A recent study published in the European Heart Journal has validated the effectiveness of the natriuretic response prediction equation (NRPE) to predict the oral diuretic response in outpatients with heart failure (HF). The NRPE was based on a urine sample taken two hours after diuretic administration to predict natriuresis.

Researchers evaluated the NRPE in two cohorts, i.e., the Mechanisms of Diuretic Resistance (MDR) study and the TRANSFORM-Mechanism study. In the MDR cohort of 237 patients with 318 oral diuretic administrations, the NRPE accurately predicted poor natriuretic response, with an area under the curve (AUC) of 0.87. Similarly, in the TRANSFORM-Mechanism study, involving 110 oral administrations, the NRPE showed strong predictive accuracy (AUC 0.89).

Self-assessment of the patients about diuretic response was unreliable, with an AUC of just 0.57. It was significantly worse than NRPE predictions.