PAH clearance

Para-aminohippurate (PAH) clearance is a method used in renal physiology to measure renal plasma flow, which is a measure of renal function.

PAH clearance
Parameter Value
renal blood flow RBF = 1000 mL/min
hematocrit HCT = 40%
glomerular filtration rate GFR = 120 mL/min
renal plasma flow RPF = 600 mL/min
filtration fraction FF = 20%
urine flow rate V = 1 mL/min
Sodium Inulin Creatinine PAH
SNa = 150 mEq/L SIn = 1 mg/mL SCr = 0.01 mg/mL SPAH =
UNa = 710 mEq/L UIn = 150 mg/mL UCr = 1.25 mg/mL UPAH =
CNa = 5 mL/min CIn = 150 mL/min CCr = 125 mL/min CPAH = 420 mL/min
ER = 90%
ERPF = 540 mL/min
Purposemeasure renal plasma flow

PAH is completely removed from blood that passes through the kidneys (PAH undergoes both glomerular filtration and tubular secretion), and therefore the rate at which the kidneys can clear PAH from the blood reflects total renal plasma flow.

The concentration of PAH is measured in one arterial blood sample (PPAH) and one urine sample(UPAH). The urine flow (V) is also measured. Renal perfusion flow is then calculated by:

What is calculated is the effective renal plasma flow (eRPF). However, since the renal extraction ratio of PAH almost equals 1, then eRPF almost equals RPF.

Precision

The renal extraction ratio of PAH in a normal individual is approximately 0.92,[1] and thus not exactly 1.0. Thus, this method usually underestimates RPF by approximately 10%. This margin of error is generally acceptable considering the ease with which eRPF is measured.

See also

References
  1. Reubi FC (September 1953). "Glomerular filtration rate, renal blood flow and blood viscosity during and after diabetic coma". Circulation Research. 1 (5): 410–3. doi:10.1161/01.res.1.5.410. PMID 13082682.
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