Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital BeiHu Branch and National Taiwan University College of Medicine, Taipei, Taiwan; Geriatric and Community Medicine Research Center, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
Department of Nursing, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
J Ren Nutr. 2021 Jan;31(1):49-56. doi: 10.1053/j.jrn.2020.06.006. Epub 2020 Aug 7.
Gustatory function is frequently impaired in patients with chronic kidney disease (CKD), and the associated taste dysfunction contributes to compromised nutrition. Whether gustatory dysfunction is an underappreciated risk factor for frailty in patients with CKD remains unclear. The objective of this work was to examine the role of gustatory dysfunction as a risk factor for frailty in patients with CKD.
We prospectively enrolled patients with stage 3 or higher CKD from a single institute, with their gustatory function assessed using both objective (taste strip method) and subjective approaches, and frailty identified using the Edmonton frail scale, FRAIL scale, and Study of Osteoporotic Fracture (SOF) scale. Multiple regression analyses were performed to investigate whether results from gustatory function tests independently correlated with frailty.
Among the enrolled patients with CKD, 14 (17.9%) were found to be frail. We discovered that higher taste strip scores, or better taste function, were significantly associated with a lower frail probability (odds ratio [OR] 0.74 per score, 95% confidence interval [CI] 0.57-0.97), independent of clinical features, while better subjective taste function (OR 0.84 per score, 95% CI 0.74-0.96) and better oral cavity intactness (OR, 0.94; 95% CI, 0.9-0.98) were similarly associated with a lower frail probability among patients with CKD.
Gustatory dysfunction may be an important risk factor for frailty in patients with CKD. It is tempting to presume that interventions aiming to ameliorate such deficits may bear the potential of reducing frailty severity in this population with a high frailty burden.
味觉功能经常在慢性肾脏病（CKD）患者中受损，相关的味觉功能障碍导致营养摄入受损。味觉功能障碍是否是 CKD 患者衰弱的一个被低估的危险因素尚不清楚。本研究旨在探讨味觉功能障碍作为 CKD 患者衰弱的危险因素的作用。
我们前瞻性地招募了来自一家医院的 3 期或更高分期的 CKD 患者，使用客观（味觉条法）和主观方法评估他们的味觉功能，并使用埃德蒙顿虚弱量表（Frail scale）、衰弱指数（FRAIL scale）和骨质疏松性骨折研究（SOF）量表来确定虚弱状态。进行多元回归分析，以探讨味觉功能测试的结果是否与虚弱状态独立相关。
在纳入的 CKD 患者中，有 14 例（17.9%）被判定为虚弱。我们发现，味觉条评分越高，即味觉功能越好，与较低的虚弱概率显著相关（每评分的优势比[OR]为 0.74，95%置信区间[CI]为 0.57-0.97），独立于临床特征，而主观味觉功能越好（OR 每评分 0.84，95%CI 为 0.74-0.96）和口腔完整性越好（OR，0.94；95%CI，0.9-0.98）也与 CKD 患者较低的虚弱概率相关。
味觉功能障碍可能是 CKD 患者衰弱的一个重要危险因素。人们不禁假设，旨在改善这些缺陷的干预措施可能具有降低该衰弱负担高的人群中衰弱严重程度的潜力。
