#754 Chemosensory function and food preferences among long term hemodialysis patients and correlation with nutritional status

Abstract Background and Aims Malnutrition frequently occurs in patients treated with chronic hemodialysis (HD), which in turn increases their mortality and morbidity. Disturbed sense of smell and taste, which has been reported in HD patients is associated with poorer nutritional status and increased mortality. The aim of the study was to investigate and compare the chemosensory function and food preferences among patients in long term HD with those of age – matched healthy controls and correlate it with the nutritional status of the patients. There is very few data published on this and in much smaller sample sizes. Method We performed a single center prospective randomized case control study on 50 patients undergoing HD and 50 age matched healthy individuals at Sri Ramachandra University, India over three months. We assessed the chemosensory function using Indian Smell Identification Test (INSIT) and Taste Drop Test (TDT). Food preferences in both the groups were assessed by a questionnaire over 44 items and was divided into 7 groups based on the category of foods. Malnutrition was assessed by the DMS (Dialysis Malnutrition Score) and body mass index (BMI). We only included patients who are more than 18 years and on HD for more than six months. Subjects with dementia, mental illnesses, less than one year after stroke, previous chemotherapy, or head/neck radiation therapy were excluded from both the groups. Results The baseline characteristics in the study showed 56% males and 40% females in cases and controls respectively with mean ages being 49.5 years and 52.7 years. The mean BMI was lower in cases (23.7) when compared with controls (28.3). The mean DMS in the control group was 13.44 (Normal) while cases had a significantly higher score of 25(moderate malnutrition). When compared to controls, 20%, 16%, and 38% of cases, respectively, did not appreciate the taste of sugar, salt, or tamarind, which was significant (p values of 0.001, 0.003, and 0.000). Similarly, 46%, 48%, and 32% of cases, respectively, had significant p values of 0.004, 0.003, and 0.008 for the inability to smell vanilla, rose, and pineapple. Fruits, vegetables and starches food groups were highly preferred by the cases. On the other hand, they showed little preference for meat, dairy and seafood which was significantly lower than the controls. Conclusion In HD patients, when compared to the controls, they had considerable impairment in their ability to smell and taste. The greatest impairment in taste was noticed for sour flavour, with just 62% of patients being able to recognise the taste, compared to 80% for sweet and 84% for salt. This, along with a significant degree of olfactory impairment has significantly affected the food preferences among the HD patients in our study who preferred vegetables over dairy. This also correlated with poorer nutritional status of the HD patients in terms on BMI and DMS score. They had significantly higher preference for fruits, dairy, snacks and starches compared to controls. Understanding each patients unique sensory preference can help individualise their diet more effectively, potentially improve their overall health and quality of life in HD patient.