Renal interstitial pressure measured in the subcapsular space using an in vivo oncometer.

Abstract

Continuous measurements of renal interstital pressure are of importance for several reasons. The present paper describes an in vivo oncometer developed for this purpose. A piece of dialysis tubing was filled with a 0.15 M NaCl solution containing 5 g albumin 100 ml-1. For detecting the hydrostatic pressure inside the tubing, a thin catheter and a silver wire were inserted into it and both ends of the tubing were sealed with glue. The catheter and the silver wire were connected to a servo-nulling pressure device. The oncometer was then placed under the renal capsule. The pressure inside the dialysis tubing was pi onc+Psc-pi sc, and since pi onc was known, the net interstitial pressure (Pnet, i.e. Psc-pi sc) could be measured continuously in the subcapsular space. Measurements were made during (I) intravenous bolus injection of 2 ml of 0.9% NaCl, (2) saline expansion of 5% of body weight, and (3) elevation of renal venous pressure to 20 mmHg by clamping the renal vein. In the control situation, Pnet averaged-3.3 mmHg, a value in good accordance with findings in earlier studies in which the hydrostatic and oncotic pressure components have been measured separately. Following bolus injection of fluid, Pnet increased transiently by 2.6 mmHg, whereas volume expansion produced a permanent increase in Pnet of almost the same magnitude. During elevated renal venous pressure Pnet was unaffected, except for a minor increase on clamping and a minor decrease on release of the clamp. The results show that reproducible and accurate measurements of Pnet in the renal subcapsular space can be made with an in vivo oncometer.