So w’asaabo wɔ apɔwmuden? Momma yensua Kidney Function Tests ho ade wɔ ɔkwan a ɛnyɛ den so!

So woasusuw ho pɛn sɛ ebia yɛn asaabo te sɛ afiri a wɔde yiyi mu anaa? Yiw, ɛyɛ nokware. Saa asaabo abien yi yɛ adwuma kɛse de yi nwura fi yɛn nipadua mu na ɛma yɛn nipadua no nya apɔwmuden. Enti, ɛnnɛ yɛrebɛka nhwehwɛmu a wɔyɛ de hu sɛ saa asaabo yi reyɛ adwuma yiye anaa. Yɛfrɛ saa asaabo dwumadie nhwehwɛmu yi, anaa wɔ Borɔfo kasa mu no `(Kidney Function Tests)`. Ɛtɔ da bi a wɔsan frɛ eyinom `(Renal Function Tests)`. Mma ɛnhaw wo, eyi yɛ mmerɛw yiye. Ma yɛnhwɛ nea eyinom yɛ.

Dɛn ne asaabo? Dwuma bɛn na wodi wɔ yɛn nipadua mu?

Sɛ yɛbɛka no tiawa a, asaabo yɛ yɛn nsu a yɛde tow nsu mu no fã. Nnipa dodow no ara wɔ asaabo abien. Wɔwɔ yɛn yafunu akyi, yɛn akyi berɛmo no afã abien no nyinaa, wɔ yɛn mpampam ase pɛɛ. Wɔn nsusuwii te sɛ bankye nnua abien.

Adwuma a akwaa nketewa abien yi yɛ no yɛ nwonwa. Susuw ho hwɛ:

• Nneɛma a wɔsɛe no a wɔyi fi mu: Ɛboa ma yɛyi nneɛma a yɛmpɛ ne nwura a ɛwɔ yɛn mogya mu no fi nipadua no mu sɛ nsuo. Saa filtration adwuma yi, filters nketenkete a wɔfrɛ no `(Glomeruli)` a ɛwɔ asaabo mu titiriw na ɛyɛ.
• Nsu ne nkyene a ɛkari pɛ wɔ nipadua no mu: Asaabo boa ma nsu dodow a ɛfata wɔ yɛn nipadua mu, ne nkyene a ɛho hia (electrolytes) te sɛ sodium ne potassium nso kɔ so tra hɔ.
• Hormone a wɔyɛ:
• Ɛma hormone ahorow a ɛhwɛ yɛn mogya mmoroso so.
• Asaabo no yɛ hormone bi a wɔfrɛ no ``Erythropoietin'', a ɛboa ma mogya mu nkwammoaa kɔkɔɔ yɛ. Mogya mu nkwammoaa kɔkɔɔ ne nea ɛde mframa pa kɔ nipadua no mu nyinaa.
• Asaabo no nso boa ma vitamin D a ɛboa ma nnompe ne ntini ahorow nya apɔwmuden no yɛ adwuma.

Woahu, ɛmfa ho sɛ asaabo no sua no, ɛyɛ adwuma kɛse!

Dɛn nti na ɛsɛ sɛ yɛyɛ Asaabo Dwumadi Ho Nhwehwɛmu?

Nyarewa bi wɔ hɔ, sɛ nhwɛso no, asikreyare anaa mogya mmoroso, a ebetumi aka yɛn asaabo dwumadi. Sɛ wowɔ tebea a ɛte saa a, ebia wo duruyɛfo bɛkamfo asaabo mu nhwehwɛmu yi akyerɛ na ama woahwɛ sɛnea w’asaabo no te.

Afei nso, sɛ wowɔ sɛnkyerɛnne bi a ɛkyerɛ sɛ wowɔ asaabo mu haw a, wobetumi aka akyerɛ wo nso sɛ wɔnyɛ nhwehwɛmu ahorow yi. Dɛn ne sɛnkyerɛnne ahorow yi?

• Mogya a ɛwɔ nsu mu (Hematuria) .
• Nsu a ɛyɛ ahurututu (eyi betumi akyerɛ sɛ proteinuria) .
• Ɛyaw anaa ɔhyew a ɛba bere a woretow nsu (Dysuria) .
• Ɛho hia sɛ wɔtaa tow nsu
• Oliguria (nsu a ɛba fam pii sen sɛnea wɔhwɛɛ kwan) .
• Sɛ wote nka sɛ wo ho nyɛ wo dɛ bere a woafi ase reto nsu no
• Nipadua a ɛho ahonhon, titiriw nsa, anan, ne nansoaa (Edema) .
• Ɔbrɛ kɛse a wɔte nka (Ɔbrɛ) .
• Akisikuru ne ɔfe
• Akɔnnɔ

Sɛ wowɔ saa sɛnkyerɛnne yi mu biako anaa nea ɛboro saa a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu.

Dɛn ne asaabo dwumadi ho nhwehwɛmu ahorow yi?

Ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ nhwehwɛmu biako anaa nea ɛboro saa. Yebetumi akyekyɛ eyinom mu akuw atitiriw abien: mogya mu nhwehwɛmu ne nsu mu nhwehwɛmu.

Mogya mu Nhwehwɛmu

Eyinom ne mogya mu nhwehwɛmu a wɔtaa yɛ no bi:

• Mogya mu Urea Nitrogen (BUN): Eyi kyerɛ nitrogen dodow a ɛwɔ wo mogya mu. Saa nitrogen yi yɛ bere a protein a yedi no yam na ɛpaapae no.
• GFR a wɔabu akontaa (eGFR): Eyi yɛ sɔhwɛ a ɛho hia yiye. Ɛsusu sɛnea w’asaabo yi wo mogya mu yiye (`(Filtration Rate)`), na esusuw nneɛma te sɛ protein dodow a ɛwɔ wo mogya mu, mfe a woadi, ɔbarima anaa ɔbea (`(Ɔbarima ne ɔbea nna)`), wo tenten, ne wo mu duru ho.
• Serum Creatinine: Eyi kyerɛ sɛnea nneɛma a wɔsɛe no a wɔfrɛ no ``Creatinine'' wɔ wo mogya mu no dodow. Saa nwura a wɔfrɛ no ``Creatinine'' yi yɛ bere a yɛn ntini mu ntini no asɛe no.

Nsuo mu Nhwehwɛmu

Ebia oduruyɛfo no nso bɛka akyerɛ wo sɛ sɔ nsu a wɔaboaboa ano wɔ nnɔnhwerew 24 mu no ahwɛ.

• Microalbuminuria: Eyi hwehwɛ protein bi a wɔfrɛ no `(Albumin)` pɔtee wɔ wo nsu mu. Asaabo a ɛte apɔw no nyɛ saa `(Albumin)` protein yi kakraa bi pɛ wɔ nsu mu.
• Nsu mu nhwehwɛmu: Eyi yɛ nsu mu nhwehwɛmu a wɔyɛ no nyinaa. Ɛhwɛ wo nsu mu sɛ ebia nneɛma te sɛ mogya, protein, nsu mu acid, tumi pɔtee a ɛtwe ade ba fam, ne sɛ ebia nneɛma nketenkete a ɛte sɛ ntini (casts) ne ahwehwɛ wɔ hɔ anaa.

Yɛyɛ dɛn siesie yɛn ho ma sɔhwɛ ahorow yi?

Ɔkwan a ɛsɛ sɛ wofa so siesie wo ho no bɛsono a egyina sɔhwɛ ko a wɔreka akyerɛ wo sɛ yɛ so.

Sɛ woreyɛ wo mogya mu nhwehwɛmu a, susuw nneɛma yi ho:

• Ebia mogya mu nhwehwɛmu bi bɛhwehwɛ sɛ wudi mmuada nnɔnhwerew pii. Wo duruyɛfo no bedi kan abɔ wo amanneɛ wɔ eyi ho.
• Ma wo nsa ho were no nyɛ nwini sɛnea ɛbɛyɛ a ɛnyɛ den sɛ phlebotomist no betumi de ade no ahyɛ mu.
• Sɛ wowɔ suro a ɛfa nnade ho (`(Trypanophobia)`) a, di kan ka kyerɛ wo duruyɛfo anaa onipa a ɔretwe wo mogya no. Afei wɔbɛma wo akwankyerɛ a ɛfa sɛnea wobɛma wo ho adwo wo bere a wɔreyɛ oprehyɛn no.

Sɛ woreyɛ wo nsu mu nhwehwɛmu a, mpɛn pii no wunhia ahosiesie pii.

• Nom nsu kuruwa biako pɛ foforo ansa na woayɛ sɔhwɛ no. Eyi bɛma ayɛ mmerɛw sɛ wɔbɛma wɔanya nsu a ɛdɔɔso a wɔde bɛyɛ nhwehwɛmu no.
• Sɛ worekɔ brayɛ mu a, ɛbɛyɛ papa sɛ wobɛka eyi nso ho asɛm akyerɛ wo duruyɛfo, efisɛ mogya a ɛba brayɛ mu ne nsu a ɛba wo awotwaa mu betumi aka nea ebefi mu aba no.

Dɛn na ɛba bere a wɔreyɛ sɔhwɛ no?

Eyi nso yɛ adeyɛ a ɛyɛ mmerɛw yiye.

Ɔkwan bɛn so na wɔyɛ nsu mu nhwehwɛmu? (Titiriw nnɔnhwerew 24 a wɔde gye nsu) .

Sɛ wowɔ nnɔnhwerew 24 nhwehwɛmu a wɔde gye nsu a, wubetumi ayɛ wɔ fie. Wo duruyɛfo bɛma wo ade titiriw bi a wode bɛboaboa wo nsu ano.

1. Da a wɔbɛyɛ sɔhwɛ no, ade a edi kan anɔpa sɛ wosɔre a, tow wo ho gu tiafi mu sɛnea wotaa yɛ no. Mmommoa nsu no.

2. Afei da mũ no nyinaa, bere biara a wobɛtow nsu no, fa nsu gu toa a wɔde ama no mu.

3. Ade kyee anɔpa no, boaboa nsu a wode gu toa koro no ara mu no ano.

4. Afei fa nsu a wɔde yɛ nhwehwɛmu no kɔ oduruyɛfo adwumayɛbea anaa lab.

Nsu mu nhwehwɛmu a wɔtaa yɛ no hwehwɛ sɛ wɔde nsu bi bɛka kuruwa ketewaa bi a aduruyɛdan no de ama ho ara kwa.

Ɔkwan bɛn so na wɔyɛ mogya mu nhwehwɛmu?

Sɛ wobɛyɛ mogya mu nhwehwɛmu a, ɛsɛ sɛ wokɔ oduruyɛfo adwumayɛbea anaa lab. Ɛhɔ no, phlebotomist (oduruyɛfo a wɔatete no) de ade ketewaa bi twe mogya kakraa bi, mpɛn pii no efi ntini bi a ɛwɔ wo nsa mu. Eyi gye simma kakraa bi. Ebia wobɛte nka sɛ woabɔ wo kakra, nanso ɛnyɛ yaw kɛse.

Wɔ nnipa binom fam no, mogya a wɔde ma no betumi ayɛ nea ɛnyɛ dɛ kakra. Ɛno yɛ ade a ɛfata. Nanso nhwehwɛmu ahorow yi ho hia yiye sɛ wubehu w’asaabo akwahosan ho asɛm. Nnuruyɛfo nim eyi, enti wɔbɛboa wo ma woayɛ eyi ntɛm sɛnea wubetumi.

Dɛn na wubetumi ahwɛ kwan wɔ sɔhwɛ no akyi?

Asaabo dwumadi ho nhwehwɛmu nyɛ mmerɛw na ɛnyɛ asiane biara a ɛtra hɔ kyɛ. Nanso, nnipa binom betumi anya nea edidi so yi bere a wɔde mogya ama akyi:

• Ebia ade no bɛbɔ kakra wɔ baabi a wɔde hyɛɛ mu no.
• Ebia wobɛte nka sɛ wo ho ayɛ wo yaw kakra.
• Ebia nnipa binom bɛte nka sɛ wɔabrɛ kakra.

Sɛ saa sɛnkyerɛnne ahorow yi kɔ so, anaasɛ wuhu biribi foforo a ɛyɛ soronko a , ɛbɛyɛ papa sɛ wo ne oduruyɛfo bɛkasa.

Dɛn na sɔhwɛ mu aba yi ka?

Eyi ne ɔfã a ɛho hia sen biara. Saa nhwehwɛmu mu aba yi ne nea ɛkyerɛ wo sɛ w’asaabo reyɛ adwuma sɛnea wɔhwɛ kwan no anaa. Asaabo mu nhwehwɛmu dodow no ara twe adwene si susuw atitiriw abien so: `eGFR` (Estimated Glomerular Filtration Rate) ne `uACR` (Urine Albumin-Creatinine Ratio).

Dɛn ne eGFR (Glomerular Filtration Rate a Wɔabu akontaa)?

`eGFR` susuw mogya dodow a w’asaabo yiyi simma biara (wɔ mililita mu).

• Sɛ wɔkyekyem pɛpɛɛpɛ a , `eGFR` bo a ɛsom ma ɔpanyin yɛ 100 anaa nea ɛboro saa a .
• Sɛ `eGFR` boɔ no yɛ 60 ne 100 ntam a, ɛkyerɛ sɛ ebia asaabo no asɛe kakra, nanso asaabo no da so ara reyɛ adwuma yie.
• EGFR bo a ennu 60 betumi akyerɛ sɛ asaabo mu yare a enni sabea (CKD) wɔ hɔ.

Ɔkwan bɛn so na `eGFR` botae no sesa bere a obi adi no?

Bere a yɛrenyin no, yɛn eGFR so tew kakra fi awosu mu. Eyi betumi aba sɛ wunni asaabo mu yare a enni sabea mpo a. eGFR gyinapɛn ahorow a wɔtaa de di dwuma ma mfe ahorow ni:

• Mfe 20-29: Sɛ wɔkyekyem pɛpɛɛpɛ a, eGFR bo yɛ 116
• Mfe 30-39: Sɛ wɔkyekyem pɛpɛɛpɛ a, eGFR bo yɛ 107
• Mfe 40-49: Sɛ wɔkyekyem pɛpɛɛpɛ a, eGFR bo yɛ 99
• Mfe 50-59: Sɛ wɔkyekyem pɛpɛɛpɛ a, eGFR bo yɛ 93
• Mfe 60-69: Sɛ wɔkyekyem pɛpɛɛpɛ a, eGFR bo yɛ 85
• Mfeɛ 70+: Sɛ wɔkyekyɛ mu a, eGFR boɔ yɛ 75

Eyinom yɛ gyinapɛn ahorow a wɔkyekyem pɛpɛɛpɛ ara kwa. Wo ne wo duruyɛfo nkasa na woahu nea wo eGFR yɛ ankasa.

Dɛn ne uACR (Nsuo mu Albumin ne Creatinine Nkyɛmu)?

`uACR` susuw dodow a `(Albumin)` (protein bi) ne `(Creatinine)` (ade a wɔsɛe no) dodow a ɛwɔ wo nsu mu. Ɛyɛ saa abien yi nsusuwii na wɔhwɛ (wɔ miligram mu wɔ gram biara mu - mg/g).

• Ɛsɛ sɛ `uACR` bo a ɛfata no nnu 30 mg/g.

uACR bo no korɔn dɛn, dodow no ara na asiane a ɛwɔ hɔ sɛ asaabo no bedi nkogu no yɛ kɛse?

Sɛ `uACR` boɔ yɛ 300 mg/g anaa nea ɛboro saa a, ɛkyerɛ sɛ wowɔ asiane kɛseɛ paa sɛ asaaboɔ bɛdi nkoguo. Afei nso, asiane a ɛwɔ hɔ sɛ obi benya komayare `(Myocardial Infarction)` anaasɛ akisikuru `(Stroke)` nso yɛ kɛse.

Bere tenten ahe na egye ansa na wɔahu nea efi mu ba?

Eyi betumi ayɛ soronko wɔ mmeae ahorow. Ɛtɔ da bi a, oduruyɛfo no ne wo bɛkasa afa nea ebefi mu aba no ho da koro no ara. Anaasɛ, wobetumi de nhwɛsode no akɔ lab na nea ebefi mu aba no betumi agye nna kakraa bi.

Na sɛ nea efi mu ba no da asaabo mu yare ho sɛnkyerɛnne a edi kan adi nso ɛ?

Nha wo ho. Sɛ w’asaabo mu nhwehwɛmu no da asaabo mu yare ho sɛnkyerɛnne adi ntɛm a, wo duruyɛfo no ne wo bɛkasa afa nea ɛsɛ sɛ woyɛ akyi ne ayaresa a wubetumi apaw ho. Ebia wɔbɛma wo nnuru a ekum mogya mmoroso na ama woatumi asiw wo mogya mmoroso ano. Wobetumi nso de wo akɔ oduruyɛfo a ne ho akokwaw wɔ asaabo mu yare (asaabo ho ɔyaresafo) nkyɛn.

Sɛ nea efi mu ba no nyɛ nea wɔhwɛ kwan anaasɛ ɛnyɛ nea ɛfata a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ asaabo mu nhwehwɛmu mpɛn pii daakye de ahwɛ w’akwahosan ne tebea biara a ɛhyɛ ase.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Sɛ wowɔ asaabo mu yare a enni sabea (CKD), anaasɛ wowɔ asiane mu sɛ wubenya CKD a, kɔ oduruyɛfo nkyɛn ntɛm ara sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a:

• Nsu a wɔde fa nsu mu sen sɛnea wɔtaa yɛ
• Mogya a ɛwɔ nsu mu
• Nsu a ɛyɛ ahurututu
• Ɔbrɛ kɛse a wɔte nka
• Ntini mu yaw anaa ɛyaw
• Akisikuru anaa ɔfe
• Ɔhome a ɛyɛ den (Dyspnea) .
• Ɛhohoro, titiriw wɔ nsa, anan, anaa anansoaa mu

So nsu a wɔnom betumi atew creatinine so? - so wei ye nokore?

Eyi yɛ asɛm a nnipa pii bisa. Sɛ wonom nsu pii ansa na woayɛ asaabo mu mogya mu nhwehwɛmu a, ebia ɛbɛyɛ te sɛ nea wo creatinine dodow bɛkɔ fam kakra bere tiaa bi. Nanso, eyi bɛka sɔhwɛ no mu aba bere tiaa bi pɛ.Ɛho hia sɛ yɛkae sɛ nsu pii a wɔnom no ntumi nsan asaabo a asɛe no bio anaasɛ ennya nkɛntɛnso pa bere tenten wɔ creatinine dodow so.

Sɛ wowɔ asaabo mu yare a enni sabea (CKD) a ɛba ntɛm a, ɛbɛyɛ papa sɛ wo ne asaabo ho ɔyaresafo ne adwene mu aduan ho ɔbenfo bɛyɛ adwuma na ama woanya aduan a ɛfata asaabo.

Nea etwa to no, nneɛma kakraa bi a ɛsɛ sɛ wode sie w’adwenem (Take-Home Message) .

Asaabo dwumadi ho nhwehwɛmu betumi ayɛ nea ɛnyɛ dɛ kakra na ɛyɛ hu, nanso ɛyɛ nnwinnade a ɛho hia yiye a ɛboa nnuruyɛfo ma wɔhwɛ w’asaabo akwahosan na wohu tebea horow a ɛka no.

Ɛwom sɛ ɛte sɛ nea wɔde ade ketewaa bi abɔ bere a wɔreyɛ mogya mu nhwehwɛmu de, nanso adeyɛ no nyinaa gye simma kakraa bi pɛ. Nsu mu nhwehwɛmu yɛ nhwehwɛmu a ɛnyɛ yaw a ɛnyɛ den sɛ wubetumi ayɛ wɔ fie. Sɛ ɛnyɛ wo dɛ sɛ wode wo nsuo nhwɛsoɔ bɛma wo duruyɛfoɔ a, wobɛtumi akwati ɔhaw no denam kotokuo a wode bɛhyɛ kotokuo mu na wode ama wɔn no so.

Kae sɛ, sɛ wowɔ nsɛmmisa anaa biribi a ɛhaw wo a, ntwentwɛn wo nan ase da sɛ wo ne wo duruyɛfo bɛkasa. Wɔwɔ hɔ sɛ wɔbɛboa wo. Saa nhwehwɛmu ahorow yi bɛboa ma w’asaabo anya apɔwmuden!

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