Sodium and potassium changes during decongestion with acetazolamide – A pre‐specified analysis from the ADVOR trial

Aims Acetazolamide, an inhibitor of proximal tubular sodium reabsorption, leads to more effective decongestion in acute heart failure (AHF). It is unknown whether acetazolamide alters serum sodium and potassium levels on top of loop diuretics and if baseline values modify the treatment effect of ace...

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Bibliographic Details
Published in:European journal of heart failure 2023-08, Vol.25 (8), p.1310-1319
Main Authors: Dhont, Sebastiaan, Martens, Pieter, Meekers, Evelyne, Dauw, Jeroen, Verbrugge, Frederik H., Nijst, Petra, Maaten, Jozine M., Damman, Kevin, Mebazaa, Alexandre, Filippatos, Gerasimos, Ruschitzka, Frank, Tang, W.H. Wilson, Dupont, Matthias, Mullens, Wilfried
Format: Article
Language:English
Subjects:
Acetazolamide
Acute heart failure
Decongestion
Hypokalaemia
Hyponatraemia
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Summary:Aims Acetazolamide, an inhibitor of proximal tubular sodium reabsorption, leads to more effective decongestion in acute heart failure (AHF). It is unknown whether acetazolamide alters serum sodium and potassium levels on top of loop diuretics and if baseline values modify the treatment effect of acetazolamide. Methods and results This is a pre‐specified sub‐analysis of the ADVOR trial that randomized 519 patients with AHF and volume overload in a 1:1 ratio to intravenous acetazolamide or matching placebo on top of standardized intravenous loop diuretics. Mean potassium and sodium levels at randomization were 4.2 ± 0.6 and 139 ± 4 mmol/L in the acetazolamide arm versus 4.2 ± 0.6 and 140 ± 4 mmol/L in the placebo arm. Hypokalaemia (
ISSN:1388-9842
1879-0844
DOI:10.1002/ejhf.2863