Search Results (174)

Objective: To systematically evaluate the impact of a school-based sodium reduction education program using mobile health (mHealth), known as EduSaltS, on salt-related knowledge, attitudes, practices (KAP) and sodium intake among adults and children during its real-world scaling-up and to examine geographic and population heterogeneity in its effects. Methods: A multi-center pragmatic pre–post study design was used. The EduSaltS program was implemented in three cities (Ganzhou in southern China, Zhenjiang in eastern China, and Qinhuangdao in northern China) between April 2022 and July 2024. Ten primary schools were selected from each city. Baseline and follow-up surveys were conducted approximately 12 months apart, aligned with the school calendar. Electronic questionnaires were used to collect baseline and post-intervention data on the primary outcome—salt-related KAP—from adults and children. In Ganzhou and Zhenjiang, 24 h urine collections were conducted to measure urinary sodium excretion. Results: A total of 721 adults and 770 children were included in the final analysis. After the intervention, the total KAP scores significantly increased in both adults and children across the three sites: by 8.7–10.0 points in adults and by 11.4–16.7 points in children (all p < 0.001). The changes in sodium intake showed significant heterogeneity. A significant decrease in urinary sodium was observed among adults in Ganzhou (−14.0 mmol/24 h, 95% CI: −26.1, −2.0, p = 0.022), corresponding to a reduction of 0.82 g in daily salt intake. No significant change was found among adults in Zhenjiang (adjusted difference: −0.7 mmol/24 h, 95% CI: −13.4 to 12.0, p = 0.912). In children, after the one-year intervention, urinary sodium excretion showed a significant increase from baseline to follow-up in both cities (Ganzhou: +12.9 mmol/24 h, p = 0.018; Zhenjiang: +14.0 mmol/24 h, p = 0.0002). Conclusions: The pre–post evaluation showed that the EduSaltS program was associated with significant improvements in salt-related knowledge across regions. Its effectiveness in reducing sodium intake, however, varied substantially by population and geographic location. The observed increase in children’s urinary sodium excretion may partly reflect normal childhood growth and the limitations of a pre–post design without a control group. Pragmatic randomized controlled trials are warranted to verify the effectiveness of such interventions in reducing sodium intake and blood pressure across diverse populations and settings. Full article

Background/Objectives: The global rise in obesity represents a major public health issue, extending its detrimental impact beyond metabolic complications to encompass renal dysfunction. A key element in this relationship lies in the interaction between visceral obesity and glomerular hyperfiltration—an early, often silent indicator of kidney injury that may precede the onset of chronic kidney disease (CKD). Methods: In this monocentric, retrospective study, we evaluated 43 adults with obesity attending the Outpatient Clinic for Diet Therapy in Transplantation, Renal Failure and Chronic Pathology at the University of Naples Federico II between March 2022 and March 2024. Clinical, anthropometric, biochemical, and 24 h urinary parameters were recorded, along with several validated visceral adiposity indices. Glomerular hyperfiltration was assessed through measured creatinine clearance (mClCr) tertiles, while associations with adiposity indices, proteinuria, and urinary sodium excretion were explored. Results: Higher creatinine clearance values were significantly associated with increased levels of adiposity indices—particularly Lipid Accumulation Product (LAP), New Visceral Adiposity Index (NVAI), and Metabolic Score for Visceral Fat (METS-VF)—as well as greater proteinuria, urinary sodium excretion, and daily salt intake. Subjects with proteinuria ≥ 150 mg/day exhibited higher NVAI values and elevated sodium and potassium urinary excretion compared with those without proteinuria. Significant correlations emerged between LAP and mClCr, sodium excretion, and proteinuria, even after adjustment for age and BMI. Conclusions: Higher visceral adiposity indices were associated with increased creatinine clearance, proteinuria, and urinary sodium excretion in adults with obesity. These findings suggest that visceral adiposity may represent a useful marker of early obesity-related renal alterations. Prospective studies are warranted to determine the causal relationships and mechanisms underlying these associations. Full article

