XAD-4 resin hemoperfusion for digitoxic patients with renal failure

In normal subjects the major route of digoxin elimination is renal, with digoxin clearance approximating glomerular filtration rate; the maintenance of good renal perfusion and urine flow is vital for the resolution of digoxin toxicity. In subjects with renal failure digoxin half-life is much prolonged [1] and digoxin toxicity can be protracted. We report the clinical course and characteristics of XAD-4 hemoperfusion in three patients with renal failure and refractory manifestations of digoxin toxicity.