Low-Frequency Hearing Loss as an Independent Predictor of Frailty in Hemodialysis Patients

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Low-Frequency Hearing Loss as an Independent Predictor of Frailty in Hemodialysis Patients

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Co-author 1

Akihiro Maekawa a-maekawa@nagajin.jp Nagasaki Kidney Center Department of Blood Purification Nagasaki Japan *

Co-author 2

Jyunichiro Hashiguchi hashiguchi1215@gmail.com Nagasaki Kidney Center Department of Blood Purification Nagasaki Japan -

Co-author 3

Kenji Sawase sawakenurouro@yahoo.co.jp Nagasaki Kidney Center Department of Blood Purification Nagasaki Japan -

Co-author 4

Koutaro Shimoyama kaisyokai20@gmail.com Jikei University School of Medicine Department of Nephrology Tokyo Japan -

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Introduction

Frailty is highly prevalent among elderly patients receiving maintenance hemodialysis (HD) and is strongly associated with poor outcomes. However, the relationship between frailty and hearing loss—another common geriatric syndrome—remains largely unexplored in this population. This study aimed to clarify the association between hearing function and frailty status in HD patients.

Methods

We conducted a cross-sectional study involving 229 maintenance HD patients from November to December 2024 at a single center. Patients were required to be independent in daily activities; those with severe dementia or profound hearing loss were excluded. Frailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria and categorized as robust, pre-frail, or frail. Audiometric evaluation was performed before dialysis sessions, measuring both low-frequency (1000 Hz) and high-frequency (4000 Hz) thresholds. Correlation and multivariate regression analyses were used to assess associations between frailty and clinical variables, including age, sex, diabetes, dialysis vintage, and serum albumin.

Results

Among 229 patients (65.5% male; mean age 69.0 ± 11.7 years; mean dialysis vintage 8.1 ± 7.7 years), 24.8% were frail, 63.3% pre-frail, and 11.7% robust. Low-frequency hearing loss, diabetes, and older age were significantly associated with higher frailty scores. Multivariate regression identified low-frequency hearing loss (p < 0.01), diabetes (p < 0.01), and age (p < 0.05) as independent predictors of frailty (adjusted R² = 0.22).

Conclusion

This is the first study to demonstrate that low-frequency hearing loss independently predicts frailty in HD patients. Given the frequent clinical interactions in this population, incorporating simple audiometric screening into routine dialysis care may enable early identification of vulnerable individuals, allowing timely interventions to improve functional outcomes and quality of life.

Kewords