Antipyrine pharmacokinetics and d-glucaric excretion in kwashiorkor

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Abstract
Hepatic microsomal oxidation and glucuronidation were studied in 15 children with kwashiorkor on admission to the hospital and again after 3 weeks of nutritional rehabilitation. Microsomal oxidation as measured by antipyrine half-life and clearance was shown to be depressed in the acute phase of malnutrition (T½ = 7.9 ± 5.0 hr, clearance = 8.4 ± 5.1 ml/min) improving with nutritional rehabilitation (T½ = 4.3 ± 2.3 hr, clearance = 15.5 ± 8.7 ml/min). Urinary d-glucaric acid excretion increased from 60.6 ± 42.2 µmoles/24 hr to 121.8 ± 105.0 µmoles/24 hr over the same time period. Evidence is thus presented that both hepatic microsomal oxidation and glucuronidation are depressed in the acute phase of kwashiorkor but recover with nutritional rehabilitation.