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

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

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Olfactory function is impaired in patients with end-stage renal disease (ESRD) and may contribute to uremic anorexia. Only limited correlations of olfactory function and nutritional status were reported. This study examines the relationship of impaired olfactory function to malnutrition and levels of the retained uremic solutes monomethylamine, ethylamine, indoxyl sulfate, and P-cresol sulfate. Study Design: Cross-sectional observational study. Setting & Participants: 31 stable maintenance hemodialysis patients from an urban outpatient dialysis unit and 18 people with normal renal function participated. Predictor: Nutritional status assigned by using Subjective Global Assessment (SGA) score; SGA score of 7 indicates normal nutritional status; SGA score of 5 to 6, mild malnutrition; and SGA score of 3 to 4, moderate malnutrition. Outcomes & Measurements: The primary outcome is olfactory function, assessed using the University of Pennsylvania Smell Identification Test. Levels of retained uremic solutes were measured from a predialysis serum sample. Demographic data and laboratory values for nutritional status, adequacy of dialysis, and inflammation were collected. Results: Mean smell scores were 34.9 ± 1.4 for controls, 33.5 ± 3.3 for patients with SGA score of 7, 28.3 ± 5.8 for patients with SGA score of 5 to 6, and 27.9 ± 4.4 for patients with SGA score of 3 to 4 (P < 0.001 comparing healthy patients with all patients with ESRD). There was no difference in mean smell scores for healthy controls and patients with SGA score of 7. However, patients with lower smell scores had significantly lower SGA scores (P = 0.02) and higher C-reactive protein levels (P = 0.02). Neither smell score nor nutritional status was associated with levels of retained uremic solutes. Limitations: Small sample size, only cross-sectional associations can be described. Conclusions: Our results suggest an association between poor nutritional status and impaired olfactory function in patients with ESRD. Additional research is needed to discover the uremic toxins mediating these processes.

Original languageEnglish (US)
Pages (from-to)102-110
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume52
Issue number1
DOIs
StatePublished - Jul 2008

Fingerprint

Malnutrition
Chronic Kidney Failure
Nutritional Status
Smell
cresol
Dialysis
Indican
Anorexia
C-Reactive Protein
Sample Size
Sulfates
Observational Studies
Renal Dialysis
Outpatients
Cross-Sectional Studies
Maintenance
Demography
Inflammation
Kidney
Serum

Keywords

  • anorexia
  • C-reactive protein
  • ethylamine
  • indoxyl sulfate
  • Malnutrition
  • monomethylamine
  • olfaction
  • P-cresol sulfate
  • uremia

ASJC Scopus subject areas

  • Nephrology

Cite this

Relationship of Impaired Olfactory Function in ESRD to Malnutrition and Retained Uremic Molecules. / Raff, Amanda C.; Lieu, Sung; Melamed, Michal L.; Quan, Zhe; Ponda, Manish; Meyer, Timothy W.; Hostetter, Thomas H.

In: American Journal of Kidney Diseases, Vol. 52, No. 1, 07.2008, p. 102-110.

Research output: Contribution to journalArticle

Raff, Amanda C. ; Lieu, Sung ; Melamed, Michal L. ; Quan, Zhe ; Ponda, Manish ; Meyer, Timothy W. ; Hostetter, Thomas H. / Relationship of Impaired Olfactory Function in ESRD to Malnutrition and Retained Uremic Molecules. In: American Journal of Kidney Diseases. 2008 ; Vol. 52, No. 1. pp. 102-110.
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AU - Melamed, Michal L.

AU - Quan, Zhe

AU - Ponda, Manish

AU - Meyer, Timothy W.

AU - Hostetter, Thomas H.

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