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Digoxin-like immunoreactive substance in renal transplant patients
B J Schrader1, M S Maddux, S A Veremis
1Department of Pharmacy Practice, University of Illinois, Chicago.
Journal of Clinical Pharmacology
|December 1, 1991
Summary
Digoxin-like immunoreactive substance (DLIS) is infrequently found in renal transplant patients. Its presence is generally below therapeutic levels and resolves with established allograft function, suggesting low clinical significance.
Area of Science:
- Nephrology
- Immunology
- Clinical Chemistry
Background:
- Digoxin-like immunoreactive substance (DLIS) is detected in patients not on digoxin, including those with end-stage renal disease.
- The structure, physiological role, and post-renal transplant behavior of DLIS remain unknown.
Purpose of the Study:
- To prospectively investigate the presence and fate of DLIS in renal transplant recipients not receiving digoxin.
Main Methods:
- 163 non-digoxin-treated patients were evaluated pre- and post-renal transplantation.
- Three assays were employed: radioimmunoassay (RIA), affinity mediated immunoassay (ACA), and fluorescence polarization immunoassay (TDX).
- Serum DLIS levels and correlation with allograft function were assessed.
Main Results:
- DLIS was detected in 21% of patients across all three assays.
- Mean serum DLIS concentration was 0.41 +/- 0.13 ng/mL, often below digoxin's therapeutic range.
- DLIS persisted longer in patients with delayed allograft function (13.7 days) compared to those with immediate function (3 days).
Conclusions:
- DLIS detection in renal transplant recipients is infrequent with single assay methods.
- DLIS concentrations are typically sub-therapeutic and resolve with adequate allograft function.
- The presence of DLIS is unlikely to be clinically significant in this patient population.