Toxicant-induced renal failure, role

DIGOXIN NS AIDS Diclofenac, indometacin and possibly fenbufen, ibuprofen and tiaprofenic acid t plasma concentrations of digoxin and t risk of precipitating cardiac failure and renal dysfunction Uncertain postulated that NSAID-induced renal impairment plays a role however, since all NSAIDs have this effect, it is not understood why only certain NSAIDs actually influence digoxin levels Monitor renal function closely. Monitor digoxin levels watch for digoxin toxicity... 

In summary, monitoring changes in the creatinine clearance or directly measuring the GFR using markers that are not acted upon by the tubule are the best tools to detect early drug-induced renal toxicity in patients with a normal baseline creatinine concentration. Serial monitoring of the serum creatinine concentration is usually adequate in those chronic failure patients whose creatinine is already increased. The role of other endogenous compounds such as cystatin C as a way to monitor renal function is not yet known. 

---