Altered taste perception and nutritional status among hemodialysis patients

Abstract

Objective: The objective of this study was to examine the association between altered taste perception and nutritional status among hemodialysis patients.

Design: We performed a post hoc analysis of data from the Hemodialysis study (n = 1,745). Taste perception was assessed at baseline and then updated annually using an item from a quality of life survey that asked "During the past 4 weeks, to what extent were you bothered by loss of taste?" Responses were categorized as normal taste perception if subjects answered "not at all" or altered taste perception if they reported any degree of bother. Time-updated logistic regression models were used to evaluate predictors of altered taste perception. Time-updated linear regression models were used to examine the association between altered taste perception and indices of nutritional status. Multivariable proportional hazards and Poisson models were used to assess association between altered taste perception and mortality and hospitalization, respectively.

Results: At baseline, 34.6% reported altered taste perception, which was associated with poorer baseline nutritional status. On time-updated analysis, altered taste perception was associated with a persistently higher proportion of subjects requiring enteral nutritional supplements and lower serum albumin, serum creatinine, normalized protein catabolic rate, protein intake, sodium intake, and mid-arm muscle circumference. Altered taste perception at baseline was independently associated with increased all-cause mortality: adjusted hazard ratio (95% confidence interval) of 1.17 (1.01-1.37), although not with increased rate of hospitalization.

Conclusion: Altered taste perception was common among prevalent hemodialysis patients and was independently associated with poorer indices of nutritional status and increased all-cause mortality.

Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Changes in taste perception over the initial two years of follow up time. [Cens; censored]

Figure 2

Association between taste perception and use of enteral nutritional supplements at baseline and over the course of follow up. [P-values for difference in need for eneteral supplements based on TP were determined using the chi-squared test.]