Patients with advanced CKD may experience reduced smell, poorer nutrition
Key takeaways:
- Patients on maintenance hemodialysis had the lowest total odor perception scores.
- Data showed an inverse link between total odor scores and malnutrition inflammation scores’
Patients with advanced chronic kidney disease, particularly those on maintenance hemodialysis, may have reduced perception of smell, according to published data.
“The olfactory sensory system processes and interprets odor information through several steps, starting from detecting odor molecules in the nasal cavity and ending with generating signals that result in the perception and identification of various smells,” Ragibe Gulsah Dilaver, MD, of the Vanderbilt University Medical Center, division of nephrology and hypertension in Nashville, wrote with colleagues. “This multi-subsystem structure can be influenced by multiple factors, including but not limited to genetic predisposition, gender, age, environmental factors and chronic diseases, such as CKD.”
Researchers in a cross-sectional study of 139 participants, examined the link between olfactory dysfunction and protein-energy wasting as it relates to moderate-to-advanced CKD. Participants included 34 control patients from primary care and internal medicine clinics with no history of CKD; 50 patients with CKD stages 3 through 4 from nephrology outpatient clinics; and 55 clinically stable patients on maintenance hemodialysis from outpatient dialysis clinics.
The study used an odor screening test to evaluate the ability to identify 12 different smells.
Patients in the control group had the highest total odor scores and patients on maintenance hemodialysis had the lowest, according to the results. The researchers also found an inverse link between total odor scores and malnutrition inflammation scores, noting that lower smell identification may relate to poor nutritional status; however, this result was not statistically significant.
Dilaver and colleagues found patients with CKD had higher C-reactive protein levels and lower serum albumin concentrations compared with patients in the control group.
“The findings highlight the need for further investigation to understand the relationship between altered olfaction and the development of [protein-energy wasting (PEW)] in this patient population,” they wrote. “Awareness and regular screening for olfactory dysfunction can help in the early detection of PEW in patients at risk and allow for appropriate interventions to improve patient outcomes.”
As part of a larger care plan, they added, “providers can use olfactory assessments as part of patients' nutritional evaluations to develop dietary plans and create personalized nutritional strategies for [patients with CKD].”
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