Background/Objectives: Type 2 diabetes is a group of metabolic disorders whose pathophysiological outcome is sustained hyperglycemia. Several medications are available for the treatment. SGLT2 simultaneously inhibits glucose and sodium reabsorption in the renal proximal tubule, resulting in urinary glucose excretion. This study assessed the pharmacokinetic profiles of two empagliflozin 25 mg drug products under fasting conditions in healthy Mexican subjects to establish bioequivalence. Methods: This was a randomized, open-label, two-way crossover, single-dose, prospective study with a 7-day washout period. Eligible subjects were healthy adult Mexican volunteers. The drugs were dosed orally, according to the randomization, after 10 h of fasting and 4 h before breakfast, with 250 mL of 10% glucose solution at room temperature. Serial blood samples were collected before and after dosing. Empagliflozin concentrations were analyzed using high-performance liquid chromatography–tandem mass spectrometry. Results: A total of 32 subjects were enrolled, and 30 completed the study. Pharmacokinetic parameters C_max, t_max, AUC_0–t, AUC _0–∞, and t_½ of empagliflozin for test and reference formulation, expressed as mean ± SD, were 578.28 ± 125.60 ng/mL, 2.72 ± 0.85 h, 4370.88 ± 769.50 ngh/mL, 4423.93 ± 776.02 ngh/mL, 7.62 ± 0.83 h, and 593.99 ± 156.78 ng/mL, 2.86 ± 1.00 h, 4313.24 ± 885.02 ngh/mL, 4368.04 ± 887.75 ngh/mL, and 7.61 ± 0.68 h, respectively. The 90% CI for C_max, AUC_0–t, and AUC _0–∞ were 98.30 [92.72–104.22], 101.72 [98.77–104.77], and 101.64 [98.73–104.63], respectively. Serious adverse events were not observed. Conclusions: Our study demonstrated bioequivalence between the empagliflozin formulations tested in healthy subjects under fasting conditions. Full article

Background/Objectives: Nutrient profiling models are widely used to support healthier food choices, but their applicability may be limited in dietary cultures with multi-dish meals and high consumption of minimally processed foods. This study extended the Ajinomoto Group Nutrient Profiling System (ANPS), originally developed for dish- and meal-level assessment, to evaluate overall quality of daily intake (ANPS-Day) based on four components (protein, vegetables, saturated fatty acids [SFAs], and sodium), and examined its criterion-related validity using 24 h urinary biomarkers. Methods: A total of 324 healthy Japanese adults aged 20–69 years completed four-day semi-weighed dietary records and two non-consecutive 24 h urine collections. Urinary sodium, potassium and urea nitrogen were measured. Associations were examined using age- and sex-adjusted Spearman correlation coefficients and trend analyses. Results: The crude ANPS-Day score showed weak and inconsistent correlations with urinary biomarkers. In contrast, the energy-adjusted ANPS-Day score was positively correlated with estimated potassium intake (r = 0.25) and inversely correlated with the urinary sodium-to-potassium (Na/K) ratio (r = −0.24). In quartile analyses, higher energy-adjusted ANPS-Day scores were associated with higher protein and potassium intakes and with a lower Na/K ratio (all p for trend ≤ 0.001). In component analysis, vegetable points were positively associated with potassium intake, whereas sodium points were inversely associated with estimated sodium intake and the Na/K ratio. SFA points were not associated with urinary biomarkers. Conclusions: The energy-adjusted ANPS-Day score showed modest but biologically plausible associations with urinary biomarkers, providing partial evidence of criterion-related validity in assessing diet quality in multi-dish dietary settings. Full article

Background/Objectives: Urinary urea excretion is a marker of protein catabolism and follows circadian biological rhythms. Although small-scale studies have suggested a diurnal pattern, its population-level characterisation and determinants remain poorly defined. Methods: This cross-sectional study was conducted within the Ticino Epidemiological Stiffness Study (TEST-study), a population-based cross-sectional analysis of 1202 adults (≥18 years) recruited in the Italian-speaking region of Switzerland in 2017–2018. A final analytical sample of 859 participants provided 24 h urine collections divided into diurnal and nocturnal fractions, from which a day-to-night (Day/Night) urea excretion ratio was calculated as the primary outcome. Multivariable linear regression was used to identify independent determinants. Results: Across the cohort, a predominant nocturnal pattern of urinary urea excretion was observed, with a mean Day/Night ratio below 1. In younger women (<40 years), the ratio approached 1, indicating an attenuated Day/Night pattern, whereas older women (>65 years) displayed a significantly more pronounced nocturnal predominance. No comparable age-related trend was observed in men. In multivariable analysis, advancing age, greater nocturnal blood pressure dipping, and higher sodium excretion were independently associated with the Day/Night urea ratio. Conclusions: Urinary urea excretion, a surrogate marker of protein catabolism, exhibits a measurable Day/Night variation, associated with age, sex, and hemodynamic factors. These findings provide insights for chrononutritional strategies aimed at preserving muscle health across lifespan. Full article

