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Related Experiment Video

Updated: Jun 12, 2026

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Published on: April 5, 2011

Digoxin associates with mortality in ESRD.

Kevin E Chan¹, J Michael Lazarus, Raymond M Hakim

¹Fresenius Medical Care NA, Waltham, Massachusetts, USA. kevin.chan@fmc-na.com

Journal of the American Society of Nephrology : JASN

|June 26, 2010

Summary

This summary is machine-generated.

Digoxin prescription in hemodialysis patients is linked to a higher risk of death. This increased mortality risk is particularly pronounced in patients with low predialysis potassium levels.

Related Experiment Videos

Last Updated: Jun 12, 2026

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus

Published on: April 5, 2011

Area of Science:

Nephrology
Clinical Pharmacology
Cardiology

Background:

The safety of digoxin in patients with end-stage renal disease (ESRD) is not well-established.
Hypokalemia, common in dialysis patients, may increase digoxin toxicity.
Confounding by indication is a challenge when studying digoxin's effects in ESRD.

Purpose of the Study:

To analyze the association between digoxin prescription and survival in incident hemodialysis patients.
To investigate the impact of serum digoxin levels on mortality.
To examine the interaction between digoxin, mortality, and predialysis potassium levels.

Main Methods:

Retrospective cohort study of 120,864 incident hemodialysis patients.
Use of covariate- and propensity score-adjusted Cox models.
Analysis of the association between digoxin use, serum digoxin levels, and mortality, stratified by potassium levels.

Main Results:

Digoxin use was associated with a 28% increased risk of death (HR 1.28).
Increasing serum digoxin levels correlated with higher mortality (HR 1.19 per ng/ml increase).
The mortality risk associated with digoxin levels was significantly higher in patients with low predialysis potassium (<4.3 mEq/L).

Conclusions:

Digoxin prescription in hemodialysis patients is associated with increased mortality.
Low predialysis potassium levels exacerbate the mortality risk associated with digoxin.
Careful consideration of digoxin use and potassium monitoring is crucial in hemodialysis patients.