To Do With My Kidneys You Ask?

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A lot, is the short answer. There are several reasons for this:

• One of them is the functional and structural similarity in the cochlea (inner ear) and the kidney.
• When a person suffers from chronic kidney disease (CKD), the toxins that accumulate in the body due to kidney malfunction damage nerves, including those in the inner ear.
• Another reason is medication; some drugs used for kidney disease are ototoxic, that is, they damage the delicate cells in the cochlea.
• Hearing loss and kidney disease share risk factors like high blood pressure and diabetes.

Although anatomically the inner ear and the kidney are very different, at a micro-cellular or ultrastructural level, they are very similar. Epithelial cells in both organs are associated with active transport of fluids and electrolytes and keeping homeostasis in the body.

The type of hearing loss seen with chronic kidney disease is often a low frequency (250-500 Hz and high frequency (3000-8000 Hz hearing loss with better or normal hearing in the mid frequencies (750-2000 Hz).

Speech sounds have most of their energy in the mid frequencies, therefore a hearing loss might not be noticed right away, depending on which inner ear cells are affected. The cochlea has 2 types of cells called hair cells. The majority of cochlear hair cells are outer hair cells, and their job is to 'turn up the volume" so the remaining inner hair cells can transmit sounds via the hearing nerve to the brain. This is an oversimplification of a very complex process but it will help you understand the point I am trying to make. If the outer hair cells are damaged, either because of noise exposure, disease, or ototoxicity, we lose the mechanism in charge of controlling volume. If we're able to find a substitute for turning the volume up, such as an amplifier or hearing aid, then the inner hair cells can "hear" the sound and transmit it to the brain (remember this is an over simplification and there are many processes involved and facts to consider). If, on the other hand, there is damage to the inner hair cells (ototoxicity, lack of oxygen to the tissue or electrochemical imbalance), then we have what is commonly called nerve deafness or neural (nerve) hearing loss. That is, regardless of whether there is enough volume or not, the cells that transmit the information (sound) to the brain, are damaged and they can't do it well. This translates into sound that is distorted, unclear and even unrecognizable.

As part of your annual medical physical, make sure you check your hearing and if you do have hearing loss it is best to "correct" this by using good quality amplification (hearing aids) sooner rather than later.

More information on how to choose the right hearing aids will follow in the next article. Don't miss it.

Minnesota licensed audiologist with 16 years of experience in the assessment and treatment of hearing disorders with an emphasis on auditory processing disorders (APD, CAPD), tinnitus, and hearing aids. She obtained her BS degree in Psychology, Biology and Communication Disorders from the University of Minnesota, MA in Audiology also from the University of Minnesota and her Doctorate degree from the University of Florida. She also holds a certificate in Web Technologies and design and maintains websites.

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