Evidence map›Paper›PMID 38265601›Full record

SynthesisJournal of nephrology2024

Acetazolamide for acute kidney injury in patients undergoing high dose methotrexate therapy: a systematic review and meta-analysis.

Hong Hieu Truong, Swetha Reddy, Mariam Charkviani, Nasrin Nikravangolsefid, Jacob Ninan, Leslie Hassett, Kianoush Banaei Kashani, Juan Pablo Domecq

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Beyond SGLT2: proximal tubule transporters as potential drug targets for chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hong Hieu TruongDivision of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-6846-8369
Swetha ReddyDivision of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
Mariam CharkvianiDivision of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA.
Nasrin NikravangolsefidDivision of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA.
Jacob NinanMultiCare Capital Medical Center, Olympia, WA, USA.
Leslie HassettMayo Clinic Lỉbraries, Mayo Clinic, Rochester, MN, USA.
Kianoush Banaei KashaniDivision of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
Juan Pablo DomecqDivision of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA. domecq.juan@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUrine alkalization is one of the standard treatments to prevent acute kidney injury in patients receiving high-dose methotrexate. Carbonic anhydrase inhibitors are promising adjuvants/substitutes with advantages such as faster urine alkalization time and prevention of fluid overload. However, there is limited and contradictory evidence on its efficacy and safety. We aimed to compare the efficacy and safety of carbonic anhydrase inhibitors to standard treatments in adult patients receiving high-dose methotrexate.

methodsThe protocol was registered at PROSPERO (CRD42022352802) in August 2021. We evaluated the use of carbonic anhydrase inhibitors in combination with standard treatment compared to standard treatment alone. We excluded articles irrelevant to the efficacy and safety of acetazolamide in patients receiving high dose methotrexate and/or did not provide sufficient data regarding doses, recruitment criteria, and follow-up period. Two authors performed the data extraction independently.

resultsAmong 198 articles retrieved, six observational studies met all eligibility criteria. Four studies with five datasets (totaling 558 patients/cycles) had enough data to be included in the meta-analysis. We independently report the results from the two remaining studies. The results did not show a significant difference between acetazolamide versus standard treatment in acute kidney injury (AKI) rate (OR = 0.79, 95% CI 0.48-1.29, P = 0.34, I

conclusionsThis systematic review showed no significant difference between acetazolamide and standard care treatment regarding urine alkalinization time and AKI rate in adult patients receiving high dose methotrexate. We suggest performing a large blinded, randomized, controlled trial to evaluate the potential benefits of this low-cost medication.

Indexed as

AcetazolamideAcute Kidney InjuryCarbonic Anhydrase InhibitorsMethotrexateHumansTreatment OutcomeAcetazolamideCarbonic Anhydrase InhibitorsMethotrexateAcetazolamideAcute kidney injuryHigh dose methotrexateMeta-analysis

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.