Serum Urea and Creatinine Levels are Better Predictors of Mortality than Serum Potassium
Levels in Chronic Digoxin Toxicity.
Digoxin is a cardiotonic drug that produces positive inotropic, negative chronotropic
and negative dromotropic effects by sodium-potassium ATPase inhibition.
The most important factor limiting its use is its narrow therapeutic index.
Though digoxin use has decreased in the last few decades, the number of digoxin
toxicity cases has not decreased accordingly Compared with acute digoxin toxicity, chronic
digoxin toxicity is more frequent.
The majority of these patients are diagnosed and treated in the emergency departments where
they initially present. Therefore, it is important for emergency physicians to predict the prognosis
of patients with chronic digoxin toxicity.
Hyperpotassemia is the most common electrolyte abnormality observed in digoxin toxicity
and is associated with poor prognosis. Especially in acute digoxin poisoning, hyperpotassemia
has critical importance.
In addition to elevated serum potassium (K+) levels, increased serum creatinine
and urea levels have also been reported to be cardiotoxic. However, the effect of potassium,
creatinine and urea elevation on the clinical course of chronic
digoxin poisoning has not been fully elucidated.
Our aim in this study was to investigate the relationship between serum urea,
creatinine and potassium levels and mortality in patients with chronic digoxin toxicity.
This retrospective study was conducted between June 2010 and May 2015
at a tertiary urban ED with an annual admission rate of nearly 200,000. Ethical
committee approval was waived due to the retrospective nature of the study.
Emerg Med Open J. 2018; 4(1): 5-9. doi: 10.17140/EMOJ-4-147
