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3/10/2026 8:21:51 AM | Browse: 0 | Download: 0
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Received |
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2026-01-04 08:26 |
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Peer-Review Started |
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2026-01-04 08:28 |
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2026-01-21 07:39 |
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2026-01-21 15:51 |
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2026-01-30 13:45 |
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Second Decision by Editor |
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2026-02-24 02:47 |
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Final Decision by Editorial Office Director |
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2026-02-24 10:18 |
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Articles in Press |
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2026-02-24 10:18 |
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Edit the Manuscript by Language Editor |
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Typeset the Manuscript |
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2026-03-03 03:52 |
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Publish the Manuscript Online |
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2026-03-10 06:59 |
| ISSN |
2308-3840 (online) |
| Open Access |
This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
| Copyright |
©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc. |
| Article Reprints |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/247
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| Permissions |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Cardiac & Cardiovascular Systems |
| Manuscript Type |
Systematic Reviews |
| Article Title |
Adjunctive pharmacologic therapies for diuretic resistance in acute decompensated heart failure: Systematic review of randomized trials
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| Manuscript Source |
Unsolicited Manuscript |
| All Author List |
Vaishvik Patel, Rabia Zameer, Beesham Kumar and Mehta Das |
| Funding Agency and Grant Number |
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| Corresponding Author |
Mehta Das, Department of Internal Medicine, Kabul Medical University, Ataturk Road, Jamal Mina, District 3, Kabul 100310, Afghanistan. mehtadas91@gmail.com |
| Key Words |
Acute decompensated heart failure; Diuretic resistance; Adjunctive pharmacologic therapy; Acetazolamide; Thiazide diuretics; Sodium-glucose cotransporter 2 inhibitors; Congestion management; Loop diuretics |
| Core Tip |
Diuretic resistance remains a major obstacle to effective decongestion in acute decompensated heart failure (HF). This systematic review synthesizes randomized controlled trial evidence evaluating adjunctive pharmacologic therapies added to loop diuretics. Therapies targeting proximal tubular sodium handling, particularly acetazolamide, consistently improve decongestion and natriuresis without excess renal risk. Thiazide diuretics, which act at the distal convoluted tubule, enhance diuretic response but increase the risk of renal dysfunction and therefore require cautious use. Sodium-glucose cotransporter 2 inhibitors offer modest diuretic effects, reduce worsening HF events, and provide benefits that are not limited by baseline kidney function. In contrast, older adjuncts such as dopamine, nesiritide, and high-dose spironolactone show no clinical benefit in overcoming acute diuretic resistance. |
| Publish Date |
2026-03-10 06:59 |
| Citation |
Patel V, Zameer R, Kumar B, Das M. Adjunctive pharmacologic therapies for diuretic resistance in acute decompensated heart failure: Systematic review of randomized trials. World J Meta-Anal 2026; 14(1): 118496 |
| URL |
https://www.wjgnet.com/2308-3840/full/v14/i1/118496.htm |
| DOI |
https://dx.doi.org/10.13105/wjma.v14.i1.118496 |
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