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Related Experiment Videos

Maturation and renal digoxin clearance

L A Linday, M A Engle, M M Reidenberg

    Clinical Pharmacology and Therapeutics
    |December 1, 1981
    PubMed
    Summary

    Digoxin clearance relative to creatinine clearance is higher in children than adults, indicating reduced renal tubular secretion at puberty. This impacts pediatric digoxin dosing and renal physiology.

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    Area of Science:

    • Pharmacology
    • Nephrology
    • Pediatrics

    Background:

    • Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
    • Renal excretion is the primary route of digoxin elimination.
    • Maturation-related changes in renal function may affect digoxin disposition.

    Purpose of the Study:

    • To investigate the impact of maturation on the renal disposition of digoxin.
    • To determine how the ratio of digoxin clearance to creatinine clearance changes with age.

    Main Methods:

    • Studied 35 patients aged 3 days to 79 years at steady-state digoxin levels.
    • Measured digoxin clearance and creatinine clearance.
    • Calculated the ratio of digoxin clearance to creatinine clearance.

    Main Results:

    • The mean digoxin clearance/creatinine clearance ratio was 1.49 in prepubertal children and infants (≥2 months).
    • The mean ratio decreased significantly to 0.82 in sexually mature adults (P < 0.005).
    • A decrease in net renal tubular secretion of digoxin was observed around puberty.

    Conclusions:

    • Renal tubular secretion of digoxin decreases at puberty.
    • This developmental change in renal tubular physiology may explain higher digoxin doses needed in children.
    • Findings suggest broader implications for understanding pediatric renal tubular function.

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