Welcome to #TenTweetNephJC
✳️ 10 tweet #NephJC catch-up ✳️
Did you ever think of using acetazolamide for acute congestive heart failure?
Read on to see whether we should or we should not!
✳️ 10 tweet #NephJC catch-up ✳️
Did you ever think of using acetazolamide for acute congestive heart failure?
Read on to see whether we should or we should not!
2/10
What did I miss?
Can acetazolamide, a carbonic anhydrase inhibitor, improve the efficiency of loop diuretics, leading to increased & faster decongestion in patients with acute heart failure with volume overload? ADVOR looked to answer this.
nejm.org
What did I miss?
Can acetazolamide, a carbonic anhydrase inhibitor, improve the efficiency of loop diuretics, leading to increased & faster decongestion in patients with acute heart failure with volume overload? ADVOR looked to answer this.
nejm.org
3/10
1 tweet methods
✅ Multicenter, double-blind, RCT
✅ Adult patients admitted with decompensated heart failure
✅ Already on home dose of diuretics, at least 40 mg furosemide
✅ Compared addition of 500 mg IV acetazolamide (for 3 days or until decongestion) to placebo
1 tweet methods
✅ Multicenter, double-blind, RCT
✅ Adult patients admitted with decompensated heart failure
✅ Already on home dose of diuretics, at least 40 mg furosemide
✅ Compared addition of 500 mg IV acetazolamide (for 3 days or until decongestion) to placebo
4/10
1 tweet results
🔹259 patients in acetazolamide arm and 260 in placebo arm
🔹 Successful congestion by day 3 achieved in 42.2% acetazolamide arm vs 30.5% of control arm
🔹 Adverse events similar
1 tweet results
🔹259 patients in acetazolamide arm and 260 in placebo arm
🔹 Successful congestion by day 3 achieved in 42.2% acetazolamide arm vs 30.5% of control arm
🔹 Adverse events similar
5/10
A figure paints 1000 words
A figure paints 1000 words
6/10
Give me something clever to say
“Addition of acetazolamide to IV loop diuretics led to more diuresis, natriuresis, shorter hospital length of stay and higher likelihood of being discharged without signs of congestion.”
Give me something clever to say
“Addition of acetazolamide to IV loop diuretics led to more diuresis, natriuresis, shorter hospital length of stay and higher likelihood of being discharged without signs of congestion.”
7/10
Chat consensus?
1️⃣ Addition of thiazide-like diuretics & MRAs much more common - would they help just as much?
2️⃣ Adding acetazolamide may achieve the sought after “Total Nephron Blockade”!
3️⃣ Would be nice to know if acetazolamide still works when flozins on board
Chat consensus?
1️⃣ Addition of thiazide-like diuretics & MRAs much more common - would they help just as much?
2️⃣ Adding acetazolamide may achieve the sought after “Total Nephron Blockade”!
3️⃣ Would be nice to know if acetazolamide still works when flozins on board
8/10
Quote of the fortnight!
Quote of the fortnight!
9/10
I want more info
✅ Follow @FH_VErbrugge @WilfriedMullens & read👇
✅ NephJC summary by @DrPSVali & @sayalithakare
nephjc.com
✅ Tweetorial from @captainchloride
✅ VA by @Api_chew👇
I want more info
✅ Follow @FH_VErbrugge @WilfriedMullens & read👇
✅ NephJC summary by @DrPSVali & @sayalithakare
nephjc.com
✅ Tweetorial from @captainchloride
✅ VA by @Api_chew👇
10/10
Final thoughts
✳️ Great trial, evidence that acetazolamide works & can be safely used to ⬆️natriuresis. Acetazolamide status needs to be elevated!
👉 Up next - #NephTrials chat on registry based RCTs with @manasib33
nephjc.com
Tweetorial by @nephrokavitha
Final thoughts
✳️ Great trial, evidence that acetazolamide works & can be safely used to ⬆️natriuresis. Acetazolamide status needs to be elevated!
👉 Up next - #NephTrials chat on registry based RCTs with @manasib33
nephjc.com
Tweetorial by @nephrokavitha
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