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European Archives of Oto-Rhino-Laryngology

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01-11-2018 | Laryngology

The effect of electrolyte balance on the voice in hemodialysis patients

Authors: Saime Sagiroglu, Adem Doganer

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2018

Abstract

Objective

The aim of the study was to demonstrate the effect of blood electrolytes on the voice in chronic hemodialysis patients.

Methods

The study included a total of 59 hemodialysis patients. Pre- and post-dialysis voice recordings were performed. In the analysis of vocal acoustic parameters, fundamental frequency (F0), jitter, shimmer, the noise-to-harmonics ratio (NHR), and F0 minimum and F0 maximum were measured. The Voice Handicap Index-10 (VHI-10), and maximum phonation time (MPT) were evaluated. For perceptual evaluation, the GRBAS scale was used. The duration of dialysis (years) and changes in weight during dialysis were recorded for each patient. From venous blood samples, measurements were taken of hemoglobin (Hb), albumin, Na+, K+, creatinine, uric acid, phosphorus, Ca++, and parathormone.

Results

The difference in the pre and post-dialysis values of F0, shimmer, NHR and MPT were found to be statistically significant (p = 0.001). The only variable determined to have an effect on the change in F0 values was uric acid, and the change in the F0 values was statistically significant (p = 0.009). The only variable determined to have an effect on the change in shimmer values was sodium, and the change was statistically significant (p = 0.034). The only variable determined to have an effect on the change in NHR values was creatinine, and the change in the NHR values was statistically significant (p = 0.028). Hb and the duration of dialysis were determined to have a statistically significant effect on the change in MPT values (p = 0.001).

Conclusions

The results showed that uric acid was the agent creating a reduction in vocal cord vibration, the agent increasing the difference between vibration waves was Na+, and creatinine increased the NHR rate. The effect of these variables can be considered important in the understanding of vocal cord physiology.

Baer T (1978) Effect of single motor unit firings on fundamental frequency of phonation. J Acoust Soc Am 64:90–95CrossRef

Hamdan AL, Medawar W, Younes A, Bikhazi H, Fuleihan N (2005) The effect of haemodialysis on voice: an acoustic analysis. J Voice 19:290–295CrossRef

Prezant DJ (1990) Effect of uremia and its treatment on pulmonary function. Lung 168:1–14CrossRef

Odden MC, Amadu AR, Smit E, Lo L, Peralta CA (2014) Uric acid levels, kidney function, and cardiovascular mortality in US adults: National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 1999–2002. Am J Kidney Dis 64:550–557CrossRef

Nashar K, Fried LF (2012) Hyperuricemia and the progression of chronic kidney disease: is uric acid a marker or an independent risk factor? Adv Chronic Kidney Dis 19(6):386–391CrossRef

Bowman GL, Shannon J, Frei B, Kaye JA, Quinn JF (2010) Uric acid as a CNS antioxidant. J Alzheimers Dis 19:1331–1336CrossRef

Paganoni S, Zhang M, Quiroz Zarate A, Jaffa M, Yu H, Cudkowicz ME et al (2012) Uric acid levels predict survival in men with amyotrophic lateral sclerosis. J Neurol 259:1923–1928CrossRef

Feig DI, Kang DH, Johnson RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359:1811–1821CrossRef

Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G (2009) Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417,734 men and women in the Apolipoprotein Mortality Risk study (AMORIS). J Intern Med 266(6):558–570CrossRef

10.

Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C et al (2001) Prevalence of high blood pressure and elevated serum creatinine level in the United States findings from the Third National Health and Nutrition Examination Survey (1988–1994). Arch Intern Med 161(9):1207–1216CrossRef

11.

Shulman NB, Ford CE, Hall WD, Blaufox MD, Simon D, Langford HG et al (1989) Prognostic value of serum creatinine and effect of treatment of hypertension on renal function: results from the Hypertension Detection and Follow-up Program. Hypertension 13:80–93CrossRef

12.

Friedman PJ (1991) Serum creatinine: an independent predictor of survival after stroke. J Intern Med 229:175–179CrossRef

13.

Matts JP, Karnegis JN, Campos CT, Fitch LL, Johnson JW, Buchwald H et al (1993) Serum creatinine as an independent predictor of coronary heart disease mortality in normotensive survivors of myocardial infarction. J Fam Pract 36:497–503PubMed

14.

Kilic MA, Okur E, Yildirim I, Ogut F, Denizoglu I, Kizilay A et al (2008) Reliability and validity of the Turkish version of the Voice Handicap Index [Article in Turkish]. Kulak Burun Bogaz Ihtis Derg 18:139–147PubMed

15.

