End Stage Renal Disease Clinical Trial
Official title:
Pilot Study of Taste Sensations in Patients With End-stage Renal Disease on Hemodialysis
Individuals on dialysis due to kidney failure have very prescriptive diets. These diets help increase dialysis effectiveness and help patients control blood levels of electrolytes including potassium and phosphate, acid-base balance, blood pressure, and fluid between dialysis treatments. However, patient compliance with these diets often can be very low, and one reason for this low compliance is disguesia (abnormal taste sensations) which can make the diets unpalatable. This experiment tests the hypothesis that disguesia, and subsequent lack of adherence to a dialysis friendly diet, is a result of either vascular taste (tasting your own blood through the basolateral side of taste cells) or altered chemical composition of saliva in between dialysis appointments. However, to study these hypotheses, data are needed on the types of substances that may contribute to the disguesia. Substances for which the concentration is influenced by kidney function (in healthy people) or dialysis (in patients) are the prime candidates for the disguesia under our hypotheses. Thus, this experiment tests whether taste or flavours experienced from sodium, calcium, potassium, creatinine, urea, phosphates, glutamate, and iron may be related to altered taste experienced by patients on dialysis.
A. Background:
Individuals on dialysis due to kidney failure have very prescriptive diets. These diets help
increase dialysis effectiveness and help patients control blood levels of electrolytes
including potassium and phosphate, acid-base balance, blood pressure, and fluid between
dialysis treatments. However, patient compliance with these diets is often very low, and one
reason for this low compliance is disguesia (abnormal taste sensations) which can make the
diets unpalatable. The investigators hypothesize this disguesia, and subsequent lack of
adherence to a dialysis friendly diet, is a result of either vascular taste (tasting one's
own blood through the basolateral side of taste cells) or altered chemical composition of
saliva in between dialysis appointments. However, to study these hypotheses, data are needed
on the types of substances that may contribute to the disguesia. Substances for which the
concentration is influenced by kidney function (in healthy people) or dialysis (in patients)
are the prime candidates for the disguesia under our hypotheses.
B. Objectives:
The investigators will study how dialysis patients perceive sodium, calcium, potassium,
creatinine, urea, phosphate, glutamate (umami taste), and iron solutions, and whether
alterations in saliva may contribute to altered sensations from these compounds. These
solutions will be used to:
1. Determine whether dialysis patients recognize the flavour of specific stimuli as similar
to the disguesias experienced between dialysis treatments.
2. Determine if the intensity of the flavour from these solutions is more or less intense
at the beginning of dialysis compared to the end.
3. Determine if patients' ratings for the solutions differ from healthy, control
individuals.
4. Determine if saliva of patients contains different concentrations of analytes such as
sodium, potassium, creatinine, urea, phosphates, iron, or glutamates from healthy
controls.
5. Determine if concentrations of these analytes in saliva decrease over the course of
dialysis treatment.
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