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The multifaceted links between hearing loss and chronic kidney disease

Nature Reviews Nephrology volume 20, pages 295–312 (2024)Cite this article

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Abstract

Hearing loss affects nearly 1.6 billion people and is the third-leading cause of disability worldwide. Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. From a developmental perspective, the structures responsible for hearing have a common morphogenetic origin with the kidney, and genetic abnormalities that cause familial forms of hearing loss can also lead to kidney disease. On a cellular level, normal kidney and cochlea function both depend on cilial activities at the apical surface, and kidney tubular cells and sensory epithelial cells of the inner ear use similar transport mechanisms to modify luminal fluid. The two organs also share the same collagen IV basement membrane network. Thus, strong developmental and physiological links exist between hearing and kidney function. These theoretical considerations are supported by epidemiological data demonstrating that CKD is associated with a graded and independent excess risk of sensorineural hearing loss. In addition to developmental and physiological links between kidney and cochlear function, hearing loss in patients with CKD may be driven by specific medications or treatments, including haemodialysis. The associations between these two common conditions are not commonly appreciated, yet have important implications for research and clinical practice.

Key points

  • Chronic kidney disease (CKD) and hearing loss are common conditions that individually cause tremendous morbidity but which often coexist.

  • The kidneys and the hearing organs share a common morphogenetic origin and rely on similar biological structures (for example, cilia) and processes (for example, specialized cellular transport mechanisms) to function.

  • Genetic abnormalities that cause CKD can also cause hearing loss, and vice versa.

  • A strong, graded and independent relationship exists between kidney function and the risk of hearing loss; the highest risk is observed in patients on haemodialysis, but kidney transplant recipients and people with mild CKD are also at increased risk.

  • Infants, children and possibly adults with malformation or dysfunction of their hearing organs should be evaluated for the presence of malformation or dysfunction of their kidneys, and vice versa.

  • Additional funding is needed to support basic, clinical and health services research that explores the intersection between these two relatively neglected conditions.

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Fig. 1: Shared developmental origins of the kidney and inner ear.
Fig. 2: Ciliated cells are found in the ear and kidney.

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  1. Program in Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada

    Dina Greenberg & Norman D. Rosenblum

  2. Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Toronto, Ontario, Canada

    Dina Greenberg & Norman D. Rosenblum

  3. Department of Paediatrics, Temerty Faculty of Medicine, Toronto, Ontario, Canada

    Norman D. Rosenblum

  4. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

    Marcello Tonelli

Authors
  1. Dina Greenberg
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  2. Norman D. Rosenblum
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  3. Marcello Tonelli
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Contributions

All authors researched data for the article, contributed substantially to discussion of the content and wrote the article. N.D.R. and M.T. reviewed and/or edited the manuscript before submission.

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Correspondence to Marcello Tonelli.

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Nature Reviews Nephrology thanks Judy Savige and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Greenberg, D., Rosenblum, N.D. & Tonelli, M. The multifaceted links between hearing loss and chronic kidney disease. Nat Rev Nephrol 20, 295–312 (2024). https://doi.org/10.1038/s41581-024-00808-2

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