What is the consequence of worsening renal function in patients on digoxin?

Worsening renal function in patients taking digoxin can lead to increased digoxin levels in the bloodstream. This is primarily due to the fact that renal clearance is a significant pathway for digoxin elimination. As kidney function declines, the body's ability to excrete digoxin diminishes, resulting in elevated drug levels.

This situation can be particularly concerning because elevated digoxin levels can lead to toxicity, which presents with symptoms such as nausea, vomiting, arrhythmias, and confusion. Therefore, monitoring renal function is crucial in managing patients on digoxin therapy to avert the potential complications associated with increased drug levels.