Poorer Dialysis Patient Survival Linked to Impaired Taste

Altered taste perception is common among hemodialysis (HD) patients, and it is independently associated with poorer markers of nutritional status and increased risk of death, according to a new study.

Steven M. Brunelli, MD, of Brigham and Women's Hospital in Boston, and colleagues analyzed data from 1,745 participants in the Hemodialysis Study. In that study, investigators assessed taste perception at baseline and then annually. Patients with end-stage renal disease (ESRD) are at increased risk for taste perception impairment. Although the mechanism for this impairment is not well understood, it is thought to be a consequence of uremia, the authors noted. Another possibility is that zinc deficiency, which is common because of high dialytic removal.

At baseline, 34.6% of patients reported altered taste perception, and this was associated with poorer baseline nutritional status, according to a report published in the Journal of Renal Nutrition (2013;23:288-295). Compared with patients who had normal taste perception, those with altered taste perception had lower serum albumin, lower serum creatinine, lower normalized protein catabolic rate, lower reported protein intake, lower reported sodium intake, lower parathyroid hormone levels, and smaller mid-arm muscle circumference.

After a median two years of follow-up, 739 patients died. In adjusted analysis, altered taste perception was associated with a significant 17% increased risk of all-cause mortality compared with the normal taste perception.

Dr. Brunelli's team explained that nutritional decline is common among HD patients, and their findings suggest that altered taste perception may be one pathway through which HD patients become malnourished. One plausible mechanism by which altered taste perception may influence nutritional outcome is though effects on appetite, they pointed out.

The authors stated that altered taste perception may be a relevant component of nutritional assessment, a potential target for therapeutic intervention, or both.

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