Pharmacokinetic aspects of digoxin in patients with terminal renal failure. II. On hemodialysis.

Pharmacokinetics of digoxin was studied in 9 patients during hemodialysis. All patients were treated with a short-dialysis schedule, using Gambro Lundia Major dialysers for 5 patients and Gambro Lundia Nova dialysers for 4 patients. Clearances of the dialysers and half-lives were calculated from plasma digoxin levels in blood samples taken simultaneously from arterial and venous blood lines during hemodialysis. The mean clearances of the Major and Nova were 28.3 and 21.8 ml/min respectively. During hemodialysis the mean plasma half-life was 13.8 hours with the Major and 19.1 hours with the Nova. The mean net lowering effect of hemodialysis on the plasma concentration decay line was 9.5 and 6.5% for the Major and Nova respectively. Post-dialysis plasma concentration data suggest that the rate at which digoxin returns to plasma from body tissues is the rate-controlling factor in the elimination of digoxin by the artificial kidney.