Key result
Continuous venovenous hemodialysis successfully decreased digoxin levels in a patient with digoxin toxicity and severe acute kidney injury without the use of digoxin-specific Fab antibodies.
Why the study?
Standard hemodialysis and peritoneal dialysis are considered ineffective for digoxin removal, leaving limited options for patients with digoxin toxicity and severe renal dysfunction who cannot access digoxin-Fab antibody.
Does continuous venovenous hemodialysis reduce digoxin levels in a patient with digoxin toxicity and severe acute kidney injury?
Case Report (n=1)
Does continuous venovenous hemodialysis reduce digoxin levels in a patient with digoxin toxicity and severe acute kidney injury?
Continuous venovenous hemodialysis may be an effective alternative for digoxin removal in patients with toxicity and severe renal dysfunction when Fab antibodies are unavailable.
May support CVVHD for digoxin removal in toxicity with severe AKI when Fab unavailable; leaves open need for prospective validation before practice change.
Digoxin is a cardiac glycoside that is used for the treatment of heart failure and atrial fibrillation. Besides its careful close follow-up, toxicity affects nearly 1% of congestive heart failure patients. Cessation of the drug, appropriate electrolyte and rhythm control and digoxin-Fab antibody are the mainstay for toxicity treatment in these patients. As known, hemodialysis and peritoneal dialysis are not effective by the means of digoxin removal. We present a 66-year-old patient who admitted to hospital with digoxin toxicity and severe acute kidney injury. The patient was treated with continuous venovenous hemodialysis because of her hypervolemia, hyperkalemia, cardiac instability, and the thought of probable decrease in digoxin levels concerning the continuous nature of solute clearance. Without the treatment using digoxin-specific Fab antibodies, the patient's digoxin level was decreased successfully with continuous venovenous hemodialysis. In conclusion, continuous venovenous hemodialysis may be a treatment option in digoxin toxicity especially those who suffer from severe renal dysfunction and cannot access digoxin antidote.
No takes yet. Share an insight, caveat, or question.
Gökalp et al. (2020) conducted a case report in Digoxin toxicity and severe acute kidney injury (n=1). Continuous venovenous hemodialysis was evaluated on Decrease in digoxin level. Continuous venovenous hemodialysis successfully decreased digoxin levels in a patient with digoxin toxicity and severe acute kidney injury without the use of digoxin-specific Fab antibodies.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: