
    lack of efficacy
  
['renal impairment', 'heart failure']
['mk-7145', 'furosemide', 'torsemide']

        Inclusion Criteria:

        Parts I and II

          -  If female, must be of non-child bearing potential or, if of child-bearing potential
             agrees to use at least 2 acceptable contraceptive measures

          -  Body Mass Index (BMI) >=17.5 and <=38 kg/m^2

          -  No present history of clinically significant uncontrolled arrhythmias on
             electrocardiogram (ECG)

          -  Nonsmoker or a light smoker consuming up to an average of 20 cigarettes (or equivalent
             tobacco product) per day.

        Part I Only

        - Estimated creatinine clearance of ≤45 mL/min.

        Part II Only

          -  Class II or III heart failure as specified by the New York Heart Association (NYHA)
             functional classification for heart failure with NT-proBNP >=1000 pg/mL on clinically
             optimized therapy with a stable dose (for at least 2 weeks) of furosemide or torsemide

          -  Estimated creatinine clearance of ≤45 mL/min

        Exclusion Criteria:

        Parts I and II

          -  Mentally or legally institutionalized and/or incapacitated, has significant emotional
             problems or has a history of a clinically significant psychiatric disorder over the
             last 5 years. This includes any mood disorder requiring concomitant use of lithium

          -  Diagnosed with acute coronary syndrome or acute cardiovascular (CV) event, or has been
             hospitalized for HF exacerbation within less than 3 months of study entry

          -  Unstable angina pectoris

          -  Diabetes requiring high dose peroxisome proliferator-activated receptor (PPAR)
             antagonist (e.g. >30 mg of pioglitazone) or unstable insulin use

          -  Infectious disease requiring concomitant use of aminoglycosides

          -  Low plasma potassium (hypokalemia)

          -  Recent (within 6 months) history of stroke, uncontrolled seizures, or uncontrolled
             major neurological disorder

          -  Urinary retention, hydronephrosis or hydroureter

          -  Active nephrocalcinosis, nephrolithiasis, or hypercalciuria

          -  Functional disability that can interfere with rising from a semi-recumbent position to
             the standing position

          -  History of malignant neoplastic disease

          -  Unable to refrain from the use of medication, including prescription and
             non-prescription drugs such as high-dose aspirin (≥325 mg/day), non-steroidal
             anti-inflammatory drugs (NSAIDs), human immunodeficiency virus (HIV) protease
             inhibitors (ritonavir, indinavir, nelfinavir), macrolide antibiotics (erythromycin,
             telithromycin, clarithromycin), chloramphenicol, azole antifungals (fluconazole,
             ketoconazole, itraconazole, nefazodone, aprepitant, verapamil, diltiazem, etc.),
             anticonvulsants and mood stabilizers (e.g., phenytoin, carbamazepine, oxcarbazepine),
             barbiturates (phenobarbital), HIV non-nucleoside reverse transcriptase inhibitors
             (efavirenz, nevirapine, etravirine), rifampicin, modafinil, St John's wort,
             cyproterone (antiandrogen, progestin), etc. beginning approximately 2 weeks (or 5
             half-lives), prior to administration of the initial dose of study drug, throughout the
             study (including washout intervals between treatment periods) until the poststudy
             visit

          -  Consumes excessive amounts of alcohol, defined as greater than 5 glasses of alcoholic
             beverages (1 glass is approximately equivalent to: beer [284 mL/10 ounces], wine [125
             mL/4 ounces], or distilled spirits [25 mL/1 ounce]) per day

          -  Consumes excessive amounts, defined as greater than 6 servings (1 serving is
             approximately equivalent to 120 mg of caffeine) of coffee, tea, cola, or other
             caffeinated beverages per day

          -  Had major surgery, donated or lost 1 unit of blood (approximately 500 mL) or
             participated in another investigational study within 4 weeks

          -  Regular user of any illicit drugs or has a history of drug (including alcohol) abuse
             within approximately 6 months
      