title: Development and validation of a dietary screening tool for high sodium consumption in Australian renal patients.
abstract: OBJECTIVE
  The study objective was to develop and evaluate the feasibility and validity of a self-administered Scored Sodium Questionnaire (SSQ) for use in the routine clinical care of Australian chronic kidney disease (CKD) patients.
  
  
  METHODS
  The study took place in community-based outreach clinics using a multidisciplinary model of care. Assessment of sources of dietary sodium intake in the target population used comprehensive diet history interviews (Phase 1) to inform development of a 10-item food frequency questionnaire that was scored and validated using 24-hour urinary sodium and 2 alternative dietary intake methods (Phase 2). Subjects were adults with CKD Stages 3 to 5 (Phase 1 n = 30; Phase 2 n = 47).
  
  
  METHODS
  On a single day, participants (n = 47) completed the SSQ, feasibility survey, 24-hour urine collection, and 24-hour food record. A diet history interview was also conducted to confirm sodium intake on the day of data collection reflected habitual intake.
  
  
  METHODS
  Validity of the SSQ score was confirmed by correlation with 24-hour urine sodium. Validity of a cutpoint on the SSQ score to correctly identify high- versus low-sodium consumers was confirmed by receiver operating characteristic curve analysis: area under the curve, sensitivity, and specificity.
  
  
  RESULTS
  Total SSQ score correlated significantly with 24-hour urine sodium (r = 0.371; P = .031). Correlation between 24-hour food record and diet history sodium confirmed consumption on the data collection day reflected habitual intake (r = 0.701; P ≤ .001). A cutpoint of 65 or greater on the SSQ score was confirmed as valid to identify high-sodium consumers: area under the curve 0.713, sensitivity 61%, and specificity 82%.
  
  
  CONCLUSIONS
  The SSQ is feasible and valid to assess habitual sodium intake in the Australian CKD population and to identify high-sodium consumers for referral to individualized counseling on a low-sodium diet.
authors.affiliation: Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia. Electronic address: Belinda_Mason@health.qld.gov.au.
authors.forename: Belinda
authors.initials: B
authors.lastname: Mason
authors.affiliation: Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Lynda
authors.initials: L
authors.lastname: Ross
authors.affiliation: Nutrition and Diet Therapy Department, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Gill
authors.affiliation: Department of Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Healy
authors.affiliation: Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Juffs
authors.affiliation: Department of Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003430:Cross-Sectional Studies; D015930:Diet Records; D004034:Diet Surveys; D004039:Diet, Sodium-Restricted; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007674:Kidney Diseases; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000652:urine; D011795:Surveys and Questionnaires
chemical_list: D012982:Sodium, Dietary