Heart failure & cardiomyopathies
Natriuretic response prediction equation for use with oral diuretics in heart failure
Authors' conclusion
Natriuretic response to an oral diuretic can be rapidly and accurately assessed with a urine sample collected 2 h after an oral diuretic dose and the NRPE.
Study context
- Population
- Patients with heart failure (HF) receiving their home oral loop diureticMechanisms of Diuretic Resistance (MDR): 318 administrations
- Participants
- 237 patients
- Comparison
- Natriuretic response prediction equation (NRPE) vs patient self-assessment for predicting poor natriuretic response to oral loop diuretics
- Outcome
- Validation of the NRPE's assessment of oral diuretic response in patients with HF
Methodological detailstwo cohorts (MDR and TRANSFORM-Mechanism)
- Two cohorts (MDR and TRANSFORM-Mechanism)
Performance
As reported in the abstract
Prediction of poor natriuretic response (cumulative natriuresis < 50 mmol), MDR cohort
| Test or model | AUC |
|---|---|
| NRPE | .87 (95% CI .83-.91) |
NRPE
AUC.87 (95% CI .83-.91)
- NRPE accuracy similar to previously validated intravenous NRPE performance
- P = 0.16
- Patient's ability to self-estimate their diuretic response was poor, AUC .57 (95% CI .44-.70), significantly worse than oral NRPE
- P < 0.001
Further findings
| Outcome | NRPE |
|---|---|
| Poor diuretic response (TRANSFORM-Mechanism cohort, 110 oral diuretic administrations) | |
| AUC | .89 (95% CI .80-1.0) |
Original publication
Natriuretic response prediction equation for use with oral diuretics in heart failure. Eur Heart J. Published 24 April 2025. doi:10.
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