Impact of salt taste dysfunction on interdialytic weight gain for hemodialysis patients; a cross-sectional study

摘要

BackgroundPatients with chronic kidney disease (CKD), including those on hemodialysis (HD), commonly experience taste dysfunction for reasons such as zinc deficiency, dry mouth due to water loss, peripheral nerve disorders due to diabetes, adverse effects of medication, and uremia [1,2,3,4,5,6]. It was reported that as the kidney function worsens, taste dysfunction also worsens [7]. A previous study demonstrated that salt taste dysfunction was common in non-dialysis CKD patients, and that there was a positive correlation between salt taste dysfunction and salt intake [8]. For HD patients, high salt intake could lead to increased interdialytic weight gain (IDWG) [9, 10], which is a well-known prognostic factor for cardiovascular events and all-cause death [11, 12]. Moreover, it has been reported that many HD patients consume more salt than is recommended despite strong dietary salt restrictions [13]. A possible factor related to the disturbance of salt restriction is salt taste dysfunction, which makes the patient unable to sense the salt taste accurately, thus leading to consuming more salt than recommended.Salt taste dysfunction could be influenced by a variety of factors, including age, sex, smoking, diabetes, and zinc levels [14,15,16,17]. Previous studies have demonstrated that excessive salt intake increased the salt taste function threshold [18] and that the administration of zinc [19] and a 1-week in-hospital CKD education program restricting dietary salt [8] improved salt taste dysfunction. However, to date, little is known about salt taste dysfunction among HD patients and its relationship with IDWG. Therefore, we hypothesized that the prevalence of salt taste dysfunction is higher among HD patients and that salt taste dysfunction has a significant role in increasing their IDWG through higher salt intake followed by increased fluid intake, as observed in general and non-dialysis CKD populations [8]. We conducted a cross-sectional study involving patients undergoing maintenance HD to elucidate the prevalence of salt taste dysfunction and the relationship between salt taste dysfunction and IDWG.