The Renal Excretion of Digitoxin in the Acute and Chronic Cardiac Patient

The renal excretion of digitoxin was studied in cardiac patients who were (1) decompensated and (2) compensated. It was found that the renal excretion of digitoxin was not changed in patients suffering from left ventricular failure alone but diminished considerably during the first 24 hours of decompensation in patients suffering from both right and left ventricular failure. Patients who were maintained in a good state of compensation by adequate digitalization were found to excrete 30 to 40 per cent of their daily dose of digitoxin. Patients overdigitalized were found to excrete 70 or more micrograms of digitoxin a day. The maximal amount of digitoxin able to be destroyed in the body was considered to be approximately 50 µg. per day, a finding which explains why dosages in excess of 0.15 mg. almost invariably lead to overdigitalization.