Which condition is metolazone primarily indicated for?

Metolazone is primarily indicated for the treatment of heart failure, especially when fluid overload is present. It is a thiazide-like diuretic that enhances the elimination of sodium and water from the body, which helps reduce edema and improve symptoms associated with heart failure. Although metolazone can have effects on blood pressure and may indirectly help in managing hypertension, its primary use in the context of heart failure makes it particularly useful in patients who have resistant edema, often in combination with loop diuretics.

In chronic kidney disease, although metolazone may have some utility, it is typically not the primary choice for renal failure itself. Its role is more supportive in the management of fluid overload that can occur in patients with heart failure. For hypertension, it can be used but is not the primary indication as other medications specifically target high blood pressure more effectively. Diabetes does not directly relate to metolazone's primary indications; instead, management for diabetes focuses on glucose control rather than diuresis. Thus, among the choices, the condition for which metolazone is primarily indicated is indeed heart failure.