And the Nose…
Since I wrote about the ears and kidney disease last week, I got curious about the nose and kidney disease. Makes sense to me. If CKD can affect your hearing, why not your sense of smell? I was delighted to find out I wasn’t the only one interested in this.
Photo by Anastasia Shuraeva on Pexels.com
” data-medium-file=”https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=300″ data-large-file=”https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=470″ width=”1880″ height=”1253″ src=”https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg” alt class=”wp-image-7227″ style=”width:194px;height:auto” srcset=”https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg 1880w, https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=150&h=100 150w, https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=300&h=200 300w, https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=768&h=512 768w, https://renal.platohealth.ai/wp-content/uploads/2024/02/and-the-nose.jpg?w=1024&h=682 1024w” sizes=”(max-width: 1880px) 100vw, 1880px”>
I started my inquiry with the Sage Journal which calls itself “Your gateway to world-class research.” There I found a study originally published in Ear, Nose and Throat Journal that came to the following conclusion:
“The study has demonstrated that patients with CKD have prevalence of olfactory dysfunction, and it appears that the affectation was more at the central olfactory pathway. The severity of olfactory dysfunction increases with worsening severity of kidney disease. This finding will serve as basis to ensure olfactory function assessment is included as parts of routine evaluation of patients with CKD, with the aim of improving their overall well-being and quality of life.”
How very interesting. Therefore, if your kidneys become worse, so does your sense of smell. But why? Wait a minute. I never received an evaluation of my sense of smell at my nephrologist’s. Have you?
Let’s go back to seeing if we can figure out why our sense of smell is somehow attached to our kidney function. This is PubMed’s contribution to our search:
“Olfactory receptors (ORs) are chemosensors that are responsible for one’s sense of smell. In addition to this specialized role in the nose, recent evidence suggests that ORs are also found in a variety of additional tissues including the kidney. As this list of renal ORs continues to expand, it is becoming clear that they play important roles in renal and whole-body physiology, including a novel role in blood pressure regulation.”
As usual [Ah, you know me so well.] I needed more:
Science Digest included this information that may help:
Nefrologia (English Edition) points out the key points about loss of smell in kidney disease;
“Alterations in the olfactory function of patients with CKD in pre-dialysis, PD and HD are common, although little recognised.
- •
The tests most widely used for assessing olfactory function are odour threshold, discrimination and identification tests.
- •
One of the most important consequences of olfactory deficits is their association with the patient’s nutritional status.
- •
The effect of HD on smell is still not fully understood, as not all studies have shown correction of the deficit with treatment.
- •
Renal transplantation corrects dysosmia….” [Gail here. This is an altered perception of smell.]
While I find this fascinating, I wondered why it was important. The National Kidney Foundation had the answer:
“’Impairments in smell and taste have been linked with decreased appetite and food intake and can decrease the quality of life for affected patients,’ said Katherine Lynch, MD, a junior faculty member at Beth Israel Deaconess Medical Center. ‘The ability to smell and taste declines with age, but patients with chronic kidney disease tend to have earlier and greater decline in these senses than patients without kidney disease.’”
Dr. Lynch is studying the effects of smell and taste loss in order to identify ways to combat malnutrition and improve the lifestyle of patients with kidney disease. Her research is being supported by a Young Investigator’s Grant from the National Kidney Foundation.”
Umm, who said anything about taste. Let’s take a look at that, too. Kidneywise blew me away with their informative chart:
| “Changes in CKD | Effects of change |
| Reduced saliva flow | Some studies have found that people with end-stage kidney disease have a reduced flow of saliva which may be caused by changes in fluid status. This can cause dry mouth which affects the taste buds. |
| Changes in saliva pH | Normal saliva is slightly acidic but some studies have shown that the saliva of people with end-stage kidney disease is more alkaline which can affect taste. |
| High levels of urea in saliva | People with end-stage kidney disease have higher levels of urea in their saliva than those with normal kidney function. This affects the perception of bitter taste, causing either an increase or a decrease in perception of bitter taste. It can also cause a metallic taste. |
| High levels of sodium in saliva | This can increase the salt taste threshold and can therefore cause a salty taste. |
| High levels of bicarbonate in saliva | This can cause a reduction in the intensity of savoury (umami) taste and may be one of the reasons for lack of interest in meat in many people with CKD. |
| High levels of potassium in saliva | This can cause a metallic taste. |
| Lower levels of zinc in blood | Zinc deficiency can be as high as 40% in those receiving haemodialysis treatment. Zinc deficiency can lead to a reduction in overall taste.” |
I started wondering if they had the same kind of chart for loss of smell. No such luck. On to how to treat loss of taste due to kidney disease. I crossed the pond [so to speak] and found what I was looking for on the National Health Service’s website:
| “Food tastes | |
| If your food tastes. | Tips |
| Bitter | Avoid foods sweetened with saccharin – this can leave a bitter aftertaste |
| Metallic | Gargle lemon juice before eating Use plastic cutlery |
| Sweet | Add lemon juice to your water Dilute drinks with soda or mineral water Use spices such as ginger, nutmeg, and cinnamon to sugary foods/puddings to offset the sweetness |
| Salty | Avoid salty and processed foods Add a pinch of sugar to food before serving |
| Aversion to meat/protein foods | Serve cold meats with pickle or chutney Serve fish, chicken, and egg dishes with strong flavoured sauces i.e., curry, sweet and sour Marinate meat in fruit juice or wine |
More ideas to help you manage taste changes:
- Rinse your mouth or clean your teeth before meals.
- Suck on mints or chew gum.
- Use herbs and spices to add flavour e.g., pepper, cumin, and rosemary.
- Allow hot foods to cool down.
- If you are prescribed nutritional supplements, your dietitian may be able to recommend a sharper tasting variety, such as a juice or yoghurt style supplement.”
Well, that’s enough to absorb in one sitting. Let me know if you have specific questions and I’ll do my very best to answer them.
Until next week,
Keep living your life!
The URI to TrackBack this entry is: https://gailraegarwood.wordpress.com/2024/02/26/and-the-nose/trackback/
- The Renal Warrior Project. Join Now
- Source: https://gailraegarwood.wordpress.com/2024/02/26/and-the-nose/