Abstract: SA-PO177

Olfaction–Nutrition Association in Patients with Kidney Disease: Odorant Specificity

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Paunescu, Teodor G., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Xu, Dihua, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Kalim, Sahir, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Thadhani, Ravi I., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Malnutrition is common in patients with chronic kidney disease (CKD) and especially end-stage renal disease (ESRD). Most of these patients have odor identification deficits, and a reduction in odor identification score is associated with higher subjective global assessment (SGA) score and lower total cholesterol, LDL cholesterol, and albumin. We investigated whether the identification of specific odorants is linked to abnormalities in nutritional markers.

Methods

We quantified odor identification in CKD (n=36) and ESRD patients (n=100) and healthy volunteers (HV, n=25) using the University of Pennsylvania Smell Identification Test (UPSIT). We assessed the correlation between the percentage of correct answers for each of the 40 odorants on the UPSIT test and nutritional markers.

Results

Correct identification of multiple odorants significantly correlates with levels of albumin (14 odorants), LDL (15 odorants) and total cholesterol (20 odorants). In analyses restricted to ESRD patients, lower SGA scores correlate with the correct identification of 13 odorants, while higher nPCR and albumin levels correlate with the correct identification of 6 and 5 odorants, respectively.
Odorant-based analysis reveals that correct identification of certain odorants correlates more closely with nutritional markers: licorice correlates with albumin, nPCR, SGA, and triglycerides; banana correlates with albumin, pre-albumin, total and LDL cholesterol, and triglycerides; watermelon correlates with albumin, pre-albumin, SGA, and triglycerides. Some odorants, such as gasoline, lime, and natural gas, show no correlation with any of the nutritional markers we assessed.

Conclusion

Patients with kidney disease have odor identification defects that correlate with nutritional markers. Correct identification of specific odorants by ESRD patients is linked with levels of nutritional markers. These odorants should be followed to assess occurrence of malnutrition.