[False results of measuring digoxin levels in patients with renal failure. Comparison of the RIA--FPIA methods]. 1990

A Jankowski, and J Karwowski, and A Marzec, and W Kretowicz, and E Nartowicz
Zakładu Biofarmacji Centrum Medycznego Kształcenia Podyplomowego w Bydgoszczy.

During last few years were reports concerning a new endogenous digoxin -like immunologic factor (DLIF) in patients not receiving digitalis. DLIF was stated in pregnant women's blood umbilical and neonatal blood as well as in patients with renal failure or hepatopathy. This phenomenon could be related to hormones changes (pregnancy) as well as alterations of cholesterol, triglycerides, free fatty acids, albumins or total protein level (nephropathy, hepatopathy). DLIF overstated determination of serum digoxin concentration, which in the case of exceptional narrow digoxin therapeutic spectrum as well as its concentration-dependent toxicity became a significant clinical problem. Effect extent of DLIF on serum digoxin level could be also related to applied analytic technics. The aim of the study was to compare two routinely applying analytic methods: polarized immunofluorescence (FPIA-TDx Abbott) with radioimmunological assay (RIA). The study was performed in patients with renal failure to estimate DLIF effect on real serum digoxin concentration as well as on extent and DLIF elimination velocity during dialysis. DLIF occurrence in patients with renal failure not receiving digitalis was experimentally stated using both RIA and FPIA methods. However, RIA revealed DLIF in all cases: before and after dialysis as well as in not dialyzed patients with a concentration above 0.3 ng/ml, when FPIA values were respectively: 0.087; 0.043; 0.078 ng/ml, which was less than 10% of digoxine therapeutic range (0.9-2.0 ng/ml). DLIF lowered in a course of dialysis to FPIA advantage, which was proved by FPIA/RIA ratio decrease nearly of a half of its predialysis value. Pre- and postdialysis values of FPIA/RIA ratio were 0,204 and 0,134 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D011863 Radioimmunoassay Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Non-immunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. Radioimmunoassays
D003951 Diagnostic Errors Incorrect or incomplete diagnoses following clinical or technical diagnostic procedures. Diagnostic Blind Spots,Errors, Diagnostic,Misdiagnosis,Blind Spot, Diagnostic,Blind Spots, Diagnostic,Diagnostic Blind Spot,Diagnostic Error,Error, Diagnostic,Misdiagnoses
D004077 Digoxin A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666) Digacin,Digitek,Digoregen,Digoxina Boehringer,Digoxine Nativelle,Dilanacin,Hemigoxine Nativelle,Lanacordin,Lanicor,Lanoxicaps,Lanoxin,Lanoxin-PG,Lenoxin,Mapluxin,Boehringer, Digoxina,Lanoxin PG,Nativelle, Digoxine,Nativelle, Hemigoxine
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016231 Fluorescence Polarization Immunoassay Fluoroimmunoassay where detection of the hapten-antibody reaction is based on measurement of the increased polarization of fluorescence-labeled hapten when it is combined with antibody. The assay is very useful for the measurement of small haptenic antigens such as drugs at low concentrations. Immunoassay, Fluorescence Polarization,Polarization Fluoroimmunoassay,Fluorescence Polarization Immunoassays,Fluoroimmunoassay, Polarization,Fluoroimmunoassays, Polarization,Immunoassays, Fluorescence Polarization,Polarization Fluoroimmunoassays,Polarization Immunoassay, Fluorescence,Polarization Immunoassays, Fluorescence

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