Background: Ischemia-reperfusion injury (IRI) impairs kidney transplants. Diazepam can reduce IRI through peripheral benzodiazepine receptors. We aimed to evaluate the effect of diazepam premedication on the IRI of the rat kidney. Methods: Fourteen days after unilateral nephrectomy, male Sprague-Dawley rats underwent a 45 min sole kidney ischemia. Sixty minutes prior to ischemia, the animals were randomly assigned to a subcutaneous injection of 0.75 mg diazepam (n = 28) or 0.5 mL 0.9% NaCl (n = 31). Results: After 48 h, serum creatinine of diazepam-administered rats was lower and creatinine clearance was higher than in controls (119.8 ± 73.3 vs. 217.5 ± 105.3 µmol/L, p < 0.01 and 0.14 ± 0.07 vs. 0.08 ± 0.05 mL/min/100 g BM, p < 0.01, respectively). Moreover, the former had lower urinary losses of sodium and potassium (fractional excretions of 1.24 ± 1.39% vs. 2.87 ± 3.66%, p = 0.02 and 111.1 ± 95.7% vs. 199.0 ± 143.3%, p < 0.01, respectively). After 7 days, diazepam-treated rats remained superior vs. controls, regarding serum creatinine (53.7 ± 12.7 vs. 77.6 ± 21.3 µmol/L, p < 0.01), creatinine clearance (0.22 ± 0.08 vs. 0.17 ± 0.06 mL/min/100 g BM, p < 0.01), potassium sparing (50.2 ± 31.7% vs. 73.4 ± 38.7% excretion, p < 0.01), and renal edema (1.92 ± 0.45 vs. 2.30 ± 0.61 g of kidney mass, p < 0.01). Furthermore, their 24 h proteinuria was marginally reduced (4.03 ± 2.62 vs. 5.06 ± 2.74 mg, p = 0.06). Conclusions: Administration of diazepam preceding renal ischemia attenuates subsequent kidney injury in rats. Benzodiazepines may be beneficial prior to kidney transplantation. Full article

Hypertension is a major health issue, both globally and in Japan. Potassium-rich foods help prevent hypertension by promoting sodium excretion. We evaluated whether Dadacha-mame (a local potassium-rich edamame variety) improves sodium excretion and influences dietary behavior. This 2-week stratified randomized exploratory trial included 54 (mean age: 20.5 ± 1.4 years; 53.7% females) adults assigned to an intervention group [15 g/day of dried Dadacha-mame; n = 27] or a control group [usual diet; n = 27]. Urinary sodium-to-potassium (Na/K) ratios were compared. Shifts in the dietary behavior-change stages (pre-contemplation and contemplation) were assessed at baseline and post-intervention. No significant between-group baseline differences were observed. While no overall effect on the Na/K ratio was observed, subgroup analysis showed a significant reduction in the Na/K ratio in the intervention group (4.39 vs. 5.91 in Control, p = 0.027). The intervention prompted positive dietary behavior changes, with the proportion of participants in the pre-contemplation stage decreasing from 50.0% at baseline to 33.3% post-intervention. Dietary intervention with Dadacha-mame can significantly improve sodium excretion in individuals at a higher risk of hypertension and encourage healthy dietary behaviors. Utilizing local potassium-rich foods may be a valuable public health strategy, creating added value for agricultural products and benefiting community health. Full article

