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[评估ExSel®自评问卷在肾内科门诊随访患者中筛查盐摄入过量的情况]

[Evaluation of the ExSel® self-questionnaire to screen for an excess salt intake in patients followed in a nephrology consultation].

作者信息

Monntoya L M, Ducher M, Florens N, Fauvel J-P

机构信息

Department of Nephrology-Hypertension, université Claude-Bernard Lyon 1, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon, France.

EMR3738 pharmacie, hospices civils de Lyon, ciblage thérapeutique en oncologie, université Claude-Bernard Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.

出版信息

Ann Cardiol Angeiol (Paris). 2019 Oct;68(4):275-278. doi: 10.1016/j.ancard.2019.07.001. Epub 2019 Aug 27.

Abstract

AIM

To evaluate the reliability of the ExSel® self-questionnaire to detect an excess salt intake (≥12g/24h) in patients consulting for hypertension and/or renal failure.

METHODS

Results of the ExSel® self-questionnaire were compared to 24h sodium excretion using the Cohen's kappa test and a Chi test. Sensitivity, specificity, VPP and VPN were calculated. A ROC curve was realized to find an accurate cut-off.

RESULTS

Mean characteristics of the 101 patients with reliable results were: age of 67±12 years, Body Mass Index 28.4±5.6kg/m, SBP/DBP 139±23/74±13mmHg (98% were hypertensives. Mean salt intake was 7.5±3.1g/24h and mean creatininuria was 13.9±20.1mmol/24h. An excess salt intake (≥12g/24h) was observed in 8% of the patients. The Kappa test at 0.17 and the Chi at 0.66 signify that the agreement was very low. Sensitivity was 37%, specificity 90%, PPV 20% and NPV 94%. The AUC under the ROC curve was too low (0.665) to determine a threshold adapted to the renal patients.

CONCLUSIONS

The ExSel® autoquestionnaire is not adapted to outpatients, mainly hypertensives (98%) followed in a nephrology consultation to detect an excess salt consumption.

摘要

目的

评估ExSel®自填问卷在检测高血压和/或肾衰竭就诊患者中过量盐摄入(≥12克/24小时)的可靠性。

方法

使用科恩kappa检验和卡方检验将ExSel®自填问卷的结果与24小时钠排泄量进行比较。计算敏感性、特异性、阳性预测值和阴性预测值。绘制ROC曲线以找到准确的临界值。

结果

101例结果可靠的患者的平均特征为:年龄67±12岁,体重指数28.4±5.6千克/米²,收缩压/舒张压139±23/74±13毫米汞柱(98%为高血压患者)。平均盐摄入量为7.5±3.1克/24小时,平均肌酐尿为13.9±20.1毫摩尔/24小时。8%的患者观察到过量盐摄入(≥12克/24小时)。kappa检验值为0.17,卡方检验值为0.66,表明一致性非常低。敏感性为37%,特异性为90%,阳性预测值为20%,阴性预测值为94%。ROC曲线下的AUC过低(0.665),无法确定适合肾病患者的阈值。

结论

ExSel®自填问卷不适用于门诊患者,主要是在肾病门诊就诊的高血压患者(98%),以检测过量盐摄入情况。

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