Key result
Oral metolazone was noninferior to IV chlorothiazide for enhancing 24-hour net urine output in patients with ADHF and loop diuretic resistance (1319.6 vs 1397.6 ml; P=0.026 for noninferiority).
Why the study?
Does oral metolazone improve 24-hour net urine output non-inferiorly to intravenous chlorothiazide in adults with acute decompensated heart failure and loop diuretic resistance?
Cohort (n=177)
No
Does oral metolazone improve 24-hour net urine output non-inferiorly to intravenous chlorothiazide in adults with acute decompensated heart failure and loop diuretic resistance?
Absolute Event Rate: 1319.6% vs 1397.6%
p-value: p=0.026 for noninferiority
Oral metolazone is a safe, effective, and cost-saving noninferior alternative to intravenous chlorothiazide for augmenting diuresis in patients with acute decompensated heart failure and loop diuretic resistance.
May support oral metolazone as convenient alternative in ADHF diuretic resistance; leaves open need for randomized confirmation.
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Shulenberger et al. (2016) conducted a cohort in Acute decompensated heart failure with loop diuretic resistance (n=177). Oral metolazone vs. Intravenous chlorothiazide was evaluated on Change in 24-hour net urine output (UOP) from before to after thiazide-type diuretic administration (p=0.026 for noninferiority). Oral metolazone was noninferior to IV chlorothiazide for enhancing 24-hour net urine output in patients with ADHF and loop diuretic resistance (1319.6 vs 1397.6 ml; P=0.026 for noninferiority).
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