Patients
renal impairment, AHF, dyspnea
RENAL IMPAIRMENT
The PUSH-AHF trial enrolled adult patients presenting with AHF requiring treatment with intravenous loop diuretics. Diagnosis of AHF was based on signs and symptoms, as indicated in the ESC HF guidelines, and could be either new onset or an exacerbation of known HF. The main exclusion criteria were severe renal impairment requiring ultrafiltration or dialysis, and dyspnea due to other causes. There was no ejection fraction or natriuretic peptide inclusion or exclusion criteria. The inclusion and exclusion criteria were left intentionally broad to enroll a contemporary, representative, all-comer AHF population. The full inclusion and exclusion criteria can be found in Supplementary Note All participants provided written informed consent. The ethics committee of the University Medical Center Groningen approved the study for deferred consent on the basis of the necessity of swift enrollment at the emergency department and the low-risk nature of the study and intervention, hereby allowing immediate randomization after diagnosis and before start of treatment. Deferred (written) informed consent was obtained in all enrolled patients within the first 4 days of hospitalization.