title: Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss.
abstract: BACKGROUND
  The association between hearing loss and chronic kidney disease and hemodialysis has been well documented. However, the classification used for the degree of loss may underestimate the actual diagnosis due to specific characteristics related to the most affected auditory frequencies. Furthermore, correlations of hearing loss and hemodialysis time with hearing handicap remain unknown in this population.
  
  
  OBJECTIVE
  To compare the results of Lloyd's and Kaplan's and The Bureau Internacional d'Audiophonologie classifications in chronic kidney disease patients, and to correlate the averages calculated by their formulas with hemodialysis time and the hearing handicap.
  
  
  METHODS
  This is an analytical, observational and cross-sectional study with 80 patients on hemodialysis. Tympanometry, speech audiometry, pure tone audiometry and interview of patients with hearing loss through Hearing Handicap Inventory for Adults. Cases were classified according to the degree of loss. The correlations of tone averages with hemodialysis time and the total scores of Hearing Handicap Inventory for Adults and its domains were verified.
  
  
  RESULTS
  86 ears (53.75%) had hearing loss in at least one of the tonal averages in 48 patients who responded to Hearing Handicap Inventory for Adults. The Bureau Internacional d'Audiophonologie classification identified a greater number of cases (n=52) with some degree of disability compared to Lloyd and Kaplan (n=16). In the group with hemodialysis time of at least 2 years, there was weak but statistically significant correlation of The Bureau Internacional d'Audiophonologie classification average with hemodialysis time (r=0.363). There were moderate correlations of average The Bureau Internacional d'Audiophonologie classification (r=0.510) and tritone 2 (r=0.470) with the total scores of Hearing Handicap Inventory for Adults and with its social domain.
  
  
  CONCLUSIONS
  The Bureau Internacional d'Audiophonologie classification seems to be more appropriate than Lloyd's and Kaplan's for use in this population; its average showed correlations with hearing loss in patients with hemodialysis time≥2 years and it exhibited moderate levels of correlation with the total score of Hearing Handicap Inventory for Adults and its social domain (r=0.557 and r=0.512).
authors.affiliation: Hospital Vida, Centro Universitário CESMAC, Programa de Pós-graduação, Maceió, AL, Brazil. Electronic address: kvtc@uol.com.br.
authors.forename: Klinger Vagner Teixeira da
authors.initials: KVTD
authors.lastname: Costa
authors.affiliation: Hospital Vida, Centro Universitário CESMAC, Programa de Pós-graduação, Maceió, AL, Brazil.
authors.forename: Sonia Maria Soares
authors.initials: SMS
authors.lastname: Ferreira
authors.affiliation: Hospital Vida, Centro Universitário CESMAC, Programa de Pós-graduação, Maceió, AL, Brazil; Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, Brazil.
authors.forename: Pedro de Lemos
authors.initials: PL
authors.lastname: Menezes
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D003430:Cross-Sectional Studies; D003638:Deafness; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Audiometria; Audiometry; Chronic kidney disease; Doença renal crônica; Hearing loss; Perda auditiva