Pubertal changes in net renal tubular secretion of digoxin

Linda A. Linday, Dennis E. Drayer, Ali Khan, Cynthia Cicalese, Marcus M. Reidenberg

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


To evaluate the effect of puberty on the net renal tubular secretion of digoxin, we measured the ratio of digoxin clearance to creatinine clearance in 23 patients aged 4 to 21 yr and correlated this ratio with both sexual maturity (Tanner31 stage) and chronologlc age. All subjects were at steady-state levels for digoxin treatment; all had normal serum creatinine values for age as well as normal serum potassium levels. Mean ratio for immature children (n = 14, Tanner 1 through 3.5) was 1.45 ± 0.66. Mean ratio for mature adolescents (n = 9, Tanner 4 through 5) was 0.95 ± 0.28. The difference between the two groups was significant (P < 0.05). When patients were regrouped by age using either 13 or 15 yr as a cutoff, the difference in ratios was no longer statistically significant. Based on 45 subjects (new and from our previous study21) aged 2 mo to 80 yr, there was a significant decrease in the clearance ratio with increasing age, but when the 23 subjects aged 4 to 21 yr were analyzed separately, the correlation between ratio and age was not significant. It appears that the decrease in net renal tubular secretion of digoxin from childhood to adulthood correlates better with full sexual maturation at puberty (Tanner 4 through 5) than with chronologlc age. This observation may represent a developmental change in pharmacokinetics with broader significance than for digoxin disposition alone.

Original languageEnglish
Pages (from-to)438-446
Number of pages9
JournalClinical Pharmacology and Therapeutics
Issue number4
StatePublished - Apr 1984
Externally publishedYes


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