The result of a glomerular filtration rate (GFR) measurement on a particular patient is of limited use to the referring physician since normal GFR values vary widely with the patient's age and build, etc. To overcome this problem, it is usual to normalise the measured GFR by dividing it by the patient's surface area and multiplying the result by the surface area of a 'standard' man. This transforms the measurement onto a scale which applies to all patients, young and old, large and small, where normal values fall within a well-defined range and where the degree of renal impairment can be quantified. We have examined the generally accepted surface area (SA) and the less well-known extracellular volume (ECV) normalisation methods of GFR measurements in a series of 110 patients. The results show that both methods produce essentially the same result; however, ECV normalisation is theoretically more correct, can be found directly without the patient's ECV being measured and does not require the use of empirical formulae. Mathematical justification for ECV normalisation is presented, and a proposed distribution pattern for the normalised measurement is introduced. A simple mathematical model shows that accurate GFR measurements can be made in the presence of an enlarged ECV, but normalisation of these will produce misleading low values.

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We have modified an experimental technique in which two different isotopes (Cr51 and I125) were used simultaneously as blood markers for determining the amount of blood removed by feeding ticks. This method enables us to measure separately and directly the volumes of red blood cells and plasma in ticks and to calculate the ratio between the two parameters (concentrating ability). The concentration of red blood cells in nymphs of Amblyomma hebraeum Kock and Rhipicephalus appendiculatus Neumann and in females of these species plus in those of Hyalomma truncatum Kock were found to be twice the amount measured in the labeled blood of goats. Concentrations of plasma in the ticks were approximately two-thirds of that measured in samples taken directly from these same goats. Small nonsignificant differences between the ability of various tick species to concentrate red blood cells and dilute host plasma were found. The advantage of this method is compared with that of the colorimetric and gravimetric methods, and its potential use is discussed.