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Effect of chronic renal failure on voice: an acoustic and aerodynamic analysis




This study was conducted to investigate the effect of chronic renal failure (CRF) on acoustic and aerodynamic parameters of voice and to compare the results with a group of individuals with normal renal function.


The participants in this study were divided into two groups. A clinical group (the patient group) consisted of 66 adults diagnosed as having CRF (26 male patients and 40 female patients), with their age ranging from 19 to 68 years. The control group consisted of 66 healthy adults (36 male individuals and 30 female individuals). Their age ranged from 20 to 60 years and they did not have any impairment in renal function or any complaints concerning their voice. All participants underwent evaluation of their voice acoustically and aerodynamically. Acoustic analysis was performed using computerized speech lab. The acoustic parameters studied include average pitch, jitter, shimmer, and noise-to-harmonic ratio. Aerodynamic analysis was performed using Aerophone II Model 6800. The aerodynamic parameters studied include vital capacity, maximum phonation time, phonation quotient, mean flow rate, subglottic pressure, and glottal efficiency. The data were analyzed using the independent t-test to compare the significance of difference between means across the two groups.


In acoustic analysis, there was a significant increase in pitch in male patients with CRF and an increase in shimmer with borderline significance in the total group with CRF. The total group as well as the female subgroup with CRF showed a significant increase in noise-to-harmonic ratio. With respect to the aerodynamic analysis, the total group as well as the male and female subgroups with CRF showed a significant decrease in the vital capacity. There was also a significant decrease in the maximum phonation time in the total and female subgroup with CRF.


Participants with CRF exhibit clinical evidence of voice disorders both acoustically and aerodynamically. Hence, the present study sheds light on the interplay of different body systems and laryngeal muscles.


  1. Pierson DJ. Respiratory considerations in the patients with renal failure. Respir Care 2006; 51: 413–422.

    PubMed  Google Scholar 

  2. Mckinney JC. The diagnosis and correction of vocal faults. Nashville, TN: Genevox Music Group; 1994.

    Google Scholar 

  3. Kumar S, Chakravarti A, Sahni JK, Dubey NK. Ear, Nose and Throat manifestations in pediatric chronic renal failure patients undergoing peritoneal dialysis. Indian J Otolaryngol Head Neck Surg 2004; 56: 205–207.

    PubMed  PubMed Central  Google Scholar 

  4. Riella MC(editor). Princípios de nefrologia e distúrbios hidroeletrolíticos. 2nd ed. Rio de Janeiro: Guanabara Koogan; 1996.

    Google Scholar 

  5. Prezant DJ. Effect of uremia and its treatment on pulmonary function. Lung 1990; 168: 1–14.

    Article  CAS  Google Scholar 

  6. Bark H, Heimer D, Chaimovitz C, Mostoslovski M. Effect of chronic renal failure on respiratory muscle strength. Respiration 1988; 54: 153–161.

    Article  CAS  Google Scholar 

  7. Karacan O, Tutal E, Colak T, Sezer S, Eyübolu Fo, Haberal M. Pulmonary function in renal transplant recipients and end stage renal disease patients undergoing maintenance dialysis. Transplant Proc 2006; 38: 396–400.

    Article  CAS  Google Scholar 

  8. Kumar RB, Bhat JS. Voice in chronic renal failure. J Voice 2010; 24: 690–693.

    Article  Google Scholar 

  9. Nesiæ M, Veljkoviæ S, Obrenoviæ J, Cekiæ S, Velickoviæ D, Radenkoviæ M. Voice frequencies in patients treated with chronic hemodialysis. Srp Arh Celok Lek 1996; 124: 99–101.

    Google Scholar 

  10. Hamdan AL, Medawa W, Younes A, Bikhazi H, Fuleihan N. The effect of hemodialysis on voice: an acoustic analysis. J Voice 2005; 19: 290–295.

    Article  Google Scholar 

  11. Sala E, Noyszewski EA, Campistol JM, Marrades RM, Dreha S, Torregrossa JV, et al. Impaired muscle oxygen transfer in patients with chronic renal failure. Am J Physiol Regul Integr Comp Physiol 2001; 280: 1240–1248.

    Article  Google Scholar 

  12. Kumar P, Clark M. Clinical medicine: a textbook for medical students and doctors. 4th ed., 1999, W.B. Saunders, London.

    Google Scholar 

  13. Seikel JA, King DW, Drumwright DG. Anatomy and physiology for speech, language and hearing. New York: Thomson Delmer Learning; 2005.

    Google Scholar 

  14. Dujic Z, Tocilj J, Ljutic D, Eterovic D. Effects of hemodialysis and anemia on pulmonary diffusing capacity, membrane diffusing capacity and capillary blood volume in uremic patients. Respiration 1991; 58: 277–281.

    Article  CAS  Google Scholar 

  15. Siafakas NM, Argyrakopoulos T, Andreopoulos K, Tsoukalas G, Tzanakis N, Bouros D. Respiratory muscle strength during continuous ambulatory peritoneal dialysis (CAPD). Eur Respir J 1995; 8: 109–113.

    Article  CAS  Google Scholar 

  16. Kovelis D, Pitta F, Probst VS, Peres CA, Delfino VD, Mocelin AJ, et al. Pulmonary function and respiratory muscle strength in chronic renal failure patients on hemodialysis. J Bras Pneumol 2008; 34: 907–912.

    Article  Google Scholar 

  17. Bush A, Gabriel R. Pulmonary function in chronic renal failure, effects of dialysis and transplantation. Thorax 1991; 46: 424–428.

    Article  CAS  Google Scholar 

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Correspondence to Eman S. Hassan MD.

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Hassan, E.S. Effect of chronic renal failure on voice: an acoustic and aerodynamic analysis. Egypt J Otolaryngol 30, 53–57 (2014).

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