الفهرس 
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Abstract
Chronic kidney disease in children has many unique features that are not seen in older patients. Its manifestations can affect multiple body systems (cardiovascular, endocrine, hematopoietic, otological, gastrointestinal, central nervous) during particularly vulnerable times of development in children with the potential for permanent sequelae, However, as renal function gradually declines, various signs and symptoms ―volume overload, hypertension, fatigability‖.
Although the gross anatomy of the kidney and cochlea differs considerably, there are many similarities at the ultrastructural level (Both contain epithelial structures in close contact with their vascular supply, the cochlea and kidney have similar physiological mechanisms, namely the active transport of fluid and electrolytes performed by the stria vascularis and the glomerulus, respectively. They may also have common antigenicity.
Deterioration in the function of hearing organs is one of the most significant clinical problems in patients with chronic renal failure. The incidence of sensorineural hearing loss among patients with CRF is considerably higher than that in the general population. Hearing loss, mainly cochlear, is present in a high percentage of patients with CRF. So, the aim of this study was to evaluate the audiological status in children with end - stage renal disease on regular hemodialysis in Pediatric hemodialysis unit, Menoufia University.
To elucidate our aim, this study was conducted on 46 patients with End - Stage Renal Disease who were attended to the pediatric nephrology unit of Menoufia University Hospital during a period time from April 2022 to April 2023.
All patients were subjected to the following:
Full detailed history including Age, Course and duration of chronic renal failure, Complications developed, Previous hospital admission, Family history of similar disease, Is there is hypertension or not and Medications received ex, ototoxic drugs and its duration.
Clinical examination for each patient including General examination including: all children were clinically examined: Weight, Height, Blood pressure.
Systemic examination including: Heart examination, Chest examination, Abdominal examination for organomegaly and Otoscopic examination.
Investigations: The following was done for each patient: Basic audiological evaluation includes pure tone audiometry and tymanometry. Routine laboratory investigations in the form of; Complete blood count, Kidney function tests, Serum electrolytes and parathormone hormone level, iron, ferritin.
The results of this study could be summarized as follow:
There was no statistically significant difference between the two studied groups in terms of age, sex distribution, BMI and MAP.
PTA score was insignificantly different between the right and left ears at all frequencies in both groups. The comparison between both groups revealed a statistically significant difference at all frequencies (P<0.05) as both ears of CKD patients gave significantly higher PTA score than those of the healthy controls.
Eight CKD patients of 28 had SNHL (6 had mild and 2 had moderate to severe SNHL). Moreover, 4 patients had mild conductive HL. Out of 28 patients, 3 had their right ears affected, 2 had their left ears affected and 6 had both of their ears affected.
Urea and creatinine levels were significantly higher in the study group compared to the healthy control (P<0.001). On the other hand, both groups were comparable in terms of electrolytes, Hb, TLC, PLT and PTH.