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Would you consider using acetazolamide to manage glomerular hyperfiltration in patients with type 1 diabetes, since SGLT2 inhibitors are contraindicated in this population?

Ginsburg et al., PMID 39466253
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Would you consider using acetazolamide to manage glomerular hyperfiltration in patients with type 1 diabetes, since SGLT2 inhibitors are contraindicated in this population?

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2 Answers
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Nephrology · Rush Medical College
Answered on

Clever idea, but I think it is a bit much to assume that increased Na delivery from carbonic anhydrase blockade proximally would have the same renoprotective effect as an SGLT2i. So, no, I would not do this. However, I admire anyone thinking outside the box!

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Nephrology · Penn Medicine Cherry Hill
Answered on

I would probably not jump to use acetazolamide in type 1 diabetes based on this study. I would want to see more data on effect on proteinuria, electrolytes, and GFR over time. Too preliminary but something to explore.

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