Key result
Adding acetazolamide to loop diuretics drives greater day 3 natriuresis and negative fluid balance in ADHF.
Why the study?
Limited data regarding the efficacy and safety of adding acetazolamide to loop diuretics have precluded its incorporation into clinical guidelines for acute decompensated heart failure.
Does adding acetazolamide to loop diuretics improve natriuresis, fluid balance, and weight loss in patients with acute decompensated heart failure?
Meta-Analysis
Does adding acetazolamide to loop diuretics improve natriuresis, fluid balance, and weight loss in patients with acute decompensated heart failure?
Effect estimate: SMD 0.68 (95% CI 0.32, 1.04)
p-value: p=0.0002
Adding acetazolamide to standard loop diuretic therapy significantly improves natriuresis and fluid balance in patients with acute decompensated heart failure without increasing adverse events.
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Supports adjunct acetazolamide for better decongestion in ADHF; reinforces consensus on loop diuretic augmentation.
Interior et al. (2025) conducted a meta-analysis in Acute decompensated heart failure (ADHF). Acetazolamide vs. Loop diuretics alone was evaluated on Natriuresis by day 3 (SMD 0.68, 95% CI 0.32, 1.04, p=0.0002). Adding acetazolamide to loop diuretics in patients with ADHF significantly increased natriuresis by day 3 (SMD 0.68; 95% CI 0.32-1.04; P=0.0002) and resulted in a more negative fluid balance.
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