Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure

Exclusion Criteria

• •Previous use of acetazolamide or metolazone prior to the study period.
• •Known hypersensitivity or allergies to the study drugs (acetazolamide or metolazone) or their components.
• •Patients with electrolyte disturbances, especially hypokalemia.
• •End-stage renal disease requiring dialysis or GFR \< 20 mL/min/1.73 m².
• •Pregnant or breastfeeding women.
• •Severe hypotension (systolic blood pressure \< 90 mmHg) or other significant comorbidities like congenital cardiac illness requiring surgery.
• •Patients requiring renal replacement therapy during the hospitalization.
• •History of significant electrolyte imbalances or acid-base disturbances.