Pressure-dependent PAH and creatinine transport from the brain ventricles.

Abstract

The brain ventricular system of the adult dog was perfused with an artificial cerebrospinal fluid (CSF) containing inulin, creatinine and radioactively labeled p-aminohippuric acid (PAH) and mannitol. Inflow and outflow rates and concentrations of test molecules were measured at different intraventricular pressures, allowing calculation of their steady-state rates of removal from the ventricles. Clearance of inulin, a measure of CSF bulk absorption varied nearly with intraventricular pressure (- 15 to +12 cm H2O relative to the external auditory meatus). The efflux coefficient (Ko; representing clearance of a molecule by means other than bulk absorption) for mannitol was independent of intraventricular pressure. Ko's for PAH and creatinine were pressure dependent. PAH and creatinine efflux may be related to the amount of fourth ventricular choroid plexus surface exposed to the perfusion fluid. Ko's for creatinine and PAH (46 plus or minus 4 mul/min; 34 plus or minus 4mul/min, respectively) were significantly greater than mannitol (16 plus or minus 8 mul/min) at comparable intraventricular pressures, suggesting that both creatinine and PAH leave the CSF by an active process in addition to passive diffusion.