Monntoya L M, Ducher M, Florens N, Fauvel J-P
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.
Ann Cardiol Angeiol (Paris). 2019 Oct;68(4):275-278. doi: 10.1016/j.ancard.2019.07.001. Epub 2019 Aug 27.
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.
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.
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.
The ExSel® autoquestionnaire is not adapted to outpatients, mainly hypertensives (98%) followed in a nephrology consultation to detect an excess salt consumption.
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。
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。
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。
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。
