Ka yi tunanin, likitanka yana zargin kana da matsala da kodarka . Don haka, ya ce ka yi gwajin jini don duba aikin kodarka. Za ka yi mamaki idan ya gaya maka cewa adadin da ke cikin wannan rahoton ya bambanta dangane da ƙabilarka, ko ba haka ba? "Ta yaya aikin kodata ya bambanta dangane da ƙabilata?" Wataƙila kana mamaki. Wannan babbar matsala ce da ta daɗe tana faruwa a duniyar likitanci, kuma yanzu ana gyara ta. Yau za mu yi magana a kai.
Menene wannan lissafin da ke auna aikin koda?
Kodanmu kamar matatun ruwa guda biyu ne masu ƙarfi a jiki. Babban aikin kodan shine tace sharar da ba dole ba daga jini da kuma tsaftace jiki. Don haka, ɗaya daga cikin manyan ma'aunin da likitoci ke amfani da su don duba lafiyar kodan shine eGFR . Wannan yana nufin ƙimar ƙwanƙwasa ta Glomerular .
A taƙaice dai, yana auna yadda kodanku ke tsaftace jininku cikin sauri da inganci. Domin yana da wuya a auna wannan kai tsaye, muna kimanta shi ta amfani da lissafin lissafi wanda ke amfani da abubuwa kamar matakin sharar da ake kira creatinine a cikin jininku, shekarunku, da kuma jinsinku.
Rage darajar eGFR yana nuna cewa kodan ba sa aiki yadda ya kamata. Wannan ƙimar muhimmin abu ne da ke taimaka wa likitoci su yanke shawara ko mutum yana buƙatar fara dialysis ko kuma a yi masa dashen koda.
A ina matsalar ta fara? Ta yaya 'tseren' ya zama abin da ya jawo hakan?
Na ɗan lokaci, akwai wani abu mai ban mamaki a cikin wannan lissafin eGFR: 'tseren' . Amma wannan bai shafi dukkan jinsi ba. Yana aiki ne kawai idan wani ya gano a matsayin "Baƙar fata."
Wato, farar fata da baƙar fata masu shekaru iri ɗaya, jinsi, da matakin creatinine sun sami ƙimar eGFR guda biyu. Idan baƙar fata farar fata ne, lissafin ya ƙara girman wannan ƙimar ta hanyar wucin gadi.
Me ya faru? EGFR ya nuna cewa aikin koda na baƙar fata ya fi yadda yake a zahiri. Sakamakon haka, an jinkirta musu samun maganin da suke buƙata, kamar fara dialysis ko kuma sanya su cikin jerin waɗanda za a yi wa dashen koda. Wannan babban rashin adalci ne, ba a yi niyya ba.
| Tsohon lissafin eGFR (gami da launin fata) | Sabuwar lissafin eGFR (ba tare da ƙabilanci ba) |
|---|---|
| An yi la'akari da matakin creatinine, shekaru, jinsi da kuma 'kabila' (ko baƙar fata ne ko a'a) a cikin lissafin. | An cire 'Tsire' gaba ɗaya daga lissafin. Yanzu matakin creatinine, shekaru da jinsi ne kawai ake la'akari da su. |
| An nuna cewa ƙimar eGFR a cikin marasa lafiya baƙar fata ta hanyar wucin gadi an ƙara ta hanyar wucin gadi. | Yana ƙididdige eGFR ta hanyar da ta fi dacewa, ta amfani da ma'auni iri ɗaya ga marasa lafiya na dukkan ƙabilu. |
| Wannan ya haifar da rashin daidaito da jinkiri wajen rubuta magani da kuma tsara lokacin da za a yi dashen koda. | Yana taimakawa wajen rage bambancin ra'ayi a fannin tura marasa lafiya zuwa asibiti. |
Me yasa aka haɗa kalmar 'ƙasa' tun daga farko?
Wannan ya faru ne saboda binciken da aka gudanar a shekarun 1990. Wani bincike da aka gudanar a wancan lokacin (Gyaran Abinci a Cutar Koda - binciken MDRD) ya gano cewa baƙar fata suna da matakan creatinine a cikin jini fiye da fararen fata. Sun danganta wannan da wani tsohon imani, wanda yanzu aka ