W’asaabo te dɛn? Momma yɛnhwehwɛ mu denam (eGFR) sɔhwɛ no so!

So woahu botae bi a wɔfrɛ no `(eGFR)` wɔ mogya mu nhwehwɛmu amanneɛbɔ so pɛn? Ebia oduruyɛfo bi aka eyi ho asɛm akyerɛ wo. Ɛwom sɛ ebia ɛbɛyɛ te sɛ nea ɛyɛ den kakra ma nnipa pii de, nanso nokwarem no, `(eGFR)` yɛ sɔhwɛ a ɛnyɛ den a ɛkyerɛ yɛn nsɛm a ɛho hia pii fa yɛn asaabo akwahosan ho. Enti, ɛnnɛ yɛbɛka nneɛma pii ho asɛm wɔ nsɛm a ɛnyɛ den mu, te sɛ nea `(eGFR)` yɛ, nea ebetumi aka akyerɛ yɛn, ne onii ko a ɛho hia ma.

Dɛn ne asaabo? Dɛn na `(eGFR)` kyerɛ ankasa?

Sɛ yɛbɛka no tiawa a, yɛn asaabo te sɛ nneɛma nketenkete abien a wɔde yiyi mu wɔ yɛn nipadua mu. Eyinom wɔ nneɛma nketenkete afoforo ɔpepem pii a wɔde yiyi nneɛma mu a wɔfrɛ no `(glomeruli)`. Eyinom na wɔyiyi nwura ne awuduru a yɛmpɛ a ɛwɔ yɛn mogya mu no na afei woyi fi mu sɛ nsu. Fa no sɛ ɛte sɛ nsu a wɔde yiyi nsu mu a ɛhohoro nsu ho.

Afei, saa `Estimated Glomerular Filtration Rate (eGFR)` yi yɛ boɔ a ɛkyerɛ mogya dodoɔ a wɔde filters a wɔfrɛ no `(glomeruli)` a ɛwɔ w'asaabo mu no tew ho simma biara, sɛ wɔde toto wo nipadua kɛseɛ ho. Mpɛn pii no, sɛ woyɛ mogya mu nhwehwɛmu a, wunya saa `(eGFR)` botae yi sɛ `(basic metabolic panel)` no fã.

Saa `(eGFR)` botae yi ho hia yiye ma nnuruyɛfo sɛ wobehu sɛ ebia ɔhaw bi wɔ w'asaabo ho, titiriw asaabo mu yare . Yɛn asaabo yɛ ade a ɛho hia yiye wɔ nsu a yɛde fa nsu mu no mu . Sɛ asaabo mu yare ba a, ahoɔhare a saa afiri yi de tew mogya no ho no so tew. Afei, awuduru a epira fi ase boaboa ano wɔ mogya no mu.

Nea ɛyɛ awerɛhow no, ebia asaabo mu yare ho sɛnkyerɛnne te sɛ nsu a wɔtaa tow ne ntini a ɛyɛ mmerɛw no renna adi kosi sɛ asaabo no bɛhwere wɔn dwumadi bɛyɛ 40%. Ɛno nti na eGFR sɔhwɛ no ho hia no. Etumi hu yare no ntɛm na efi ase sa yare ma asaabo no sɛe brɛoo anaasɛ egyae.

Hena na saa `(eGFR)` sɔhwɛ yi ho hia kɛse ma?

Nnuruyɛfo de eGFR nhwehwɛmu no di dwuma de hwɛ sɛ ebia asaabo mu yare afi ase anaa, ne sɛnea wɔde hu yare no fã a ɛwɔ obi a ɔwɔ asaabo mu yare dedaw mu.

Nnipa a wɔwɔ akwahosan tebea horow bi wɔ asiane kɛse mu sɛ wobenya asaabo mu haw ahorow. Sɛ wowɔ saa tebea horow yi bi, anaasɛ worenom nnuru ama a, wo duruyɛfo betumi de eGFR nhwehwɛmu ahwɛ w’asaabo akwahosan daa:

• Sɛ wowɔ awo mu dɛmdi a ɛka asaabo dwumadi a.
• Sɛ wowɔ komayare anaa komayare a .
• Sɛ wowɔ asikreyare (Diabetes Mellitus) a .
• Sɛ obi wɔ abusua no mu anya asaabo mu yare a .
• Sɛ wotaa nya ɔyare mmoawa a ɛma wo ho yɛ wo hyew (UTIs) anaasɛ wo ho siw wo nsu mu a .
• Sɛ wowɔ mogya mmoroso a .
• Sɛ wowɔ sigaretnom ho abakɔsɛm a .
• Sɛ woyɛ kɛse mmoroso a .

Ɛho hia yiye sɛ nnipa a wɔwɔ saa asiane ahorow yi hu wɔn eGFR bo a ɛsom.

Ɔkwan bɛn so na nnuruyɛfo hu saa `(eGFR)` botae yi?

Nokwarem no, nhwehwɛmu ahorow a wɔde susuw sɛnea asaabo no yi mogya (GFR) no pɛpɛɛpɛ no yɛ nea emu yɛ den yiye. Ɛno nti na wɔtaa yɛ wɔ nhwehwɛmu nkutoo so anaasɛ wɔ nsɛm titiriw bi mu, te sɛ asaabo a wɔde si ananmu no. Mmom no, nnuruyɛfoɔ de aduru bi di dwuma de hwehwɛ boɔ a wɔasusu, a wɔfrɛ no ``eGFR''. Saa aduru yi gyina nea efii wo ``serum creatinine'' mogya mu nhwehwɛmu mu bae so, ne nsɛm te sɛ wo mfe ne wo bɔbeasu .

Afei, dɛn ne saa `(serum creatinine)` mogya mu nhwehwɛmu yi ? Ɛsusu nwura bi a wɔfrɛ no `(creatinine)` dodow a ɛwɔ wo mogya mu. Yɛn nipadua no yɛ nnuru bi a wɔfrɛ no `(creatinine)`, na ɛno na ɛma yɛn ntini ahoɔden. Sɛ yɛn ntini de saa ahoɔden yi di dwuma a, ntini no mu ntini no sɛe, na awuduru bi a wɔfrɛ no `(creatinine)` fi mogya no mu. Asaabo a ɛwɔ apɔwmuden yi saa awuduru a wɔfrɛ no `(creatinine)` yi fi mogya no mu na ɛyi fi nipadua no mu bere a woreto nsuo no. Nanso, sɛ wowɔ asaabo mu yare a, saa `(creatinine)` yi tra mogya no mu na efi ase boaboa ano nkakrankakra.

Sɛ wobɛbu wo eGFR a, wo duruyɛfoɔ de biribi te sɛ National Kidney Foundation akontabuo nhyehyɛeɛ bedi dwuma. Nneɛma a edidi so yi na ɛka eyi:

• Wo creatinine dodow a ɛwɔ wo mu.
• Mfeɛ.
• Bɔbea.
• Ɔsorokɔ ne ne mu duru.
• Abusuakuw ne/anaasɛ abusuakuw (eyi nso ka akontaabu ahorow bi).

Dɛn na ɛsɛ sɛ woyɛ ansa na woayɛ `(Serum Creatinine)` mogya mu nhwehwɛmu?

Saa `(serum creatinine)` mogya mu nhwehwɛmu yi yɛ nea ɛyɛ mmerɛw yiye. Enti, ɛsɛ sɛ wudi wo duruyɛfo akwankyerɛ akyi yiye ansa na woayɛ mogya mu nhwehwɛmu. Ebia wɔbɛka akyerɛ wo sɛ di mmuada (mmuadadi) , a ɛkyerɛ sɛ wobɛnom nsu nkutoo na woanni nnuan a ɛyɛ den, bere bi ansa na wɔayɛ sɔhwɛ no. Ebia wɔbɛka akyerɛ wo nso sɛ gyae nnuru bi nom kakra.

Ade foforo nso ne sɛ ebia wo duruyɛfo nso betu wo fo sɛ kwati sɛ wubedi nam a wɔanoa da a edi nhwehwɛmu no anim. Nhwehwɛmu ahorow bi ada no adi sɛ nam a wodi betumi ama creatinine dodow akɔ soro bere tiaa bi. Enti, eye sɛ wobɛhwɛ yiye wɔ saa nneɛma yi ho na ama woanya nea efi mu ba no pɛpɛɛpɛ.

Dɛn na `(eGFR)` gyinapɛn ahorow kyerɛ?

Nnuruyɛfo susuw eGFR wɔ mililita mu simma biara, na wɔakyekyɛ mu sɛnea nipadua no ani te (mL/min/1.73m2) .

`(eGFR)` gyinapɛn ahorow betumi ayɛ soronko a egyina mfe a obi adi, ɔbarima ne ɔbea nna, ne nneɛma afoforo so. Saa bo yi so tew kakra fi awosu mu bere a yɛrenyin na yɛn ntini mu duru so tew no. Sɛ nhwɛso no, bere a sɛ wɔkyekyem pɛpɛɛpɛ a, `(eGFR)` bo a ɛsom ma obi a wadi mfe 20 no bɛyɛ 116 mL/simma/1.73m2 no, ebetumi akɔ fam akodu bɛyɛ 85 mL/simma/1.73m2 ama obi a wadi mfe 60.

Mpɛn pii no, ``eGFR'' bo a ɛboro 60 kyerɛ sɛ anyɛ yiye koraa no w'asaabo dwumadi yɛ 60%. Dodow a ɛsom bo no, dodow no ara na wobu asaabo no dwumadi yiye .

Ebia wobɛhunu `(eGFR)` botaeɛ mmienu wɔ wo amanneɛbɔ mu, baako ma abibifoɔ na baako ma abibifoɔ a wɔnyɛ abibifoɔ. Nhwehwɛmu bi ada no adi sɛ nnipa a wofi Afrika no wɔ `(creatinine)` a wɔyɛ ne wɔn ntini mu duru a ɛkɔ soro kakra sen afoforo, enti wɔn `(eGFR)` bo nso betumi ayɛ kɛse. Esiane sɛ lab no nnim wo mmusuakuw nti, ɛtɔ mmere bi a wɔde gyinapɛn abien no nyinaa mena wɔ amanneɛbɔ no mu. Nanso, ebia eyi mfata yɛn a yɛwɔ Sri Lanka no kɛse, nanso eye sɛ yebehu. Ade a ɛho hia sen biara ne sɛ wo duruyɛfo bɛkyerɛkyerɛ w’amanneɛbɔ no mu pɛpɛɛpɛ.

Abusuabɔ bɛn na ɛda eGFR ne asaabo mu yare ntam?

Sɛ wo eGFR nnu 60 asram abiɛsa a ɛtoatoa so a , wo duruyɛfo betumi ahu sɛ wowɔ asaabo mu yare a enni sabea .

Asaabo mu yare yi afã atitiriw anum na ɛwɔ hɔ:

• Ɔfã 1 (eGFR 90 anaa nea ɛboro saa): Eyi kyerɛ sɛ ebia asaabo no asɛe nketenkete, nanso asaabo no da so ara reyɛ adwuma yiye.
• Ɔfã 2 (eGFR a ɛwɔ 60 kosi 89 ntam): Eyi kyerɛ sɛ asaabo no asɛe kakra asen ɔfã 1, nanso ɛda so ara yɛ adwuma yiye.
• Ɔfã 3 (eGFR a ɛwɔ 30 kosi 59 ntam): Eyi kyerɛ sɛ asaabo dwumadi so atew. Nsɛnkyerɛnne ahorow bi betumi aba wɔ saa bere yi mu.
• Ɔfã 4 (eGFR a ɛwɔ 15 ne 29 ntam): Eyi kyerɛ sɛ asaabo no ntumi nyɛ adwuma yiye koraa, na asaabo no sɛe kɛse.
• Ɔfã 5 (eGFR nnu 15): Eyi yɛ asaabo a entumi nyɛ adwuma yiye ho sɛnkyerɛnne . Wei kyerɛ sɛ w’asaabo reyɛ adwuma nnu 15%. Saa fã yi ne nea asiane wom sen biara na ebetumi de nkwa ato asiane mu. Ebia ɛho behia sɛ wɔyɛ saa nkurɔfo yi dialysis (wɔde afiri tew mogya no ho) anaasɛ wɔde asaabo foforo ma .

Nsuro, bere a woahu saa stage yi ho asɛm pɛn no. Adeɛ a ɛho hia ne sɛ, sɛ `(eGFR)` boɔ no sua mpo a, sɛ wɔhunu no ntɛm na wɔyɛ ayaresa ne asetena mu nsakraeɛ a ɛfata a, wɔbɛtumi adi asaabo no asɛe no so kɛseɛ.

Dɛn ne sɔhwɛ ahorow a edi hɔ sɛ `(eGFR)` botae no nyɛ nea ɛfata a?

Sɛ wo eGFR no nyɛ nea ɛfata a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu yi biako anaa nea ɛboro saa de ahwɛ sɛnea asaabo no asɛe kodu na wahu nea ɛde ɔhaw no bae:

• Nsu mu nhwehwɛmu: Wɔhwɛ sɛ albumin (protein bi) ne mogya wɔ nsu mu anaa. Eyinom betumi ayɛ asaabo mu yare ho sɛnkyerɛnne a edi kan.
• Asaabo mu ultrasound anaa CT scan:Hwɛ sɛ ebia asaabo mu abo, asaabo mu kokoram, anaa ɔhaw afoforo a ɛwɔ nsu mu.
• Creatinine clearance test: Ɛkyerɛ creatinine dodow a ɛwɔ nsu ne mogya mu bere koro mu.
• Asaabo mu nhwehwɛmu: Hu asaabo mu yare ko ne sɛnea emu yɛ den yiye.

Wobegyina nsɛm a wobenya afi nhwehwɛmu ahorow yi mu so ahu ayaresa a eye sen biara a wɔde bɛma wo.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ asaabo mu yareɛ, anaa wowɔ nneɛma a ɛde asiane ba asaabo mu yareɛ a, kɔ oduruyɛfoɔ ntɛm ara sɛ wohu saa nsɛnkyerɛnneɛ yi bi a:

• Sɛ ɛho hia sɛ wotaa tow nsu, sɛ mogya wɔ wo nsu mu, anaasɛ wo nsu mu yɛ ahuru a.
• Sɛ honam ani yɛ nwunu, ɛyɛ wo yaw, anaasɛ ɛwɔ kɔla tuntum a.
• Sɛ wote nka sɛ woabrɛ kɛse a .
• Sɛ ntini no twitwiw na nipadua no te sɛ nea ɛreyɛ ayɛ mmerɛw a.
• Sɛ wowɔ akisikuru anaasɛ wofe a .
• Sɛ ɛyɛ den ma wo sɛ wobɛhome a .
• Sɛ wo nsa, wo nan, anaa wo nansoaa ho ahonhon a .

Mma w’ani ngu saa sɛnkyerɛnne ahorow yi so. Ɛho hia paa sɛ wobɛhwehwɛ aduruyɛ mu afotu ntɛm ara.

Adeɛ a ɛho hia paa - nneɛma a ɛhia sɛ yɛkae (Take-Home Message) .

Okay, enti yɛaka `(eGFR)` ho asɛm pii seesei, ɛnte saa?

Kae sɛ, sɛ wowɔ asiane mu sɛ wobɛnya asaabo mu yareɛ, anaasɛ wowɔ asaabo mu yareɛ dedaw a, ɛho hia paa sɛ wobɛhwɛ wo ``eGFR`` boɔ so daa. Eyi fa wɔn a wɔnom nnuru bi nso ho.

Sɛ wo eGFR da asaabo mu yare bi adi a, wubetumi ayɛ nneɛma bi de abɔ w’asaabo ho ban na ansɛe bio. Ebia wo duruyɛfo bɛkyerɛw nnuru a wɔde sa mogya mmoroso anaa asikreyare. Wubetumi nso ama asaabo akwahosan atu mpɔn denam wo mu duru a wobɛtew so (sɛ ɛho hia a), apɔw-mu-teɛteɛ, ne aduan a ahoɔden wom a nkyene nnim a wubedi so .

Enti, hwɛ wo `(eGFR)` botae no so. Sɛ wowɔ nsɛmmisa anaa adwenem naayɛ bi a, nsuro sɛ wubebisa wo duruyɛfo. Asaabo abien a ɛte apɔw yɛ nkɔso kɛse ma asetra a ahoɔden wom!

` Asaabo, eGFR, creatinine, asaabo mu yare, mogya mu nhwehwɛmu, akwahosan, nsu mu nhwehwɛmu