Document Type : Original Articles


1 Student Research Committee, Babol University of Medical Sciences, Babol, Iran.

2 Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Department of Audiology, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran.

3 Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

5 Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran


Background: The study aims to investigate the impact of chronic kidney diseases (CKD) on the auditory processing abilities of patients, including uremic neuropathy. The impairment of auditory processing may result in communication, social, and emotional problems in their lives. Accordingly, this study analyzes the communication abilities and speech perception of noise in CKD patients to identify potential auditory disorders rapidly.
Methods: In this cross-sectional-comparative study, the authors randomly selected 30 CKD patients and 29 normal adults aged 20-55, all of whom had normal peripheral hearing. The participants underwent the consonant-vowel (CV) test with five signal-to-noise ratios (SNR) and silence. Additionally, the participants completed the speech, spatial, and qualities of hearing scale questionnaire (SSQ), which consisted of three subscales. The scores of the two groups were compared using the Mann-Whitney U test.
Results: In both groups, the recognition scores for consonant-vowel decreased as the noise level increased. However, the normal group consistently outperformed the CKD patients at all noise levels. Regarding the three subscales of the SSQ, the patients obtained lower scores than the normal group, but this difference was not statistically significant.
Conclusions: Chronic renal failure appears to have a negative impact on speech perception abilities in noise, suggesting auditory neurological involvement in CKD. Although patient self-assessment did not indicate any speech processing disability, conducting regular and periodic assessments of central hearing in CKD patients is still advisable. Early diagnosis of hearing disability can help mitigate its consequences, and appropriate rehabilitation measures should be taken if a disability is detected.


