ToolsCalculators
Natriuretic Response Prediction Equation (NRPE)
Predicts sodium output from a 2-hour post-diuretic spot urine sample to guide loop diuretic titration.
Natriuretic Response Prediction Equation (NRPE)
Estimated GFR (e.g., CKD-EPI)
mL/min/1.73m2
Height
Weight
Serum creatinine
mg/dL
Spot urine creatinine (~2h post-diuretic)
mg/dL
Spot urine sodium (~2h post-diuretic)
mmol/L
Complete the fields above to see the result.
When to use
- Guiding loop diuretic titration in acute decompensated heart failure using a spot urine sample obtained about 2 hours after a diuretic dose, instead of relying on fluid balance or weight.
Formula
Na output (mmol) = eGFR x (BSA/1.73) x (serum Cr / urine Cr) x 60 x 3.25 x (urine Na / 1000), where BSA is by the Du Bois formula (0.007184 x height[cm]^0.725 x weight[kg]^0.425) and 3.25 is an empiric constant converting peak instantaneous natriuresis to cumulative 6-hour output.
Pearls and pitfalls
- Derived and validated with spot urine sodium and creatinine drawn ~1-2 hours after IV loop diuretic administration.
- Used to drive nurse-protocolized diuretic up-titration (the Yale Diuretic Pathway) with improved decongestion in the original cohort.