Adjunctive metolazone in critically ill children with moderate-to-severe acute kidney injury and furosemide-refractory fluid overload

The authors aimed to evaluate the efficacy of metolazone in critically ill children with moderate-to-severe acute kidney injury (AKI) who were experiencing fluid overload and were unresponsive to furosemide. The study found that metolazone treatment significantly increased urine output, and a greater increase in urine output within the first 24 hours was associated with a reduced likelihood of requiring kidney replacement therapy (KRT). These findings suggest that metolazone may be beneficial in this patient population, but further prospective studies are needed to validate the results.