Relationship of Impaired Olfactory Function in ESRD to Malnutrition and Retained Uremic Molecules

Raff, Amanda; Lieu, Sung; Melamed, Michal L.; Quan, Zhe; Ponda, Manish P.; Meyer, Timothy W.; Hostetter, Thomas H.

doi:10.1053/j.ajkd.2008.02.301

Cited by 62 publications

(55 citation statements)

References 35 publications

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“…This association was observed in women but not in men, and it persisted after adjusting for age, socio-demographic factors (education, living status, and receipt of pension payment), and BMI. Full enjoyment and appreciation of food flavors require an intact olfactory system [26]; hence, it is not surprising that nutritional problems are important sequelae of olfactory dysfunction that can occur with the aging process [27]. Our study findings supports this observation, as it showed that older adults with moderate/severe versus normal olfactory impairment had poorer diet quality in the longer term, after accounting for potential confounders.…”

Section: Discussionsupporting

confidence: 83%

Olfactory impairment in older adults is associated with poorer diet quality over 5 years

et al. 2015

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Section: Discussionsupporting

confidence: 83%

Olfactory impairment in older adults is associated with poorer diet quality over 5 years

et al. 2015

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“…It remains unknown whether the measurement of other olfactory characteristics, such as detection thresholds, perceived intensity or liking, would have revealed a similar result since this is the first study of smell function in children with CKD. In contrast, adults with severe CKD have been reported to have a reduced ability to identify odours, based on the results of odour identification and discrimination tests [7,8], and odour threshold tests [9,30]. Not all adults with CKD have changes in olfactory function.…”

Section: Olfactionmentioning

confidence: 99%

“…Not all adults with CKD have changes in olfactory function. For example, in a study of 8 7 0 3 ARB 1 4 0 0 Mycophenolate 1 0 0 3 Cyclosporine 1 2 0 1 Tacrolimus 1 0 0 3 Azathioprine 0 1 0 1 Sirolimus 1 1 0 0 Prednisolone 3 5 0 8 Atenolol 1 3 0 0 Atorvastinin 3 2 0 1 patients with end stage renal disease, the odour identification ability of the least malnourished patients was no different to that of controls [30]. Clearly, differences in testing methodology, patient age and severity of CKD make it difficult to adequately compare the findings-not only between studies, but also between adults and children.…”

Section: Olfactionmentioning

confidence: 99%

Smell and taste function in children with chronic kidney disease

et al. 2010

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Loss of appetite and poor growth are common in children with chronic kidney disease (CKD), and changes in smell and/or taste function may be responsible, but the hypothesis has not been proven. This aims of this prospective age- and gender-controlled study were to determine whether: (1) changes in smell and taste function occur in children with CKD; (2) smell or taste dysfunction are associated with estimated glomerular filtration rate (eGFR); (3) there is an association between smell or taste loss and body mass index (BMI). The study cohort consisted of 72 children of whom 20 were CKD stage 3-5 patients, 12 were CKD stage 2 patients, 20 were clinical controls (CC) and 20 were healthy children (HC). The CKD patients and clinical controls were recruited from Sydney Children's Hospital and The Children's Hospital, Westmead, and healthy controls were recruited from a local school. Scores for each group from taste and smell chemosensory function tests were compared, and their relationship with renal function and BMI investigated. The CKD stage 3-5 group had a significantly lower taste identification score (85.6%, P< 0.001) than the CC (94.8%) and HC (94.8%) groups, with almost one third of the children in the CKD stage 3-5 group exhibiting taste loss. Decreased taste function was associated with decreased eGFR (r = 0.43, P < 0.01), but no association between BMI and taste function was found (r = 0.001, P > 0.9). Odour identification scores were not different; however, there was a positive relationship with BMI (r = 0.427, P = 0.006). We conclude that a loss of taste can occur in children with CKD and that when it occurs, it worsens as eGFR declines and is found early in kidney disease.

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“…In a small study, no relation could be found between four retention solutes (monomethylamine, ethylamine, indoxyl sulfate, and p-cresol sulfate) and either olfactory discrimination or global assessment of nutrition (36). All of these studies have used assays targeted for specified solutes.…”

Section: Epidemiologic Association Of Solutes With Outcomesmentioning

confidence: 99%

Searching for Uremic Toxins

Dobre

Meyer

Hostetter

2013

Clinical Journal of the American Society of Nephrology

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SummaryTreatment of uremia by hemodialysis has become widespread over the last 40 years and has improved substantially over that time. However, people treated with this modality continue to suffer from multiple disabilities. Retention of organic solutes, especially those poorly removed by hemodialysis, likely contributes to these disabilities. Certain classes of solutes are removed less well than urea by hemodialysis and by the normal kidney. These include protein-bound solutes, relatively large solutes, sequestered compounds, and substances removed at rates higher than urea by the normal kidney. Several strategies could be used to discover the solutes responsible for residual morbidities in standardly dialyzed people. Rather than continue to focus only on urea removal as an index for dialysis adequacy, finding additional approaches for removing toxic solutes with characteristics different from urea (and the similar small solutes it represents) is a desirable and feasible goal.

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Relationship of Impaired Olfactory Function in ESRD to Malnutrition and Retained Uremic Molecules

Cited by 62 publications

References 35 publications

Olfactory impairment in older adults is associated with poorer diet quality over 5 years

Olfactory impairment in older adults is associated with poorer diet quality over 5 years

Smell and taste function in children with chronic kidney disease

Searching for Uremic Toxins

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