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Renal digoxin clearance: dependence on plasma digoxin and diuresis
European Journal of Clinical Pharmacology
|January 1, 1982
Summary
This study reveals that the kidneys reabsorb digoxin in humans, a process influenced by plasma digoxin levels and urine flow. Increased urine flow may enhance digoxin clearance, potentially aiding in managing digoxin toxicity.
Area of Science:
- Pharmacology
- Nephrology
- Drug Metabolism
Background:
- Digoxin's renal handling in humans was previously thought to involve only glomerular filtration and tubular secretion.
- Animal studies indicated glomerular filtration, tubular secretion, and tubular reabsorption of digoxin.
Purpose of the Study:
- To investigate the influence of plasma digoxin concentration and urine flow on the renal handling of digoxin in healthy human volunteers.
- To determine if tubular reabsorption of digoxin occurs in humans.
Main Methods:
- Studied 6 healthy volunteers.
- Measured plasma digoxin concentration and urine flow.
- Calculated non-glomerular renal excretion of digoxin (tubular secretion minus tubular reabsorption).
Main Results:
- Non-glomerular renal excretion of digoxin showed an inverse correlation with plasma digoxin concentration.
- Non-glomerular renal excretion of digoxin demonstrated a direct correlation with urine flow.
- Confirmed the occurrence of tubular reabsorption of digoxin in humans.
Conclusions:
- Human renal digoxin handling involves glomerular filtration, tubular secretion, and tubular reabsorption.
- Increased urine flow may enhance renal digoxin clearance.
- Findings suggest potential therapeutic implications for managing digoxin toxicity through urine flow manipulation.