Chronic kidney disease and taste changes
Do you have chronic kidney disease and are experiencing taste changes? It is a common complaint experienced by many people as kidney disease progresses. Here’s the low down on why it happens.
Taste and sensory alterations in CKD can occur when eGFR or renal function falls below 15. The cause of these taste changes are multifactorial and may include genetics, the build up of uraemic toxins, metabolic derangement, fluid imbalances, a reduced number of taste buds and changes to saliva composition.
A lot of my clients tell me food doesn’t taste like it should and eating has lost its mojo. Usually people complain of a bitter taste in their mouth. We know from research that the saliva composition in renal patients is different to those without CKD. The saliva contains increased salivary bicarbonate, potassium and urea concentrations and this contributes to the hypersensitivity to bitter tastes. It is common at this stage of your CKD to go off eating protein rich foods like meat and opt for carbohydrate and sweet foods in preference.
If your taste is impaired this is probably going to affect your nutritional status as taste is arguably one of life's greatest pleasures. There is evidence that altered taste can affect appetite, reduce oral intake and negatively affect quality of life.
So here are a few of my tips on how to deal with taste changes, particularly the bitter or metallic taste.
Eat regular meals as eating turns over saliva
Eat well tolerated foods ie. Small meals more often
Cold foods with no smell can be better tolerated
Suck mints and chew gum as this overpowers the bitter taste
Ginger products can also help overpower the bitter taste
Prevent dehydration if possible as it concentrates saliva. Its difficult if you have a fluid restriction as part of your kidney treatment
Rinse regularly with sodium bicarbonate
Add sweet or sour flavours to your cooking to balance out the bitter e.g lemon
You may want to consider reducing the foods that give bitter tastes like meat, alcohol, tea and coffee. Ask your dietitian for more help around this.
Kirilee is a specialist dietitian with experience in renal disease. She sees clients on the North Shore and Northern Beaches of Sydney. If you would like more help navigating the taste changes in advanced kidney disease and malnutrition please get in touch to achieve your nutrition and lifestyle goals.
References
Manley, K.J., Haryono, R.Y., & Keast, R.S.J. (2012). Taste changes and saliva composition in chronic kidney disease. Renal Society of Australasia Journal, 8(2), 56-60.
NSW Health. (2017). Managing taste changes in advanced CKD. NSW Renal Dietitians.
Stevenson, J. et al. (2017). Nutrition in Renal Supportive Care: Patient-driven and flexible. Nephrology, 22, 739–747
