This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Cardiovascular system, Subject name: Pharmacology
[{'content': 'Digoxin can accumulate to toxic level in patient with \nSelect and explain. \nA. Renal insufficiency, B. Chronic hepatitis, C. Advanced cirrhosis, D. Chronic pancreatitis', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Refer kDT 7/e 497 Digoxin incompletely distributes across the placental barrier. Most of the digoxin is eliminated unchanged by the kidneys. ... Renal failure also decreases the clearance of digoxin, and may cause accumulation to toxic levels if dosage is not adapted thoroughly.', 'role': 'assistant'}]