Abstract: FR-PO803
The Association of Altered Sense of Smell with Nutritional Status in Patients with Advanced CKD
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Dilaver, Ragibe Gulsah, Vanderbilt University Division of Nephrology and Hypertension, Nashville, Tennessee, United States
- Bal, Zeynep, Ankara Egitim Ve Arastirma Hastanesi, Ankara, Ankara, Turkey
- Guide, Andrew, Vanderbilt University Medical Center Department of Biostatistics, Nashville, Tennessee, United States
- Greevy, Robert, Vanderbilt University Medical Center Department of Biostatistics, Nashville, Tennessee, United States
- Ikizler, Talat Alp, Vanderbilt University Division of Nephrology and Hypertension, Nashville, Tennessee, United States
Background
Anorexia is common in patients with advanced CKD and could lead to protein energy wasting (PEW). Altered sense of smell, a reflection of olfactory dysfunction, is a potential mechanism that exacerbates the impact of anorexia on PEW. In this study, we examined the extent of altered sense of smell and its association with PEW in patients with moderate to advanced CKD.
Methods
We studied 139 participants (34 healthy subjects, 50 patients with stage 3-4 CKD, 55 patients on maintenance hemodialysis (MHD)) using the odor identification test (Sniffin’ Sticks odor screening test containing 12 different smells). Odor identification test were scored as correct or incorrect, and a total odor score was calculated for each participant. Malnutrition Inflammation Score was used to assess PEW.
Results
CKD patients had elevated levels of C-reactive protein and reduced eGFR and serum albumin concentrations compared to controls (Table1). There was a gradual decrease in the total odor score between groups, controls with highest and MHD patients with lowest scores. A similar gradual worsening was observed in MIS scores with MHD patients displaying worst nutritional score (p ≤ 0.001) (Table 1). The number of participants with severe olfactory dysfunction (≤ 6 correct answers) was statistically significantly higher in the CKD and MHD groups compared to the control group (p ≤ 0.01) There was a statistically significant inverse correlation between total odor score of the participants and MIS score for the entire population (r = -0.3, p ≤ 0.001) (Figure 1),more prominently observed in the CKD and MHD groups.
Conclusion
This cross-sectional study suggests that olfactory dysfunction, as assessed by an odor identification test, is altered in patients with advanced CKD, most notably in ones on MHD. In CKD patients, the severity of the loss of sense of smell is directly associated with worse protein-energy wasting. Further studies are needed to examine the casual relationship between odor sensation and development of PEW in patients with CKD.
Table 1
Figure 1