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논문분류	춘계학술대회 초록집
제목	Mixed Hearing Loss in Diabetic Kidney Disease and Post-Tuberculosis Lung Disease
저자	Teodorus Tomy Saputra
출판정보	2024; 2024(1):
키워드
초록	Diabetic Kidney Disease (DKD) is the most common cause of end-stage renal disease (ESRD) worldwide. A 52-year-old man with diabetes mellitus 20 years ago without antidiabetic drugs. In 2021, He was diagnosed with Tuberculosis and completely treated with combination of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol for 12 months. He was admitted because of dyspnea and cough since 1 week, hearing loss since 3 months before admission. Physical Examination results are BMI 23.43 kg/m2, pale, tympanic membrane perforation, rhonchi, and edema. Laboratory results showed Haemoglobin 6.4g/dl, Ureum 114mg/dl, Creatinine 8.5mg/dl, post-prandial blood glucose 213mg/dl, LDL 150mg/dl, total cholesterol 202mg/dl, albumin 2.7mg/dl, partially compensated respiratory alkalosis on blood gas analysis, negative gene expert of M. Tuberculosis, albuminuria (+3), glucosuria (+1). Chest x-ray examination showed wide lesion of tuberculosis. Abdominal ultrasound showed decrease of kidney size and Chronic parenchymal renal disease bilateral. Audiometry examination results are conductive hearing loss in right ear and mixed hearing loss in left ear. We diagnosed this patient with DKD 5 Dialysis, Uncontrolled Type-2 Diabetes Mellitus, Post-Tuberculosis Lung Disease, and Mixed Hearing Loss. He was treated with haemodialysis two times/week for 5 hours/session with AVF access, Packed Red Cells transfusion and erythropoietin two times/week on dialysis, subcutaneous insulin aspart 10IU three times/day, Folic Acid 400 mcg/day, Albumin three times/day, N-acetylcysteine 200 mg three times/day, Atorvastatin 20 mg/day. Chronic dialysis, diabetes mellitus, and Tuberculosis are related to the incidence of hearing loss in this patient due to oxidative stress and uremic syndrome that cause cochlear damage and Na-K-ATPase pump disorder refer to sensorineural hearing loss. Conductive hearing loss related to obstruction of Eustachius Tube by sputum production.
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