title: Steady-state extrarenal sorbitol clearance as a measure of hepatic plasma flow.
abstract: Hepatic plasma flow was assessed with sorbitol (hepatic extraction = 0.96) at steady state. After infusion of 50 mg/min for 3 h, total and renal sorbitol clearances were calculated, and the extrarenal clearance was obtained by taking the difference between the two. In normal volunteers, the mean (+/- SD) extrarenal sorbitol clearance was 10.6 +/- 2.1 ml/min.kg. In patients with various liver diseases, it was correlated more closely to the fractional clearance of indocyanine green (r = 0.83, n = 57) than the galactose elimination capacity (r = 0.66, n = 55). Hepatic vein catheterization showed that the hepatic extraction of sorbitol was always much higher than the extraction of indocyanine green; there was no evidence for extrahepatic, extrarenal sorbitol elimination. On the basis of these findings, sorbitol is kinetically superior to indocyanine green and, although the noninvasively determined extrarenal sorbitol clearance at steady state may not be equal to total hepatic plasma flow, it may at least be regarded as a measure of parenchymal liver plasma flow.
authors.affiliation: Division of Clinical Pharmacology, University of Goettingen, Federal Republic of Germany.
authors.forename: J
authors.initials: J
authors.lastname: Zeeh
authors.forename: H
authors.initials: H
authors.lastname: Lange
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: S
authors.initials: S
authors.lastname: Pohl
authors.forename: H
authors.initials: H
authors.lastname: Loesgen
authors.forename: R
authors.initials: R
authors.lastname: Eggers
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: J
authors.initials: J
authors.lastname: Chesta
authors.forename: J
authors.initials: J
authors.lastname: Bircher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D001651:Cholestasis, Extrahepatic / Q000503:physiopathology; D005260:Female; D006505:Hepatitis / Q000503:physiopathology; D006801:Humans; D007208:Indocyanine Green; D008102:Liver Circulation; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology; D008105:Liver Cirrhosis, Biliary / Q000503:physiopathology; D008107:Liver Diseases / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D013012:Sorbitol / Q000493:pharmacokinetics
chemical_list: D013012:Sorbitol; D007208:Indocyanine Green