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Title: Will mouth wash solutions of water, salt, sodium bicarbonate or citric acid improve upper gastrointestinal symptoms in chronic kidney disease
Austin Authors: Manley, Karen J
Affiliation: Departments of Nutrition and Dietetics, Austin Health
Issue Date: 2016 2016-02-18
Publication information: Nephrology 2016, epub Feb 18
Abstract: BACKGROUND: Uraemic symptoms including taste changes, nausea and dry retching is common in chronic kidney disease (CKD). Taste buds detect five basic tastes: sweet, salty, sour, umami and bitter. Saliva in CKD usually has increased concentrations of urea, sodium, potassium, phosphate and higher pH levels. Genetic sensitivities to the bitter taste, with the changes in saliva can cause taste changes and impact uraemic symptoms. AIM: To assess if mouth wash solutions of water, salt, sodium bicarbonate or citric acid improves upper gastrointestinal (GI) symptoms in CKD patients. METHODS: An interventional crossover study with forty-two CKD patients (21 males, 21 females) complaining of upper GI symptoms were recruited. Subjects completed a questionnaire to assess symptoms and tested for genetic taste sensitivities. Saliva samples were analysed. Mouth rinse solutions of salt, bicarbonate, citric acid and de-ionised water were trialled in randomised order for patient reaction and symptom improvement. RESULTS: All 42 patients experienced anorexia, 39 (93%) reported taste changes, 27 (48%) nausea and 27 (48%) dry retching. All solutions improved symptoms in some patients. Sodium bicarbonate (pā€‰=ā€‰0.005) gave the greatest improvement in mouth feel and symptom control compared to the least favoured citric acid solution. Sixty-six percent of patients found sodium bicarbonate beneficial with 40% preferrence over other solutions. CONCLUSION: Simple mouthwashes can be used to relieve or eliminate some uraemic symptoms. Rinsing the mouth with a sodium bicarbonate solution cleanses receptors on taste buds, may alter mouth pH thereby reducing some upper GI symptoms that CKD patients can experience. This article is protected by copyright. All rights reserved.
DOI: 10.1111/nep.12753
PubMed URL:
Type: Journal Article
Subjects: Sodium Bicarbonate
Renal Insufficiency, Chronic
Citric Acid
Appears in Collections:Journal articles

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