Why the study?
Does the anephric state alter the pharmacokinetics and excretion of digoxin compared to patients with normal renal function?
Does the anephric state alter the pharmacokinetics and excretion of digoxin compared to patients with normal renal function?
Anephric patients require significant reduction in digoxin maintenance doses (by one third to one half) due to prolonged half-life and reduced excretion.
Answers are grounded in this paper and cite their sources.
Supports cautious digoxin dosing in anephric patients; leaves open need for prospective validation of adjusted regimens.
Tritiated digoxin was given to 11 patients when anephric prior to renal transplant. These patients exhibited high digoxin serum levels, increased digoxin serum half-times, and reduced excretion of digoxin compared to those of patients with congestive heart failure and normal BUN and are similar in this respect to patients with severe compromise of renal function. The stool excretion of digoxin is increased in anephric patients, but this does not compensate for the lack of renal excretion of digoxin. These findings indicate the need for prudent administration of digoxin to anephric patients, as well as those with renal failure. Often the dose of digoxin may be reduced as much as one third to one half of the usual maintenance dose.
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Doherty et al. (1967) studied this question.
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