  1. Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Annals of internal medicine. 2013;158(11):825-30.
  2. Costa K, Ferreira SMS, Menezes PL. Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss. Brazilian journal of otorhinolaryngology. 2017;83(5):580-4.
  3. Gatland D, Tucker B, Chalstrey S, Keene M, Baker L. Hearing loss in chronic renal failure-hearing threshold changes following haemodialysis. Journal of the Royal Society of Medicine. 1991;84(10):587-9.
  4. Henrich WL, Thompson P, Bergstrom LV, Lum GM. Effect of dialysis on hearing acuity. Nephron. 1977;18(6):348-51.
  5. D'Andrea KF, Zeigelboim BS, Liberalesso PB, Sylvestre Lde C, Jurkiewicz AL, Marques JM. Audiological findings in patients submitted to kidney transplant. CoDAS. 2013;25(3):202-8.
  6. Bazzi C, Venturini CT, Pagani C, Arrigo G, D'Amico GD. Hearing loss in short- and long-term haemodialysed patients. Nephrology Dialysis Transplantation. 1995;10(10):1865-8.
  7. Olusanya BO, Newton VE. Global burden of childhood hearing impairment and disease control priorities for developing countries. The Lancet. 2007;369(9569):1314-7.
  8. Marziyeh Moradi Vastegani SF. Comparison of Auditory Comprehension in Different Levels of Noise in the Elderly and Young Adult Group.
  9. Falahzadeh S T, S., Azadi, F.,Farjadi, F. . speech recegnition in noise in patients with type II diabetecs. Indian journal of otology. 2020.
  10. Falahzadeh S KS, Rohani S. Systematic review of auditory behavioral tests with speech stimuli. Iran J Rehab Med 2019;8:35-47.
  11. Ataollahi M, Amini M, Delavari S, Bazrafkan L, Jafari P. Reliability and validity of the Persian version of readiness for inter-professional learning scale. International journal of medical education. 2019;10:203-7.
  12. Gordon-Salant S, Yeni-Komshian GH, Fitzgibbons PJ, Barrett J. Age-related differences in identification and discrimination of temporal cues in speech segments. J Acoust Soc Am. 2006;119(4):2455-66.
  13. Krishnan R RR. Hearing assesment in chronic renal failure patients. Orissa Otolaryngology Head Neck Surgery 2018 june;12(1):24-8.
  14. Fidan V, Binici D, Borazan A. The Prevalence of Hearing Loss in Dialysis Patients. Acta Acustica United With Acustica. 2012;98:800-3.
  15. Peyvandi A, Roozbahany NA. Hearing Loss in Chronic Renal Failure Patient Undergoing Hemodialysis. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013;65(3):537-40.
  16. Lasisi AO, Salako BL, Kodiya MA, Amusat MA, Osisanya WP. Hearing threshold in patients with chronic renal failure. Saudi medical journal. 2007;28(5):744-6.
  17. Aspris AK, Thodi CD, Balatsouras DG, Thodis ED, Vargemezis V, Danielides V. Auditory brainstem responses in patients under treatment of hemodialysis. Ren Fail. 2008;30(4):383-90.
  18. Doshad VK. Haring Assessment in Chronic Renal Failure Patients Undergoing Hemodialysis. Journal of Evolution of Medical and Dental.
  19. Nikolopoulos TP, Kandiloros DC, Segas JV, Nomicos PN, Ferekidis EA, Michelis KE, et al. Auditory function in young patients with chronic renal failure. Clinical otolaryngology and allied sciences. 1997;22(3):222-5.
  20. Renda R, Renda L, Selçuk ÖT, Eyigör H, Yılmaz MD, Osma Ü. Cochlear sensitivity in children with chronic kidney disease and end-stage renal disease undergoing hemodialysis. International Journal of Pediatric Otorhinolaryngology. 2015;79(12):2378-83.
  21. Naderpour M, Mortazavi F, Jabbari-Moghaddam Y, Sharifi-Movaghar MH. Auditory brain stem response and otoacoustic emission results in children with end-stage renal disease. International journal of pediatric otorhinolaryngology. 2011;75(5):704-7.
  22. Lotfi Y, Nazeri AR, Asgari A, Moosavi A, Bakhshi E. Iranian Version of Speech, Spatial, and Qualities of Hearing Scale: A Psychometric Study. Acta medica Iranica. 2016;54(12):756-64.
  23. Lee SY, Lee HJ, Kim YK, Kim SH, Kim L, Lee MS, et al. Neurocognitive function and quality of life in relation to hematocrit levels in chronic hemodialysis patients. Journal of psychosomatic research. 2004;57(1):5-10.
  24. Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9(1):97-113.
  25. Lotfi Y KS, Javanbakh tM, Biglarian. Development, Validity and Reliability of the Persian Version of the Consonant-Vowel in White Noise Test. JRSR. 2016;2: 29-34.
  26. Kaya Y, Ozturkeri OA, Benli US, Colak T. Evaluation of the cognitive functions in patients with chronic renal failure before and after renal transplantation. Acta Neurologica Belgica. 2013;113(2):147-55.
  27. Chandrasekaran Bharath , Jane Hornickel, Erika Skoe, Trent Nicol, Nina Kraus. Context-dependent encoding in the human auditory brainstem relates to hearing speech in noise: Implications for developmental dyslexia. Neuron. 2009 Nov 12; 64(3): 311–319.
  28. Anderson S, A Parbery-Clark, T White-Schwoch. Auditory Brainstem Response to Complex Sounds Predicts Self-Reported Speech-in-Noise Performance. J Speech Lang Hear Res. 2013 Feb; 56(1): 31–43
  29. Sharifinik Mahya ST, Ghasem Mohammadkhani, Shohreh Jalaie. Comparison of Gaps in noise test (GIN) in adults with normal and conductive hearing loss. JRRS. 2013;9(4).726-34.
  30. Tajik S, Adel Ghahraman M, Tahaie AA, Hajiabolhassan F, Jalilvand Karimi L, Jalaie S. Deficit of Auditory Temporal Processing in Children with Dyslexia-Dysgraphia. AVRJ. 2012;21(4):76-83.