Taste changes common, linked to gastrointestinal symptoms in patients with ESKD
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Researchers from Australia found taste changes are highly prevalent, but under-recognized, in patients with end-stage kidney disease. Further, these taste changes were linked with gastrointestinal symptoms, such as nausea and vomiting.
According to Jessica Dawson, MNutDiet, of the nutrition and dietetics department at St George Hospital in North South Wales, and colleagues, although there is substantial evidence related to gastrointestinal symptoms in patients with kidney disease, taste disturbances remain an under-studied area.
“The pathophysiology of taste changes in CKD is complex with few evidence-based strategies available to help ameliorate this disturbance,” the researchers wrote. “Tools such as the iPOS-renal, Dialysis Symptom Inventory, Edmonton Symptom Assessment System (renal modified) and Gastrointestinal Symptom Rating Scale are used to assess the type and severity of symptoms in patients with ESKD but typically do not include ‘taste changes’ in their inventory of symptoms. Additionally, there is little information regarding the association between taste changes and other GI symptoms or nutritional status.”
To investigate further, Dawson and colleagues included 298 patients with ESKD who were receiving outpatient renal care between 2016 and 2019 (mean age, 77 years; 145 patients were receiving conservative management; 153 patients were on renal replacement therapy).
At each appointment, patients rated the severity of any taste alteration they had experienced in the past week and described the nature of the taste alteration. Nutrition- and GI-related symptoms, as well as nutritional status, were assessed. Blood tests were also taken to examine such biochemical parameters as serum urea, eGFR and albumin.
Of the total study population, 38% reported taste changes, which were the third most prevalent GI symptom in both sub-groups. Patients most commonly described taste disturbances as foods being bland, metallic or bitter, with researchers finding women were more likely to report taste changes than men.
In addition, results showed patients reporting taste changes were more likely to be malnourished, have a greater number of other GI symptoms and rate the other symptoms as more severe. Taste changes were significantly associated with nausea, vomiting, anorexia and sore or dry mouth, but not with constipation or diarrhea.
“Our study is the first to report a significant association between taste changes and malnutrition in a CKD cohort,” Dawson and colleagues wrote, adding that more research should be conducted in earlier stages of kidney disease, as well as studies that evaluate strategies to target “the likely differing pathophysiologies of taste change presentations.”
The researchers suggested interventions for managing taste changes could include altering salivary composition, noting that regular use of mouthwash solution has been shown to improve upper GI symptoms in CKD, and further exploring the role olfaction may play.
“Given our high rate of ‘bland’ taste change descriptors, the role of olfaction in determining food flavor in ESKD warrants further attention,” they explained. “The role of olfaction (sense of smell) affecting taste perception in CKD is a poorly studied area. Olfaction plays a dominant role in our perception of taste and highlights an important area of concomitant exploration when evaluating and managing taste changes.”
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