Background and Objectives: Bladder cancer is one of the most common malignancies of the urinary tract and poses a significant clinical challenge due to its biological heterogeneity and high rates of recurrence and progression. Urothelial carcinoma represents the predominant histological subtype, ranging from non-muscle-invasive disease with relatively favorable outcomes to aggressive muscle-invasive and metastatic forms associated with poor prognosis. Accurate diagnosis, staging, prognostic stratification, and assessment of treatment response are therefore essential for optimal patient management. The objective of this review is to summarize and critically evaluate the current evidence on the role of positron emission tomography/computed tomography (PET/CT) in bladder cancer, with particular emphasis on [¹⁸F]FDG PET/CT and non-FDG radiotracers. Materials and Methods: A narrative review of the available literature was performed, focusing on clinical studies, review articles, and guideline documents addressing the use of PET/CT in bladder cancer. The literature search included articles published between 2000 and 2025, while earlier landmark studies were selectively included if considered historically important for understanding the development of PET/CT imaging in bladder cancer. The initial search yielded over 500 records; after screening titles and abstracts, more than 100 articles were selected for full-text evaluation. The analyzed evidence encompasses the clinical applications of [¹⁸F]FDG PET/CT and alternative radiotracers, including choline-, acetate-, methionine-, and sodium fluoride-based tracers, and fibroblast activation protein inhibitors (FAPI), across different stages of disease and clinical settings. Results: Conventional imaging modalities, such as computed tomography and magnetic resonance imaging, provide important anatomical information but remain limited in the evaluation of lymph node involvement, early metastatic disease, treatment response, and disease recurrence. Despite limitations related to physiological urinary excretion, [¹⁸F]FDG PET/CT has demonstrated clinical value in selected scenarios, particularly for staging, prognostic assessment, detection of recurrence, and response evaluation. To overcome FDG-related constraints, several non-FDG radiotracers have been investigated. Among these, FAPI PET/CT has emerged as a promising modality due to its ability to target the tumor stroma, potentially improving lesion detectability and tumor-to-background contrast. Conclusions: This review summarizes and critically evaluates current evidence on the role of PET/CT in bladder cancer, with a focus on [¹⁸F]FDG PET/CT and non-FDG radiotracers. The discussed studies highlight their applications in primary diagnosis, staging, prognostic assessment, detection of recurrence, and evaluation of treatment response, as well as their respective advantages and limitations. Furthermore, potential future directions for PET/CT imaging in clinical practice are outlined, emphasizing the need for further research to clarify the optimal use of established and emerging radiotracers. Full article

Accurate assessment of sodium intake and its dietary sources is essential for developing effective sodium reduction strategies. This study estimated total dietary sodium intake (DSI) and source-specific contributions using questionnaire-based methods, validated against urinary sodium excretion (USE). Two cross-sectional surveys were conducted in 2023 among adults aged 15–59 years in Burkina Faso (N = 749) and Senegal (N = 1340), selected through stratified sampling. USE was estimated from spot urine samples, calibrated using 24 h urine collections in a sub-sample (eUSE). DSI was assessed using three complementary methods: (1) household purchasing/adult male equivalent (AME) for small-commodity foods and discretionary salt, (2) 24 h recall for sodium-rich foods consumed in and outside the home, and (3) a food frequency questionnaire for composite dishes eaten outside the home. Median DSI from dietary methods (2.6 g/day) closely matched estimates from eUSE (2.7 g/day) in Burkina Faso but was overestimated in Senegal (5.4 vs. 3.1 g/day), mainly due to difficulty estimating discretionary salt use in households buying large quantities. The country-specific validation of spot urine showed good agreement with 24 h collections. Combining complementary dietary intake methods offers a feasible approach to estimating total and source-specific sodium intake in settings with frequent small salt purchases. In settings with large salt purchases and salt being used for purposes other than human consumption, the salt purchasing/AME method to quantify the use of discretionary salt at the household level should be replaced by the salt disappearance method. Full article

Chronic kidney disease (CKD) has emerged as a pervasive global health concern, for which there are no known curative treatments. Consequently, there is an imperative for the implementation of preventive and kidney-protective strategies. The renal kallikrein–kinin system (KKS) is a vasodilator, anti-inflammatory, and antifibrotic pathway located in the distal nephron, whose decline contributes to hypertension and CKD progression. In this narrative, non-systematic review, a thorough evaluation of both experimental and clinical data was undertaken to ascertain the interactions between dietary potassium, renal KKS activity, and kidney protection. A particular emphasis was placed on animal models of proteinuria, tubulointerstitial damage, and salt-sensitive hypertension, in conjunction with human studies on potassium intake and renal outcomes. A body of experimental evidence suggests a relationship between potassium-rich diets and renal kallikrein synthesis, urinary kallikrein activity, and up-regulated kinin B2 receptor expression. Collectively, these factors have been shown to result in reduced blood pressure, oxidative stress, apoptosis, inflammation, and fibrosis, and these effects are counteracted by B2 receptor blockade. In humans, higher potassium intake has been shown to enhance kallikrein excretion and lower cardiovascular and renal risk, independently of aldosterone. Conversely, low potassium intake has the potential to exacerbate CKD progression. Notwithstanding the concerns that have been raised regarding the potential necessity of increasing potassium intake in cases of advanced CKD, extant evidence would appear to indicate that potassium excretion persists until late disease stages. The activation and preservation of the renal KKS through a potassium-rich diet is a rational, cost-effective strategy for renoprotection. When combined with sodium reduction and nutritional education, this approach has the potential to halt the progression of CKD and enhance cardiovascular health on a population scale. Full article

