Don’t digitalise a dead kidney


End stage renal failure is often accompanied by cardiovascular disease, and this group of patients may be on digoxin for control of atrial fibrillation. Digoxin toxicity is already known to be worsened by hypokalaemia, and renal failure tends to make electrolyte control difficult. A new study from JASN points out how bad digoxin in renal failure can be.

The study of over 120,000 patients with end stage renal failure (although it was retrospective), just being on digoxin had a hazard ratio of 1.28 for death, and higher levels resulted in almost a 20% jump in mortality for each nanogram per millilitre increase, with potassium again being critical.

Renal failure is common, digoxin is common – may be they shouldn’t be together. Read more about the problem here.



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