Difficulty Smelling May Lead to Malnutrition In Chronic Kidney Disease Patients

MedicalResearch.com Interview with:

Dr. Teodor G. Paunescu PhD Assistant Professor of Medicine Harvard Medical School Boston

Dr. Teodor G. Paunescu

Dr. Teodor G. Paunescu PhD
Assistant Professor of Medicine
Harvard Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with kidney disease frequently report food aversion and poor dietary intake leading to malnutrition, a complication associated with high morbidity and mortality. However, there are no effective treatments currently available to address this complication, and the mechanisms underlying anorexia and food aversion in these patients remain unclear.
Because of the critical role of olfaction in flavor appreciation and dietary intake, we decided to quantify olfactory (smelling) deficits in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients.

We found that patients with kidney disease have significant olfactory deficits that need objective assessments for accurate characterization. Our results also indicate that olfactory deficits likely attribute to nutritional impairment in patients with kidney disease.

MedicalResearch.com: What should readers take away from your report?

Response: While most kidney disease patients do not perceive an olfactory problem, olfactory deficits are common among these patients, and the severity of these deficits increases with the disease severity.

Moreover, reductions in several markers of nutrition such as serum total cholesterol, low-density lipoprotein cholesterol, and albumin correlate significantly with olfactory identification impairment in CKD and ESRD patients.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: According to our data, olfactory impairment offers a novel mechanism to better comprehend malnutrition in patients with kidney disease. Since currently there is no effective intervention available to improve olfactory function in CKD or ESRD patients, we are pursuing such an intervention. Our ultimate goal is to improve nutrition in kidney patients. The data we present at the ASN Annual Meeting provide rationale for a proof-of-concept clinical trial that we initiated recently: Helping Olfaction and Nutrition On Renal Replacement (HONORR trial). This trial will determine whether theophylline nasal spray, an asthma medication, can improve olfactory ability and nutritional status in dialysis patients.
More details about our trial can be found at: https://clinicaltrials.gov/ct2/show/NCT02479451 or by contacting Dr. Sagar Nigwekar at 617-726-7872.

MedicalResearch.com: Is there anything else you would like to add?

Response: We are currently investigating the mechanism of the olfactory impairment found in kidney disease patients. Our collaborative research team includes scientists with basic, translational, and clinical research expertise, and we are applying our experience in epithelial cell biology and pathophysiology to understand the causes behind these olfactory deficits… from bench to bedside!

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


ASN 2016 abstract

Olfactory and Nutritional Impairment in Patients with Kidney Disease: Assessment and Intervention

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Last Updated on November 20, 2016 by Marie Benz MD FAAD