Background/Objectives: Hemodynamic and neurohormonal factors, including renal perfusion and venous pressure, may affect diuretic response, which may be modulated by body position. This study aimed to assess whether supine versus upright positioning influences diuretic efficacy and neurohormonal activation during early decongestion in patients with AHF and reduced ejection fraction (HFrEF). Methods: This single-center, prospective, pilot randomized study enrolled 12 hospitalized patients with decompensated HFrEF receiving guideline-directed medical therapy. Participants were randomized (1:1) to remain in either the supine or upright/seated position during intravenous furosemide administration (1 mg/kg: half of the dose administered as a bolus, half as a 2-h infusion). Serial measurements of urine volume, electrolyte excretion, and neurohormonal biomarkers (renin, aldosterone, catecholamines) were performed at baseline, 2, and 6 h after diuretic administration. Results: No significant differences were found between supine and upright groups in total urine output, urine dilution, sodium excretion, or weight change after 6 h. There were no statistically significant differences in renin and aldosterone levels across subsequent timepoints; however, renin concentration tended to be higher in upright than in supine individuals. Interestingly, supine participants demonstrated greater urinary adrenaline concentration after furosemide administration, alone and after adjustment for urinary creatinine. Conclusions: No clinically meaningful differences were found between supine versus upright position patients with AHF, receiving neurohormonal blockade. Full article

Background/Objectives: We evaluated Goreisan, a traditional Chinese medicine, for its effects on nephrotic syndrome in a rat model. Methods: Male Sprague–Dawley rats underwent right nephrectomy at 5 weeks of age, followed by adriamycin administration (5 mg/kg) at 6 and 8 weeks of age to induce nephrotic syndrome. At 10 weeks, rats were divided into three groups: vehicle (control), Goreisan 0.5 g/kg (GL), and Goreisan 1.0 g/kg (GH). Goreisan was administered daily for 4 weeks. At 14 weeks, blood, urine, mRNA expressions, and kidney histopathology were analyzed. Data were analyzed using one-way ANOVA followed by Tukey–Kramer post hoc testing. Results: Goreisan prevented worsening kidney function, with reduced glomerular and tubulointerstitial damage, lower systemic and intrarenal 8-hydroxy-2′-deoxyguanosine levels, and lower plasma aldosterone levels and expression of intrarenal renin–angiotensin–aldosterone system (RAAS)-related factors. Urine volume significantly increased in GL and GH groups compared with the control group. In the GH group, urine volume increased markedly (Δ urine volume: 10.0 ± 2.6 mL/day), whereas it tended to decrease in the Vehicle group (Δ urine volume: −1.3 ± 2.5 mL/day). Urine osmolality was lower in the GH group, with a larger decrease in Δ urine osmolality (−616.3 ± 132.8 mOsm/L). These changes occurred without an increase in urinary sodium excretion, suggesting an aquaretic effect independent of natriuresis. Creatinine clearance (CCr/kg) declined markedly in the Vehicle group but was significantly preserved in the GH group (Δ CCr/kg: −2.2 ± 0.19 vs. −0.7 ± 0.28), indicating renoprotective effects. No differences were found in serum arginine–vasopressin levels. Real-time PCR and immunohistochemical staining showed no significant differences in aquaporin (AQP) mRNA expression (AQP1, AQP2, AQP3, and AQP4), but AQP2 localization to the apical membrane in the collecting ducts was reduced with Goreisan treatment. Conclusions: Goreisan demonstrates kidney-protective and diuretic effects in nephrotic syndrome, potentially through reducing systemic oxidative stress, modulating RAAS activation, and altering AQP2 trafficking. Full article

