Digoxin can accumulate to toxic levels in patients with:: (A) Renal insufficiency, (B) Chronic hepatitis, (C) Advanced cirrhosis, (D) Chronic pancreatitis
Answer is A. Digoxin is primarily excreted unchanged by the kidney, mainly by glomerular filtration. Rate of excretion is altered parallel to creatinine clearance. Its  t½  is prolonged in elderly patients and in those with renal insufficiency: dose has to be reduced. 
Digoxin is a cumulative drug. When maintenance doses are given from the beginning, steady state levels and full therapeutic effect are attained after 4 x t½, i.e. 6-7 days.
Reference: Essentials of Medical Pharmacology Eighth Edition KD  TRIPATHI  page no 560