V.J. HEAZLEWOOD, M.B., B.S.; R.L. HEAZLEWOOD, M.SC.; L.B. JELLETT, B.S., M.D.
To the editor: The article by Graves and colleagues (1) raises serious implications concerning the measurement and subsequent interpretation of plasma digoxin levels in adult patients with renal failure, using radioimmunoassay and enzyme immunoassay techniques. Inherent interference problems with immunoassays may be related to the presence of as yet unspecified plasma proteins (2).
With the retention of middle molecules and elevated glycoprotein levels in renal failure, it would appear desirable to assay digoxin in such patients using a method involving protein precipitation. A new fluorescence polarization immunoassay (TDx System; Abbott Laboratories, Diagnostics Division, North Chicago, Illinois), using prior 5% trichloroacetic
HEAZLEWOOD V, HEAZLEWOOD R, JELLETT L. An Endogenous Digoxin-like Substance and Renal Failure. Ann Intern Med. 1984;100:618. doi: 10.7326/0003-4819-100-4-618_1
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Published: Ann Intern Med. 1984;100(4):618.
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