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D-xylose kinetics (absorption, excretion and distribution); oral (drinking water) and intravenous; 10 human patients (male/female) with impaired renal function.

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D-xylose kinetics was studied after oral administration of 25 grams D-xylose to 10 patients with impaired renal function, three of whom were being evaluated for intestinal malabsorption. The 0.32 ± 0.06 L/kg (mean ± SD) distribution volume of D-xylose in patients with uncomplicated renal impairment was larger than the value of 0.23 ± 0.04 L/kg that the authors reported previously for normal subjects (P < 0.01). Renal clearance was also reduced, averaging 87% of glomerular filtration rate estimated from creatinine clearance, so that the elimination-phase half-life was prolonged to 138 ± 39 minutes from 75 ± 11 minutes in normal individuals (P < 0.01). The 25 g oral D-xylose dose was 77.4% ± 14.8% absorbed in the patients with uncomplicated renal impairment, similar to the 69.4% ± 13.6% absorption reported in normal individuals. However, the absorption half-life was prolonged from 31 ± 12 minutes in normal subjects to a value of 62 ± 23 minutes (P < 0.02). Of the usual clinical indexes of D-xylose absorption, the serum concentration measured 1 hour after the oral dose was best correlated with the extent of D-xylose absorption (r = 0.76; P < 0.01), and the standard lower normal limit of 0.2 mg/mL was satisfactory.