Olfactory Function in Chronic Renal Failure

Background Patients with chronic renal failure (CRF) show a high prevalence of poor nutritional state so that dietary treatment becomes a significant part of the therapeutic regimen. Because smell plays an important role in nutrition, this study aimed to investigate olfactory function in CRF patients. Methods A total of 64 CRF patients were investigated. Forty-nine of them were treated with hemodialysis, 15 CRF patients were not dialysis dependent. For comparison we examined 15 healthy subjects. Olfactory function was assessed for odor discrimination, odor identification, and butanol odor thresholds. Results Olfactory loss was found in 56% of the patients, with 3 functional anosmics and 33 hyposmics. CRF had specific effects on individual tests of olfactory function. Elevated odor thresholds were found in 11% of patients, 38% of patients had reduced odor discrimination, and 48% of patients exhibited deficits in odor identification. Results of psychological tests (Mini–Mental State Examination and Trail-Making Test) correlated with results from odor identification (p < 0.01) and discrimination (p < 0.01) but not with odor thresholds. Conclusions The ability to discriminate and identify odors was found severely impaired whereas odor thresholds were similar to what is seen in the general population. Consequently, CRF patients should be counseled with regard to the possibility of reduced chemosensory functions.

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Olfactory Changes at Threshold and Suprathreshold Levels following Septoplasty with Partial Inferior Turbinectomy

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940311200117 ◽

2003 ◽

Vol 112 (1) ◽

pp. 91-97 ◽

Cited By ~ 52

Author(s):

Michael Damm ◽

Markus Jungehülsing ◽

Hans E. Eckel ◽

Thomas Hummel

Keyword(s):

Repeated Measures ◽

Rare Complication ◽

Odor Discrimination ◽

Olfactory Function ◽

Odor Identification ◽

Nasal Airflow ◽

Olfactory Test ◽

Visual Analog Scales ◽

Before And After ◽

Odor Thresholds

Partial inferior turbinectomy with septoplasty is routinely carried out for airway obstruction. However, its effects on the sense of smell have not been systematically evaluated. The aim of this prospective study was to evaluate the influence of septoplasty with partial inferior turbinectomy on threshold and suprathreshold olfactory acuity. The subjects were 30 patients undergoing septoplasty including partial inferior turbinectomy. Olfactory function was determined by the “Sniffin' Sticks,” which allow the assessment of odor thresholds, odor discrimination, and odor identification. The patients rated both olfactory function and nasal airflow using visual analog scales. Nasal airflow was measured by anterior rhinomanometry. Multivariate analyses of variance for repeated measures were used to analyze the results before and after surgery (mean interval, 9.1 weeks). After operation, 87% of the patients had increased airflow, 80% had improved olfactory function in terms of odor identification, and in 70% odor discrimination was found to be improved — but only 54% had improved olfactory function in terms of odor thresholds. Surgery increased ratings of nasal airflow in 93%, and those of olfactory function in 77% (p < .001). Similarly, bilateral inspiratory nasal flow increased (p < .001) and olfactory function was improved (p < .001) after surgical treatment. However, this increase was most pronounced for suprathreshold tests, while it was moderate for odor thresholds (interaction “surgery” × “olfactory test,” p = .001). The present investigation suggests that septoplasty in combination with inferior turbinectomy has a beneficial effect on olfaction, mainly on suprathreshold olfactory functions. This effect may be partly due to interactions between the increased perception of nasal airflow and cognitive factors involved in olfactory sensitivity. According to the present results and data from the literature, a moderate decrease of olfactory function appears to occur in as many as 20% of patients. However, anosmia seems to be an extremely rare complication of septoplasty and partial turbinectomy.

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Dietary Treatment of Chronic Renal Failure

International Journal of Food Sciences and Nutrition ◽

10.3109/09637487109144124 ◽

1971 ◽

Vol 25 (4) ◽

pp. 220-225

Author(s):

L. R.I. Baker ◽

Margaret M.E. Sanderson

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Dietary Treatment

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Improvement of Acidosis in Long-Term Dietary Treatment of Chronic Renal Failure

Prevention of Kidney Disease and Long-Term Survival ◽

10.1007/978-1-4684-4199-4_4 ◽

1982 ◽

pp. 39-42

Author(s):

Carmelo Giordano

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Dietary Treatment

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Superoxide Anion Production and Dietary Treatment in Chronic Renal Failure

Nephron ◽

10.1159/000186233 ◽

1991 ◽

Vol 57 (1) ◽

pp. 119-120 ◽

Cited By ~ 1

Author(s):

Adamasco Cupisti ◽

Giovanni Caruulli ◽

Rino Polidori ◽

Alessandra Guidi ◽

Giuliano Barsotti

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Superoxide Anion ◽

Dietary Treatment ◽

Superoxide Anion Production ◽

Anion Production

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Influence of Dietary Treatment on the Rate of Progression of Chronic Renal Failure

Nutritional Treatment of Chronic Renal Failure ◽

10.1007/978-1-4613-1583-4_24 ◽

1989 ◽

pp. 211-229 ◽

Cited By ~ 4

Author(s):

N. Gretz ◽

S. Giovannetti ◽

G. Barsotti ◽

R. Schmicker ◽

J. Rosman

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Dietary Treatment ◽

Rate Of Progression

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Survival on dialysis among chronic renal failure patients treated with a supplemented low-protein diet before dialysis.

Journal of the American Society of Nephrology ◽

10.1681/asn.v651379 ◽

1995 ◽

Vol 6 (5) ◽

pp. 1379-1385

Author(s):

J Coresh ◽

M Walser ◽

S Hill

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Mortality Rate ◽

Serum Creatinine ◽

Dietary Treatment ◽

Mortality Rates ◽

Protein Restriction ◽

Protein Diet ◽

Low Protein Diet ◽

Low Protein

Concerns have been raised about the possibility of protein restriction resulting in malnutrition and poor subsequent survival on dialysis. However, no studies have examined patients treated with protein restriction to determine their subsequent survival on dialysis. This study prospectively monitored 67 patients with established chronic renal failure (mean initial serum creatinine of 4.3 mg/dL) who were treated with a very low-protein diet (0.3 g/kg per day) supplemented with either essential amino acids or a ketoacid-amino acid mixture and observed closely for clinical complications. Forty-four patients required dialysis. Once dialysis was started, dietary treatment was no longer prescribed. The cumulative mortality rate during the first 2 yr after starting dialysis was 7% (95% confidence interval, 0 to 16%). During this period, only two deaths occurred compared with 11.5 deaths expected on the basis of national mortality rates adjusted for age, sex, race, and cause of renal disease (P = 0.002). However, the protective effect was limited to the first 2 yr on dialysis. Thereafter, mortality rates increased, resulting in a total of 10 deaths during 96.4 person-years of follow-up, which was not significantly lower than the 14.9 deaths expected (P = 0.25). Extrapolation of sequential serum creatinine measurements made before dietary treatment suggests that the improved survival cannot be due to the early initiation of dialysis. Although the lack of an internal control group and data on dialysis lends uncertainty, the large difference in mortality rate between these patients and the nationwide experience indicates that protein restriction and close clinical monitoring predialysis does not worsen and may substantially improve survival during the first 2 yr on dialysis. These findings point out the importance of studying predialysis treatments as a means for lowering mortality on dialysis.

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