Evaluation of two intravenous single-bolus methods for measuring effective renal plasma flow

This open-label, three-way crossover study examined the feasibility of measuring effective renal plasma flow (ERPF) using a single intravenous (IV) bolus method. Eight healthy young adults (four women aged 28 +/- 5 years [mean +/- SD] and four men aged 30 +/- 7 years) received on separate days an IV bolus of p-aminohippurate (PAH) 10 mg/kg, an IV bolus of phenolsulfonphthalein (PSP) 1 mg/kg, and the standard constant-rate IV infusion of PAH. The renal clearance (CLR) and plasma clearance (CLP) of PAH after constant infusion were 623.7 +/- 62.9 and 869.0 +/- 58.8 mL/min/1.73 m2, respectively. After PAH bolus injection, CLR and CLP were 538.9 +/- 110.8 and 677.6 +/- 122.4 mL/min/1.73 m2, respectively. After PSP bolus injection, CLR and CLP were 252.8 +/- 57.9 and 350.0 +/- 41.3 mL/min/1.73 m2, respectively. The ERPF measured by PSP bolus injection was significantly lower (P < 0.05) than by PAH infusion. The CLP of PAH after IV bolus injection was significantly lower than after IV infusion when men and women were analyzed together (P < 0.05). However, there appeared to be a greater magnitude of difference between the CLR after IV bolus and infusion of PAH for women than for men. In summary, PSP administered as an IV bolus injection does not appear to be a reliable marker of ERPF. The difference in ERPF determined by the PAH infusion and bolus methods may require further evaluation.