Flavor of food is terrible

(Topic from archives: Originally posted 08:17:21 08/25/2003)

My brother (44 yrs) just suffered Acute Renal Failure and was in ICU for 18 days. He has just left the hospital and is trying to adjust, recouperate, etc. My parents (75 yrs)are with him (he lives out of town) and are trying to help him get stronger. I have a challenge I need to throw out. My brother complains of a Iron Taste in his mouth and most food tastes terrible. He is losing weight (alarmingly) and is trying to work with the dialsys team. I'm just looking for anyone that may have had this symptom as well, and food suggestions or dietary website you might turn me on to! Thanks in advance.

Many people notice a "metallic" taste when their blood urea nitrogen (BUN) is high. This happens when kidneys are failing (uremia). If patients don't get enough dialysis, they will notice this taste. Since he's new on dialysis, it will take likely take time to get rid of the waste products in his blood that healthy kidneys normally remove. So far as the recent weight loss, it's possible that over months he had gained fluid weight that the dialysis has removed.

I'd recommend:

1) Your brother should ask his doctor, nurse, or dietitian what his dialysis adequacy is. His Kt/V should be 2.0 or higher or his URR should be at least 65%. See http://www.kidneyschool.org for information on labs and nutrition plus more.

2) Dialysis adequacy can be affected by how well your brother is eating. Therefore, he needs to find out from the renal dietitian (every clinic has one) what he can eat that help his nutrition. He/she can also suggest seasonings to improve the taste of food. The dietitian may also suggest foods that are less likely to have this taste and may even suggest that he eat or drink nutrition supplements.

3) Ask your brother how much weight he gained in the months before he was hospitalized and started dialysis. The nurses at his clinic are probably checking his ankles and/or shins each treatment to see if they "pit" when pressing in on his legs. This lets them know if he has fluid in his tissues (edema). They probably check this again when he gets ready leave the clinic to see if the extra fluid is gone.

4) Your brother should tell his dialysis team that his appetite is poor and that he's not eating much. They will need to adjust what they think his "dry weight" is (the weight without extra fluid). If they don't adjust this, they won't take off enough fluid, he'll have "pitting edema," his heart will have to beat harder, his blood pressure may go up, and he'll start having trouble breathing. He should be able to tell if this is becoming a problem if he's sleeping on more pillows or gets winded when doing much of anything.

I think it would be best if you consult a doctor as such rapid weight loos is alarming. A bad taste in mouth does occur to anyone who is ill. But I think the rapid wight loss is a cause for concern.