Potential Effects of Digoxin on Renal Functions in Patients With Congestive Heart Failure

Introduction: Renal dysfunction is a common complication among patients with congestive heart failure (CHF) and can significantly impact their management, especially when medications like digoxin are involved. The clearance of digoxin is closely tied to the glomerular filtration rate (GFR), which suggests that the safety and efficacy of digoxin may vary with renal function. Therefore, this study aimed to assess the potential effects of digoxin on renal function in patients diagnosed with CHF at a tertiary hospital in the Asir region of Saudi Arabia. Methods: A retrospective study examined the records of 30 CHF patients treated with digoxin. Renal function markers like estimated GFR (eGFR), creatinine, blood urea nitrogen (BUN), albumin, and urine levels were compared before and after digoxin treatment. Liver enzymes and other relevant parameters were also examined. A statistical analysis using t-tests was conducted to evaluate the changes in renal function indicators before and after digoxin treatment. Results: The mean eGFR decreased significantly from 65.4 +/- 8.9 mL/min/1.73m2 before digoxin to 57.7 +/- 7.8 mL/min/1.73m2 after (p = 0.001). Creatinine, BUN, albumin, and urine levels showed no significant changes. Digoxin significantly increased aspartate aminotransferase (AST) from 34.5 +/- 11.6 U/L to 53.8 +/- 14.6 U/L (p = 0.002), alanine aminotransferase (ALT) from 38.5 +/- 12.6 U/L to 55.3 +/- 17.6 U/L (p = 0.013), and creatine kinase from 117.7 +/- 22.5 U/L to 133.9 +/- 15.8 U/L (p = 0.012). Hemoglobin decreased significantly from 12.8 +/- 1.4 g/dL to 12.1 +/- 1.4 g/dL (p = 0.034). No significant changes occurred in myoglobin, troponin, bilirubin, platelets, potassium, calcium, or chloride levels. Effects on kidney function did not differ significantly by gender or age, except blood urea nitrogen was higher in patients over 50 years (8.3 +/- 2.3 vs. 5.6 +/- 2.7 mg/dL, p = 0.015). Conclusion: This study suggests digoxin may adversely affect renal function in CHF patients, as evidenced by reduced eGFR. However, the small retrospective design limits definitive conclusions. Further prospective research with larger samples is warranted to elucidate digoxin's renal effects in CHF patients.