Taste changes in people with chronic kidney disease in a kidney supportive care program

Aim: To examine the prevalence and severity of taste changes experienced by people with advanced chronic kidney disease (CKD) attending Kidney Supportive Care (KSC) clinics. Background: People with advanced CKD can have difficulty perceiving sweet, savoury, bitter, sour and salty flavours. Whilst taste changes; including metallic or acidic taste; and loss of taste, are common in CKD; this symptom is often under recognised by clinicians. There is also a paucity of data examining the effect of taste changes on health-related quality of life (HRQOL). Methods: Retrospective analysis of patients attending KSC clinics between September 2020 and April 2021. Taste changes were rated by patients using a Likert scale, as is used in the Renal Palliative Care Outcome Scale (IPOS-renal). Patients rated how taste changes have affected them over the past seven days. Other symptoms and HRQOL were rated using the validated IPOS renal and EQ-5D-5L. Age, sex, and severity of CKD (eGFR and kidney replacement therapy [KRT]) were also extracted from the clinical record. Results: A total of 171 patients had taste changes assessed at 235 KSC clinic visits. The median age was 79 years (Interquartile range [IQR] 70-83) and 42% were female. The median eGFR was 14 (IQR 13-18), with 20% receiving KRT. Thirty two percent of patients reported taste changes. Taste changes affected the majority of patients slightly (35%) or moderately (43%). With only 19% experiencing severe taste changes and 7% overwhelming. Poor appetite was concurrently reported with taste changes in 78%. Conclusions: This study indicates that taste changes are common in patients with advanced CKD attending KSC clinics and highlights the importance of routine assessment of this symptom.