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
Digoxin can accumulate to toxic level in patient with 
Select and explain. 
A. Renal insufficiency, B. Chronic hepatitis, C. Advanced cirrhosis, D. Chronic pancreatitis
A: Renal insufficiency
Answer: A: Renal insufficiency 
Explanation: 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.