Linguistic and Cultural Adaptation and Italian Validation of the Renal iNUT, a Nutrition Screening Tool for Hospitalized Patients with Chronic Kidney Disease.

Background/aim. Malnutrition is a frequent and serious issue among patients with chronic kidney disease (CKD), often leading to worse clinical outcomes. The Renal Inpatient Nutrition Screening Tool (Renal iNUT), originally developed in the United Kingdom, provides a quick and renal-specific method for screening hospitalized CKD patients. While a Spanish version has been adapted, no validated Italian translation is currently available. This study set out to translate and culturally adapt the Renal iNUT for application in Italian clinical contexts, as well as to evaluate its psychometric properties. Methods. The adaptation followed the methodological approach described by Sousa and Rojjanasrirat, proceeding through seven structured phases to secure conceptual, linguistic, and cultural equivalence. After a pilot phase with healthcare professionals, the tool was administered to hospitalized patients with CKD to assess both inter- and intra-rater reliability. Results. Feedback from the pilot testing indicated that the Italian Renal iNUT was clear, intuitive, and easy for clinicians to use in daily practice. Psychometric testing confirmed good intra-rater reliability [Intraclass Correlation Coefficients (ICC) = 0.83; 95% Confidence Interval (CI) 0.69 - 0.91] and excellent inter-rater reliability (ICC = 0.90; 95% CI 0.82-0.95). Total scores remained stable across repeated measurements [median = 2.0; Interquartile Range (IQR) 1.0 - 3.0/2.5]. Conclusions. Overall, the Italian version of the Renal iNUT demonstrated strong reliability and practical usability, supporting its use for nutritional screening in patients with CKD. Its implementation may help promote standardized nutritional screening and early nutritional interventions in Italian hospital settings, ultimately improving the quality of care and patient outcomes for individuals with CKD.