Acetazolamide to boost urine output and sodium removal in people hospitalized with acute heart failure

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

SANDI is a prospective, multicenter observational study enrolling patients hospitalized for acute heart failure with clinical signs of volume overload across 11 hospitals in Spain. All patients receive guideline-directed IV loop diuretics and initiation of an SGLT2 inhibitor if not already on one; congestion is reassessed after 24 hours. Patients with persistent congestion (ADVOR score >1) receive IV acetazolamide 500 mg once daily for up to two days. The study measures natriuresis at 24 and 48 hours and records clinical course while encouraging standard dietary sodium and fluid limits.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* 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.

Exclusion Criteria:

* Systolic blood pressure \<90 mmHg or mean arterial pressure \< 65 mmHg.
* Maintenance treatment with acetazolamide/ Treatment with acetazolamide in the month prior to inclusion in the study.
* Anticipated need for intravenous inotropes, vasopressors or nitroprusside during the study.
* Contraindication to ISGLT2.
* Type 1 diabetes mellitus
* GFR \< 20 ml/min/m2 or renal replacement therapy/ultrafiltration at any time prior to the study.
* Anticipated exposure to nephrotoxic agents, such as iodinated contrast during admission.
* Concurrent diagnosis of acute coronary syndrome.
* History of congenital heart disease requiring surgical correction.
* History of cardiac transplantation and/or ventricular assist device.
* Pregnant or breastfeeding patients.
* Inability to adequately collect diuresis.
* Serum potassium less than 3.5 mEq/L.
* Venous pH \<7.30
* Severe aortic stenosis or obstructive hypertrophic cardiomyopathy.
* Sulfonamide allergy, liver cirrhosis, renal lithiasis.

Where it's running

• Julia González González
  Madrid, Spain Recruiting

Study contacts

• Study coordinator: Julia González González
• Email: juliagfk@gmail.com
• Phone: 0034617453693

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.