Natriuretic Response Prediction Equation (NRPE)
Predicts the natriuretic response to intravenous loop diuretics.
Calculate using urine sodium and creatinine from a spot urine sample collected 1–2 hours after the loop diuretic dose.
Advice
Interpret results within the clinical context and use in conjunction with sound judgment and specialist expertise.
Management
Poor response (≤50 mmol):
- Escalate therapy by:
- Increasing loop diuretic dose.
- Adding sequential nephron blockade (e.g., thiazide-type diuretic).
- Consider adjuncts (e.g., acetazolamide) or ultrafiltration if refractory.
Suboptimal response (50.1–100 mmol):
- Optimize medical therapy by:
- Adjusting diuretic dose and/or frequency.
- Adding a synergistic diuretic.
- Reassess volume/sodium intake.
Excellent response (>100 mmol):
- Continue current regimen.
- Monitor for over-diuresis and renal function.