Efficiency of individual dosage of digoxin with calculated concentration

Li Zhao,1,* Peng Yang,2,* Pengmei Li,1 Xiaoxing Wang,1 Wangjun Qin,1 Xianglin Zhang1 1Department of Pharmacy, 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Digoxin is a frequent...

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Autores principales:	Zhao L, Yang P, Li PM, Wang XX, Qin WJ, Zhang XL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	serum digoxin concentration predicted concentration renal insufficiency Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/625fc10f768742f681c6ab2a7edb36fd
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spelling	oai:doaj.org-article:625fc10f768742f681c6ab2a7edb36fd2021-12-02T00:31:09ZEfficiency of individual dosage of digoxin with calculated concentration1178-1998https://doaj.org/article/625fc10f768742f681c6ab2a7edb36fd2014-07-01T00:00:00Zhttps://www.dovepress.com/efficiency-of-individual-dosage-of-digoxin-with-calculated-concentrati-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Li Zhao,1,* Peng Yang,2,* Pengmei Li,1 Xiaoxing Wang,1 Wangjun Qin,1 Xianglin Zhang1 1Department of Pharmacy, 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Digoxin is a frequently prescribed drug, particularly in the elderly population, in which there is an increased prevalence of atrial fibrillation and cardiac failure. With its complex pharmacokinetic profile and narrow therapeutic index, use of digoxin requires regular monitoring of blood levels. Recent evidence suggests that a lower concentration range (0.4–1.0 ng/mL) is preferable in patients with congestive heart failure and a higher range (0.8–2.0 ng/mL) is needed in patients with atrial tachyarrhythmia. The Konishi equation is widely used to predict the serum digoxin concentration (SDC) in Japan. This study assessed the correlation between SDC predicted by the Konishi equation and that actually measured in Chinese patients and investigated the impact of renal function on SDC. Methods: The study subjects comprised 72 patients with cardiac failure or/and atrial tachyarrhythmia seen at our hospital from January 2012 to December 2013. The patients were divided into five groups according to Kidney Diseases Outcome Quality Initiative guidelines. SDCs were measured using the Abbott Architect i1000 immunology analyzer. The correlations between measured SDCs and calculated SDCs and between clearance of digoxin and creatinine clearance rate were assessed retrospectively.Results: The correlation between measured and predicted SDC calculated by the Konishi equation was significant (r=0.655, P<0.001) for the 72 patients overall; however, correlations within the different stages of renal function were nonsignificant, with a correlation found only in patients with stage 3 (30 mL per minute < creatinine clearance <60 mL per minute). With regard to the correlation between clearance of digoxin and creatinine clearance, our results show that although there was a significant correlation between clearance of digoxin and creatinine clearance in the group overall, correlations were not evident within the different stages of renal function.Conclusion: The results of this study indicate that clearance of digoxin and the creatinine clearance rate cannot be explained by renal function alone and that the validity of the Konishi equation for individualizing the digoxin dosage in Chinese patients is limited, being applicable only in stage 3 renal disease. Further research in larger numbers of patients across all stages of renal function will be required in the future to verify the original Konishi model. Keywords: serum digoxin concentration, predicted concentration, renal insufficiencyZhao LYang PLi PMWang XXQin WJZhang XLDove Medical Pressarticleserum digoxin concentrationpredicted concentrationrenal insufficiencyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1205-1210 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	serum digoxin concentration predicted concentration renal insufficiency Geriatrics RC952-954.6
spellingShingle	serum digoxin concentration predicted concentration renal insufficiency Geriatrics RC952-954.6 Zhao L Yang P Li PM Wang XX Qin WJ Zhang XL Efficiency of individual dosage of digoxin with calculated concentration
description	Li Zhao,1,* Peng Yang,2,* Pengmei Li,1 Xiaoxing Wang,1 Wangjun Qin,1 Xianglin Zhang1 1Department of Pharmacy, 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Digoxin is a frequently prescribed drug, particularly in the elderly population, in which there is an increased prevalence of atrial fibrillation and cardiac failure. With its complex pharmacokinetic profile and narrow therapeutic index, use of digoxin requires regular monitoring of blood levels. Recent evidence suggests that a lower concentration range (0.4–1.0 ng/mL) is preferable in patients with congestive heart failure and a higher range (0.8–2.0 ng/mL) is needed in patients with atrial tachyarrhythmia. The Konishi equation is widely used to predict the serum digoxin concentration (SDC) in Japan. This study assessed the correlation between SDC predicted by the Konishi equation and that actually measured in Chinese patients and investigated the impact of renal function on SDC. Methods: The study subjects comprised 72 patients with cardiac failure or/and atrial tachyarrhythmia seen at our hospital from January 2012 to December 2013. The patients were divided into five groups according to Kidney Diseases Outcome Quality Initiative guidelines. SDCs were measured using the Abbott Architect i1000 immunology analyzer. The correlations between measured SDCs and calculated SDCs and between clearance of digoxin and creatinine clearance rate were assessed retrospectively.Results: The correlation between measured and predicted SDC calculated by the Konishi equation was significant (r=0.655, P<0.001) for the 72 patients overall; however, correlations within the different stages of renal function were nonsignificant, with a correlation found only in patients with stage 3 (30 mL per minute < creatinine clearance <60 mL per minute). With regard to the correlation between clearance of digoxin and creatinine clearance, our results show that although there was a significant correlation between clearance of digoxin and creatinine clearance in the group overall, correlations were not evident within the different stages of renal function.Conclusion: The results of this study indicate that clearance of digoxin and the creatinine clearance rate cannot be explained by renal function alone and that the validity of the Konishi equation for individualizing the digoxin dosage in Chinese patients is limited, being applicable only in stage 3 renal disease. Further research in larger numbers of patients across all stages of renal function will be required in the future to verify the original Konishi model. Keywords: serum digoxin concentration, predicted concentration, renal insufficiency
format	article
author	Zhao L Yang P Li PM Wang XX Qin WJ Zhang XL
author_facet	Zhao L Yang P Li PM Wang XX Qin WJ Zhang XL
author_sort	Zhao L
title	Efficiency of individual dosage of digoxin with calculated concentration
title_short	Efficiency of individual dosage of digoxin with calculated concentration
title_full	Efficiency of individual dosage of digoxin with calculated concentration
title_fullStr	Efficiency of individual dosage of digoxin with calculated concentration
title_full_unstemmed	Efficiency of individual dosage of digoxin with calculated concentration
title_sort	efficiency of individual dosage of digoxin with calculated concentration
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/625fc10f768742f681c6ab2a7edb36fd
work_keys_str_mv	AT zhaol efficiencyofindividualdosageofdigoxinwithcalculatedconcentration AT yangp efficiencyofindividualdosageofdigoxinwithcalculatedconcentration AT lipm efficiencyofindividualdosageofdigoxinwithcalculatedconcentration AT wangxx efficiencyofindividualdosageofdigoxinwithcalculatedconcentration AT qinwj efficiencyofindividualdosageofdigoxinwithcalculatedconcentration AT zhangxl efficiencyofindividualdosageofdigoxinwithcalculatedconcentration
_version_	1718403678918934528

Efficiency of individual dosage of digoxin with calculated concentration

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