Background: Pediatric hypertension is an increasingly recognized health concern and is commonly influenced by modifiable factors such as dietary sodium intake and obesity and non-modifiable factors like family history of hypertension. Urinary sodium excretion provides an objective surrogate marker of sodium consumption and may be associated with blood pressure severity. This study aimed to evaluate urinary sodium excretion in children with primary hypertension (PH) and to test the hypothesis that higher sodium excretion is associated with less favorable clinical, biochemical, and blood pressure parameters. Methods: This retrospective, cross-sectional, single-center study analyzed data from 369 hypertensive patients and 59 healthy children. Patients with a confirmed diagnosis of PH and ambulatory blood pressure monitoring results were included in the study group. Clinical, anthropometric, laboratory, echocardiographic, and blood pressure data were examined, and sodium excretion was evaluated using both the spot urine sodium-to-creatinine ratio and 24-h urinary sodium per kilogram of body weight. Results: Children with hypertension exhibited higher urinary sodium excretion compared to the control group. Sodium excretion of the hypertensive group, measured using the sodium/creatinine ratio and 24 h urinary sodium excretion per kilogram, was positively correlated with 25-hydroxyvitamin D, the urinary potassium/creatinine ratio, and the urinary uric acid/creatinine ratio. Moreover, negative correlations were observed for both parameters with age, body weight, serum uric acid, and left ventricular mass. In the multivariate analysis, weighted Z-score (beta = −0.393), age (beta = −0.293), 25-OHD (beta = 0.182), and arterial hypertension in the father (beta = 0.166) predicted 24 h urinary sodium excretion. Children with excessive sodium excretion had a significantly higher systolic blood pressure load over 24 h. Conclusions: Urinary sodium excretion is elevated in children with PH. Children with a lower weight for their age, who are younger, and who have a father with arterial hypertension might be at higher risk of excessive urine excretion. Our findings underscore the clinical importance of dietary sodium reduction as a non-pharmacological therapeutic target, especially in these patient populations. Prospective studies are needed to evaluate its impact on long-term cardiovascular outcomes in this population. Full article

Background/Objectives: Sleeve gastrectomy (SG) is the most commonly performed bariatric surgery worldwide. It results in significant weight loss and improves metabolic disorders such as hypertension. Weight loss is thought to be the main factor contributing to blood pressure (BP) reduction after SG. Small-intestinal hormones may also mediate the antihypertensive effects of SG. We aimed to investigate the mechanisms underlying the antihypertensive effects of SG through small-intestinal hormones independently of weight loss. Methods: This study involved male Sprague–Dawley rats that underwent a sham operation or SG, followed by a dietary intervention involving a standard diet, a high-fat and high-salt diet, or pair-feeding with SG. Results: Three weeks postoperatively, SG significantly reduced systolic blood pressure (SBP) and increased urinary sodium excretion. RNA sequencing of the small intestine revealed upregulation of the gene encoding prouroguanylin (proUGN). proUGN is a small-intestinal hormone that inhibits renal sodium reabsorption by converting sodium/hydrogen ion exchanger type 3 (NHE3) in the proximal tubules into the inactive phosphorylated form at Ser552 (pS552-NHE3). Furthermore, SG significantly increased proUGN levels in the ileum and plasma, as well as the levels of pS552-NHE3 in the renal cortex. The administration of exogenous uroguanylin, which is converted from proUGN, resulted in increased renal pS552-NHE3, increased urinary sodium excretion, and decreased SBP without body weight reduction. These effects were similar to those observed with SG. Conclusions: SG increases proUGN secretion from the small intestine, leading to increased blood concentration. This inhibits NHE3 activity in the proximal tubules, promotes natriuresis and reduces BP. Full article

Background: Arterial hypertension is highly prevalent among patients with chronic kidney disease (CKD), acting both as a cause and consequence of declining kidney function, and significantly increasing cardiovascular risk. Among modifiable risk factors, diet—particularly excessive sodium intake—plays a central role in the prevention and personalized management of CKD. Methods: This study aimed to develop an innovative, digitally accessible tool to estimate sodium intake in stages 3 to 5 CKD patients, using 24-h urinary sodium excretion as the reference standard. Results: Twenty-five clinical, biological, therapeutic, and dietary variables were collected from 493 patients followed across 6 French centers. A probabilistic Tree-Augmented Naive Bayes model was used to develop the tool based on the 15 most informative variables. The model demonstrated an internal accuracy of 71%, indicating that predicted and observed sodium intake categories matched in 71% of cases. Conclusions: This AI-based prediction model offers a promising clinical tool to estimate daily sodium intake in patients with stages 3 to 5 CKD. However, external validation using independent national and international datasets is essential to establish its robustness and generalizability prior to implementation in routine clinical practice. Full article