Plasma Digitalis-like Factor(s) Increase with Salt Loading

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To the Editor: Circulating endogenous digitalis-like factor or factors reactive with antibody to digoxin were first reported by Gruber et al.1 and have been highlighted by the recent report of radioimmunoassay values for digoxin of up to 4 ng per milliliter in infants not receiving digoxin.2 In adults, the level of digitalis-like factor has been reported to be 44±17 pg per milliliter of digoxin equivalents (mean ±S.D.) in normotensive subjects and 77±63 pg per milliliter in hypertensive subjects.3 It has been suggested that these levels may rise with increased salt intake, to promote natriuresis, especially in patients with essential hypertension . . .