Effect of Acetazolamide on Diuresis and Natriuresis in Patients With Acute Heart Failure (SANDI STUDY)

Prior treatment

• Maintenance treatment with acetazolamide/ Treatment with acetazolamide in the month prior to inclusion in the study.
• Concurrent diagnosis of acute coronary syndrome.

Other illness

• Type 1 diabetes mellitus
• History of congenital heart disease requiring surgical correction.
• History of cardiac transplantation and/or ventricular assist device.
• Sulfonamide allergy, liver cirrhosis, renal lithiasis.

Lab values

• GFR \< 20 ml/min/m2 or renal replacement therapy/ultrafiltration at any time prior to the study.
• Serum potassium less than 3.5 mEq/L.

Other

• Systolic blood pressure \<90 mmHg or mean arterial pressure \< 65 mmHg.
• Anticipated need for intravenous inotropes, vasopressors or nitroprusside during the study.
• Contraindication to ISGLT2.
• Anticipated exposure to nephrotoxic agents, such as iodinated contrast during admission.
• Pregnant or breastfeeding patients.
• Inability to adequately collect diuresis.
• Venous pH \<7.30
• Severe aortic stenosis or obstructive hypertrophic cardiomyopathy.

• Patients admitted for acute heart failure and ≥ 1 clinical sign of volume overload (edema, ascites, or pleural effusion).
• NTproBNP levels \>1000 pg/mL or BNP \>250 ng/mL on admission.
• Under treatment with furosemide and iSGLT2 according to European guidelines and indication of association of another diuretic due to residual congestion data defined by ADVOR SCORE\>1.