Introduction: Many similarities exist between the nephron & ear infrastructures, making them vulnerable to same risk factors. Idiopathic sensory neural hearing loss is frequent in pediatric patients with chronic kidney disease (CKD). 
Aim of the study: Determine the prevalence, type, & degree of hearing impairment in pediatric CKD patients.
Methods: This cross-sectional study was carried out at pediatric dialysis & nephrology unit at Children's hospital & Audiology unit, Faculty of Medicine Ain Shams University, included 45 CKD patients' stage 2-4, 45 CKD patients' stage 5 on hemodialysis, & 90 children as controls. Detailed history, physical, otological examinations & audiological assessment by standard pure tone audiometry, speech audiometry & tympanometry, also some laboratory investigations were done for all.
Results: pure tone audiometry showed 16.6% of CKD patients with hearing loss mainly sensory neural hearing loss (SNHL); (53.3%), which was significantly higher compared to the control group (p < 0.001). A mild degree of high-frequency hearing loss was frequently reported. These findings weren't significantly different between dialysis & non-dialysis patients. Regarding speech discrimination scores, controls had a higher significant change compared to CKD patients. Regarding Tympanometry test results, most of CKD patients & the controls had normal middle ear pressure.
Conclusion & recommendations: High-frequency SNHL is not uncommon in CKD pediatric patients. It's recommended to do a routine audiological evaluation & follow up for early diagnosis & intervention.