Frasnelli Johannes A, Temmel Andreas F, Quint Christian, Oberbauer Rainer, Hummel Thomas
Am J Rhinol. 2002 Sep-Oct;16(5):275-9.
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.
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.
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 werefound 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.
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.
慢性肾衰竭（CRF）患者营养状况差的患病率很高，因此饮食治疗成为治疗方案的重要组成部分。由于嗅觉在营养方面起着重要作用，本研究旨在调查CRF患者的嗅觉功能。
共调查了64例CRF患者。其中49例接受血液透析治疗，15例CRF患者不依赖透析。为作比较，我们检查了15名健康受试者。对嗅觉功能进行了气味辨别、气味识别和丁醇气味阈值的评估。
56%的患者存在嗅觉丧失，其中3例功能性嗅觉缺失，33例嗅觉减退。CRF对嗅觉功能的各项测试有特定影响。11%的患者气味阈值升高，38%的患者气味辨别能力下降，48%的患者气味识别存在缺陷。心理测试（简易精神状态检查表和连线测验）结果与气味识别（p < 0.01）和辨别（p < 0.01）结果相关，但与气味阈值无关。
发现患者辨别和识别气味的能力严重受损，而气味阈值与普通人群相似。因此，应就CRF患者化学感觉功能减退的可能性向其提供咨询。
