Acetazolamide and Spironolactone to Increase Natriuresis in Congestive Heart Failure

Exclusion Criteria

• •History of cardiac transplantation and/or ventricular assist device
• •Concurrent diagnosis of an acute coronary syndrome defined as typical chest pain and/or electrocardiographic changes in addition to a troponin rise \>99th percentile
• •Mean arterial blood pressure \<65 mmHg, or systolic blood pressure \<90 mmHg at the moment of admission
• •Use of intravenous inotropes, vasopressors or nitroprusside at any time point during the study
• •A baseline estimated glomerular filtration rate \<15 mL/min/1.73m² according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula at the moment of inclusion
• •Use of renal replacement therapy or ultrafiltration before study inclusion
• •Treatment with acetazolamide within the previous month
• •Treatment with ≥2 mg bumetanide or an equivalent dose during the index hospitalization before randomization
• •Use of diuretics, vasopressin antagonists or mineralocorticoid receptor antagonist not specified by the protocol
• •Exposure to nephrotoxic agents (i.e. contrast dye) anticipated within 3 days