Afsar Baris, Afsar Rengin Elsurer, Bastani Bahar, Rub Fadee Abu Al, Caliskan Yasar, Lentine Krista L
Saint Louis University, School of Medicine, Division of Nephrology, St. Louis, MO, USA.
Turkish J Nephrol. 2025 Jul;34(3):160-168. doi: 10.5152/turkjnephrol.2025.25922. Epub 2025 Jul 1.
The interrelationship of sodium/salt consumption and chronic kidney disease (CKD) development and/or progression is inconsistent. Difference in the methods to evaluate sodium/salt intake may be one reason for this finding. The measurement of sodium/salt intake is challenging in CKD due to alterations in circadian sodium handling and creatinine kinetics (as sodium estimation formulas use creatinine), day to day variation of urine output, recall bias and cognitive dysfunction. This paper aims to present an overview of the methods to estimate sodium/salt intake in patients with CKD.
We conducted a review of existing literature regarding the methods used to estimate sodium/salt intake in patients with CKD. PubMed, Embase, Cochrane Library, and Web of Science databases were searched. To make extensive search strategy; key terms were kept broad and included as "24-hour urinary sodium excretion and chronic kidney disease", "Spot urinary sodium and chronic kidney disease", "Food frequency questionnaires, sodium and chronic kidney disease", "Food records, sodium and chronic kidney disease". Food recalls, sodium and chronic kidney disease".
Although there are many methods to measure sodium intake in patients with CKD, none of them is perfect including 24-hour urinary sodium excretion. Furthermore, most of the formulas are derived from healthy population. Although CKD specific formulas exists; they are scarce and mostly not externally validated.
Each method to estimate sodium intake have specific advantages and disadvantages in patients with CKD. More research is necessary to find better methods to estimate sodium intake in patients with CKD.
钠/盐摄入量与慢性肾脏病（CKD）发生和/或进展之间的相互关系并不一致。评估钠/盐摄入量的方法存在差异可能是导致这一结果的原因之一。由于昼夜钠代谢和肌酐动力学的改变（因为钠估算公式使用肌酐）、尿量的每日变化、回忆偏倚和认知功能障碍，在CKD患者中测量钠/盐摄入量具有挑战性。本文旨在概述CKD患者钠/盐摄入量的估算方法。
我们对有关CKD患者钠/盐摄入量估算方法的现有文献进行了综述。检索了PubMed、Embase、Cochrane图书馆和科学网数据库。为制定广泛的检索策略，关键词保持宽泛，包括“24小时尿钠排泄与慢性肾脏病”、“随机尿钠与慢性肾脏病”、“食物频率问卷、钠与慢性肾脏病”、“食物记录、钠与慢性肾脏病”、“食物回忆、钠与慢性肾脏病”。
尽管有多种方法可用于测量CKD患者的钠摄入量，但包括24小时尿钠排泄在内，没有一种方法是完美的。此外，大多数公式是从健康人群中推导出来的。虽然存在CKD特异性公式，但数量稀少且大多未经过外部验证。
在CKD患者中，每种估算钠摄入量的方法都有其特定的优缺点。需要进行更多研究以找到更好的方法来估算CKD患者的钠摄入量。
