title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Altered taste perception was common among prevalent hemodialysis patients and was independently associated with poorer indices of nutritional status and increased all-cause mortality.
authors.affiliation: Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Lynch
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lynch
authors.forename: Gary C
authors.initials: GC
authors.lastname: Curhan
authors.forename: Steven M
authors.initials: SM
authors.lastname: Brunelli
mesh_terms: D000328:Adult; D000368:Aged; D001066:Appetite / Q000502:physiology; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D057566:Self Report; D012709:Serum Albumin / Q000032:analysis; D012982:Sodium, Dietary / Q000008:administration & dosage; D055697:Taste Perception / Q000502:physiology*
chemical_list: D004044:Dietary Proteins; D012709:Serum Albumin; D012982:Sodium, Dietary; D003404:Creatinine