Observation on the direct effect of digoxin on renal excretion of sodium and water

The effect of oral digoxin on sodium excretion, renin-angiotensin-aldosterone system and blood pressure in normotensive subjects

“…Several studies have demonstrated the extracardiac effects of infused glycosides (Farber et al, 1951;Hyman et al, 1956;Hook, 1969;Covit et al, 1983; Control' Digoxin Control Strickler & Kessler, 1961; Mason & Braunwald, 1964;Williams et al, 1958;Robinson et al, 1983), but there is little information on the extracardiac effects of digitalis glycosides given orally to normal man. In our study, a high dose of digoxin given orally for 5 days to normotensive subjects did not change sodium excretion.…”

“…He found a dose-related natriuresis and, concomitantly, a doserelated depression of Na+-K+-ATPase obtained from the renal cortex, supporting the view that inhibition of renal Na+-K+-ATPase could be responsible for the natriuretic response that was seen. Hyman et al (1956) injected digoxin directly into one renal artery of a dog and observed an increase in water and sodium excretion from the injected kidney. Strickler & Kessler (1961) injected several cardiac glycosides into one renal artery ofdogs, but found that only certain cardiac glycosides caused a natriuresis.…”

“…Digoxin and ouabain are known to cause a natriuresis when given intra-arterially or intravenously in animals and in men (Farber et al, 1951;Hyman et al, 1956;Hook, 1969), to increase vascular reactivity ofisolated arterial preparations (Flaim & DiPette, 1979;Mikkelsen et al, 1979), to increase sympathetic activity in vitro (Toda, 1980;Aarhus et al, 1983) and to cause inhibition of renin secretion both in vitro (Churchill, 1979) and in vivo (Covit et al, 1983). We, therefore, investigated the effects of digoxin given orally for 5 days to normotensive subjects, on sodium excretion, blood pressure, plasma renin activity and aldosterone.…”

Effects of Cardiac Glycosides on Renal Tubular Transport of Calcium, Magnesium, Inorganic Phosphate, and Glucose in the Dog*

“…In respect to the kidney, a number of studies have shown that when these drugs are infused into one renal artery, the resultant inhibition of renal tubular function is manifested by a profound ipsilateral natriuresis, chloruresis, and diuresis (10)(11)(12). Cade, Shalhoub, Cannessa-Fischer, and Pitts (13) observed that this renal response in the dog was associated with a diminished capacity to excrete potassium and to maintain a steep hydrogen ion concentration gradient.…”

The Heart and Digitalis

“…A new and interesting observation (Hyman et al, 1956) is that the injection of 0.06 mg. of digoxin or more into one renal artery in the dog can produce a diuresis from that kidney alone: Cahill (1962) has reviewed the subject and thinks that digitalis directly inhibits the ion transport system in the proximal renal tubule. This interference with the reabsorption of filtered sodium has been analysed by Strickler and Kessler (1961), who found that this action, out of nine glycosides examined, was possessed only by those digitalis steroids which act on the heart.…”