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Further Research Needed to Determine Safety of Digoxin in Patients on Dialysis WASHINGTON, DC -- June 24, 2010 -- For patients with kidney disease on dialysis, digoxin may lead to an increased risk of premature death, according to a study published early online and appearing in an upcoming issue of the Journal of the American Society of Nephrology. The researchers monitored more than 120,000 patients on dialysis from over 1,800 clinics across North America for up to 4 years. "We were surprised to find that digoxin use increased death risk in dialysis patients, especially in patients on higher doses," said Kevin Chan, MD, Fresenius Medical Care North America, Waltham, Massachusetts. The risk of death was 28% higher for patients on dialysis taking digoxin, after adjustment for other factors. The increase in risk was greater for patients with higher levels of digoxin in their blood and in patients who had lower serum potassium levels, which is a well-known factor that contributes to digoxin toxicity. Four percent of dialysis patients in the study were taking digoxin. "Although digoxin has been prescribed by doctors for over 200 years, widespread monitoring studies have not been conducted to examine the penetration, effectiveness, and safety of the drug among patients on dialysis," said Dr. Chan. The new and national study raises concern that digoxin could in fact be dangerous when used in patients with kidney disease who are on dialysis. However, Dr. Chan emphasises that since the study was based on clinical surveillance data, the findings cannot be considered conclusive. "Further research is needed to outline how and if digoxin can be safely prescribed in patients on haemodialysis," he said. In the meantime, Dr. Chan encourages doctors, patients, and healthcare providers to reconsider the benefits of digoxin when alternative treatments are available for heart disease in patients starting dialysis. "For patients who remain on digoxin, vigilant monitoring of digoxin and potassium blood levels can minimise the drug's possible side effects," he added. SOURCE: American Society of Nephrology E-mail this page to a friend or colleague! To print, use this version