Discover and read the best of Twitter Threads about #acetazolamide

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Read our latest analysis from the #ADVOR trial @JACCJournals. Deeper dive into the relationship of #natriuresis with decongestion & clinical outcomes after diuretic therapy in acute #heartfailure! Tweetorial below...

authors.elsevier.com/a/1h4wr2d9GHwT…

@PieterMartensMD @WilfriedMullens
First, look at detailed #ADVOR protocol below:
onlinelibrary.wiley.com/doi/full/10.10…

We did 2 consecutive urine collections:
1. Randomization => First morning (<24 h)
2. First morning => Second morning (=24 h)

If in those 2 collections, cumulative urine output <3.5 L ➡️ Failed decongestion! Image
Allocation to #acetazolamide clearly increased:
✅total urine output (+12.6%)
✅total natriuresis (+26.9%)

In relative terms: effect on natriuresis > urine output, UO🚫significant after 1st diuretic dose, natriuresis remained high!

*Normalized UO to 24 h for collection 1. Image
Read 20 tweets
Really proud moment for me today, presenting 1st time in a Featured Science session @AHAScience.

Deeper insight in #ADVOR trial with key contributions from @WilfriedMullens @PieterMartensMD @JeroenDauw @petra_nijst @EvelyneMeekers among many others. Proudly 🇧🇪!
Tweetorial below!
From #ADVOR population, we included 462 or 89% of patients with 2 correctly performed consecutive urine collections and urine sodium concentration (UNa) available.

Natriuresis:
- UNa [mmol/L] ~ diuretic efficiency
- Total natriuresis [mmol] ~ ECV & interstitial Na buffer removed
#Acetazolamide, after multivariate adjustment, was strongest predictor of #natriuresis in #ADVOR:
UNa + 16 mmol/L
Total natriuresis +115 mmol

👊 within 2 days !!!
👍 much stronger than effect on urine output itself

"#acetazolamide keeps the urine salted"
Read 9 tweets
For those who can't get enough from #ADVOR, below the promised Tweetorial!

Acetazolamide in acute #HeartFailure w volume overload on background high-dose loop diuretics:
👍Increases diuresis & natriuresis
👍More euvolemia after 3 days & discharge
👍⬇️LOS
#ESCCongress #Cardiology
First, the unsung hero's of this trial, done with a little bit over 2 million €, bargain for largest diuretic #RCT ever!
@KatrienTartagl2 & her team, with only 3FTE, they ran the most successful trial in #AHF
@PieterMartensMD & @JeroenDauw who did most fieldwork
👏
How did we come up with the idea? Actually, cause we all love #physiology. Credits go to Prof. Em. Paul Steels who teached us all how kidneys work.
@GLW_UHasselt

65% of sodium is reabsorbed in the proximal tubules, can be up to 85% in #HeartFailure
Read 12 tweets

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