Sivasankar M, Fisher K (2007) Vocal fold epithelial response to luminal osmotic perturbation. J Speech Lang Hear Res 50:886–898CrossRef

16.

Fisher K, Telser A, Phillips J, Yeates DB (2001) Regulation of vocal fold transepithelial water fluxes. J Appl Physiol 91:1401–1411CrossRef

17.

Hirano M (1988) Vocal mechanisms in singing: Laryngological and phoniatric aspects. J Voice 2:51–69CrossRef

18.

Titze IR (1988) The physics of small-amplitude oscillation of the vocal folds. J Acoust Soc Am 83:1536–1552CrossRef

19.

Ori Y, Sabo R, Binder Y, Weinstein T, Korzets A, Ori G et al (2006) Effect of hemodialysis on the thickness of vocal folds: a possible explanation for post dialysis hoarseness. Nephron Clin Pract 103:144–148CrossRef

20.

Raphael LJ, Borden GJ, Harris KS (2007) The raw materials—phonation. In: Raphael LJ, Borden GJ, Harris KS (eds) Speech science primer: physiology, acoustics, and perception of speech, 5th edn. Lippincott Williams and Wilkins, Philadelphia, pp 85–103

21.

Nesić M, Veljković S, Obrenović J, Cekić S, Velicković D, Radenković M (1996) Voice frequencies in patients treated with chronic hemodialysis. Srp Arc Celok Lek 124:99–101

22.

Gavin AR, Struthers AD (2003) Hyperuricemia and adverse outcomes in cardiovascular disease: potential for therapeutic intervention. Am J Cardiovasc Drugs 3:309–314CrossRef

23.

Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S et al (2003) Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 41(6):1183–1190CrossRef

24.

Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL et al (2001) Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension 38:1101-6CrossRef

25.

Finkelhor BK, Titze IR, Durham PL (1988) The effects of viscosity changes in the vocal folds on the range of oscillation. J Voice 13:320–325CrossRef

26.

Sivasankar M, Erickson E (2009) Short-duration accelerated breathing challenges affect phonation. Laryngoscope 119:1658–1663CrossRef

27.

Verdolini K, Titze IR, Fennell A (1994) Dependence of phonatory effort on hydration level. J Speech Lang Hear Res 37:1001–1007CrossRef

28.

Hemler RJ, Wieneke GH, Dejonckere PH (1997) The effect of relative humidity of inhaled air on acoustic parameters of voice in normal subjects. J Voice 11:295–300CrossRef

29.

Horii Y (1982) Jitter and shimmer differences among sustained vowel phonations. J Speech Hear Res 25:12–14CrossRef

30.

Cerne D, Kaplan-Pavlovcic S, Kranjec I, Jurgens G (2000) Mildly elevated serum creatinine concentration correlates with the extent of coronary atherosclerosis. Ren Fail 22(6):799–808CrossRef

31.

Culleton BF, Larson MG, Evans JC, Wilson PW, Barrett BJ, Parfrey PS et al (1999) Prevalence and correlates of elevated serum creatinine levels: the Framingham heart study. Arch Intern Med 159(15):1785–1790CrossRef

32.

Kreisman SH, Hennessey JV (1999) Consistent reversible elevations of serum creatinine levels in severe hypothyroidism. Arch Intern Med 159:79–82CrossRef

33.

Hartl DM, Hans S, Vaissiere J, Riquet M, Bransnu DF (2001) Objective voice quality analysis before and after onset of unilateral vocal fold paralysis. J Voice 15:351–361CrossRef

34.

Dejonckere P, Remacle M, Frensel EE, Woisard V, Crevier BL, Millet B (1996) Differentiated perceptual evaluation of pathological voice quality: reliability and correlations with acoustic measurements. Rev Laryngol Otol Rhinol (Bord) 117:219–224

35.

Jung SY, Ryu JH, Park HS, Chung SM, Ryu DR, Kim HS (2013) Voice change in end-stage renal disease patients after hemodialysis: correlation of subjective hoarseness and objective acoustic parameters. J Voice 28:226–230CrossRef

36.

Pierson DJ (2006) Respiratory considerations in the patients with the renal failure. Respir care 53:413–422

37.

Kumar RB, Bhat JS (2010) Voice in chronic renal failure. J Voice 24:690–693CrossRef

Title: The effect of electrolyte balance on the voice in hemodialysis patients
Authors: Saime Sagiroglu
Adem Doganer
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5098-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The effect of electrolyte balance on the voice in hemodialysis patients

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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