{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T15:36:06Z","timestamp":1793806566336,"version":"4.6.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"37","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100019353","name":"Belgian Health Care Knowledge Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019353","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>In the ADVOR trial, acetazolamide improved decongestion in acute decompensated heart failure (ADHF). Whether the beneficial effects of acetazolamide are consistent across the entire range of renal function remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a pre-specified analysis of the ADVOR trial that randomized 519 patients with ADHF to intravenous acetazolamide or matching placebo on top of intravenous loop diuretics. The main endpoints of decongestion, diuresis, natriuresis, and clinical outcomes are assessed according to baseline renal function. Changes in renal function are evaluated between treatment arms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>On admission, median estimated glomerular filtration rate (eGFR) was 40 (30\u201352) mL\/min\/1.73 m\u00b2. Acetazolamide consistently increased the likelihood of decongestion across the entire spectrum of eGFR (P-interaction = .977). Overall, natriuresis and diuresis were higher with acetazolamide, with a higher treatment effect for patients with low eGFR (both P-interaction &amp;lt; .007). Acetazolamide was associated with a higher incidence of worsening renal function (WRF; rise in creatinine \u2265 0.3 mg\/dL) during the treatment period (40.5% vs. 18.9%; P &amp;lt; .001), but there was no difference in creatinine after 3 months (P = .565). This was not associated with a higher incidence of heart failure hospitalizations and mortality (P-interaction = .467). However, decongestion at discharge was associated with a lower incidence of adverse clinical outcomes irrespective of the onset of WRF (P-interaction = .805).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Acetazolamide is associated with a higher rate of successful decongestion across the entire range of renal function with more pronounced effects regarding natriuresis and diuresis in patients with a lower eGFR. While WRF occurred more frequently with acetazolamide, this was not associated with adverse clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>ClinicalTrials.gov Identifier<\/jats:title>\n                  <jats:p>NCT03505788.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehad557","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T16:47:58Z","timestamp":1692982078000},"page":"3672-3682","source":"Crossref","is-referenced-by-count":69,"title":["Renal function and decongestion with acetazolamide in acute decompensated heart failure: the ADVOR trial"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-0132","authenticated-orcid":false,"given":"Evelyne","family":"Meekers","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg AV , Schiepse Bos 6, 3600 Genk , Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University , Universiteitslaan, Diepenbeek , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-3450","authenticated-orcid":false,"given":"Jeroen","family":"Dauw","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences, Hasselt University , Universiteitslaan, Diepenbeek , Belgium"},{"name":"Department of Cardiology, AZ Sint-Lucas , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg AV , Schiepse Bos 6, 3600 Genk , Belgium"},{"name":"Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5615-3191","authenticated-orcid":false,"given":"Sebastiaan","family":"Dhont","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg AV , Schiepse Bos 6, 3600 Genk , Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University , Universiteitslaan, Diepenbeek , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik H","family":"Verbrugge","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Diseases, University Hospital Brussels , Jette , Belgium"},{"name":"Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Jette , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7325-7734","authenticated-orcid":false,"given":"Petra","family":"Nijst","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg AV , Schiepse Bos 6, 3600 Genk , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozine M","family":"ter Maaten","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-2228","authenticated-orcid":false,"given":"Kevin","family":"Damman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia & Critical Care, Universit\u00e9 Paris Cit\u00e9, Inserm MASCOT, APHP , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital , Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Hong Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0802-9508","authenticated-orcid":false,"given":"Matthias","family":"Dupont","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg 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