Pharmaceutisch Weekblad

, Volume 9, Issue 2, pp 75–78 | Cite as

Plasma protein binding of digitoxin and some other drugs in renal disease

  • Joseph J. H. M. Lohman
  • Frans W. H. M. Merkus
Pharmacokinetics and Organ Dysfunction


Plasma protein binding of most acidic drugs is decreased in uraemia, whereas the binding of basic drugs is usually unchanged or decreased. Decreased protein binding in patients with renal disease mainly relates to drugs binding to albumin. Digitoxin binds to a specific site on the albumin molecule. Conflicting reports exist on digitoxin-protein binding in patients with renal disease. In ten patients with end-stage renal disease treated with haemodialysis we found only a slightly increased free fraction of digitoxin. A heparin-induced increase of the free fraction of digitoxin during haemodialysis has been reported. However, this increase was caused by the generation of non-esterified fatty acidsin vitro. If thisin vitro lipolysis was blocked, no increase of free digitoxin could be detected. Alterations of digitoxin-protein binding in uraemic patients during haemodialysis and during the intervals between haemodialysis treatments are small.

Key words

Albumins Digitoxin Hemodialysis Kidney diseases Orosomucoid Protein binding 


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Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1987

Authors and Affiliations

  • Joseph J. H. M. Lohman
    • 1
  • Frans W. H. M. Merkus
    • 2
  1. 1.Department of Clinical PharmacyHospital of SittardBK SittardThe Netherlands
  2. 2.Center for Bio-Pharmaceutical SciencesState University of LeidenRA LeidenThe Netherlands

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