BACKGROUND: Removal of excess @entity1372 and fluid is a primary therapeutic objective in acute decompensated @entity712 and commonly monitored with fluid balance and @entity353 . However, these parameters are frequently inaccurate or not collected and require a delay of several hours after diuretic administration before they are available. Accessible tools for rapid and accurate prediction of diuretic response are needed. METHODS AND RESULTS: Based on well-established renal physiological principles, an equation was derived to predict net @entity1372 output using a spot urine sample obtained 1 or 2 hours after loop diuretic administration. This equation was then prospectively validated in 50 acute decompensated @entity712 @entity1 using meticulously obtained timed 6-hour urine collections to quantify loop diuretic-induced cumulative @entity1372 output. Poor natriuretic response was defined as a cumulative @entity1372 output of <50 mmol, a threshold that would result in a positive @entity1372 balance with twice-daily diuretic dosing. Following a median dose of 3 mg (2-4 mg) of intravenous @entity11623 , 40% of the population had a poor natriuretic response. The correlation between measured and predicted @entity1372 output was excellent (r=0.91; P<0.0001). Poor natriuretic response could be accurately predicted with the @entity1372 prediction equation (area under the curve =0.95, 95% confidence interval 0.89-1.0; P<0.0001). Clinically recorded net fluid output had a weaker correlation (r=0.66; P<0.001) and lesser ability to predict poor natriuretic response (area under the curve =0.76, 95% confidence interval 0.63-0.89; P=0.002). CONCLUSIONS: In @entity1 being treated for acute decompensated @entity712 , poor natriuretic response can be predicted soon after diuretic administration with excellent accuracy using a spot urine sample.

Rapid and Highly Accurate Prediction of Poor Loop Diuretic Natriuretic Response in XXXX With @entity712 .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity1372 :: ('MESH:D012964', 'Chemical') :: ['sodium'] @entity11623 :: ('MESH:D002034', 'Chemical') :: ['bumetanide']
@entity1 :: (9606,Species) :: ['Patients']
