An alternate method for estimating efferent arteriolar plasma colloid osmotic pressure

Abstract

The colloid osmotic pressure (COP) of efferent arteriolar plasma in glomerular dynamic studies generally is estimated from the measured protein concentration (CE) while the nephron filtration fraction (SNFF) is derived from CE and the systemic plasma protein concentration (CA) according to the equation SNFF = (1 - CA/CE). Estimates of both SNFF and COPE are quite sensitive to small errors in protein measurement, however, with a putative coefficient of variation of +/- 5% in protein measurement at a typical SNFF of 0.33, for example, providing an uncertainty (i.e., +/- SD) of +/- 14% in the SNFF estimate and +/- 2.4 mmHg in the estimated COPE value. In this study, we evaluated in vitro the precision with which the COP of plasma samples can be estimated after ultrafiltration by coupling direct oncometry of native plasma with isotopically measured filtration fractions derived employing nanoliter and microliter volumes and applying a modification of the equation of Ladegaard-Pedersen (Scand. J. Clin. Lab. Invest. 23: 153-158, 1969). The measured and estimated oncotic pressures were then compared. The mean differences between theoretic and measured COP values at filtration fractions of less than 0.1, 0.1-0.2, 0.2-0.3 and greater were: -0.4 +/- 0.8 (SE) (n = 22); 1.8 +/- 1.1; 3.9 +/- 1.0; and 6.0 +/- 1.7%, respectively. It is concluded that the coupling of direct oncometric measurement of arterial plasma colloid osmotic pressure with isotopically determined filtration fractions provides a satisfactory estimate of COPE that is suitable for studies of glomerular dynamics.