Proteinuria as a Marker of Cochlear Microvascular Damage and Functional Hearing Deficit in Presbycusis: A Cross-Sectional Study

Background:
Presbycusis is the most prevalent sensory deficit in older adults, its
metabolic subtype involves progressive strial microvascular
degeneration. Proteinuria, a systemic marker of endothelial dysfunction,
may reflect parallel cochlear microvascular damage.
Objective:
To investigate the association between proteinuria and cochlear
dysfunction in elderly patients with presbycusis.
Methods:
In this cross-sectional study, 340 adults aged ≥60 years with clinically
confirmed presbycusis were enrolled and classified by proteinuria status
(urine albumin-creatinine ratio [ACR] ≥30 mg/g). The Hearing Handicap
Inventory for the Elderly–Screening Version (HHIE-S) and the Absolute
Bone Conduction (ABC) test were used to assess functional hearing
deficit.
Results:
Of 340 participants, 112 (32.9%) had proteinuria. The proteinuria group
showed significantly higher mean HHIE-S scores (20.4±8.6 vs. 8.2±6.4;
p<0.001) and a greater prevalence of markedly reduced ABC results
(42.9% vs. 14.0%; p<0.001). A moderately strong positive correlation
was found between ACR and HHIE-S scores (r=0.58, p<0.001).
Conclusion:
Proteinuria is strongly associated with cochlear dysfunction and
functional hearing handicap in presbycusis, supporting a shared
renal–cochlear microvascular pathology.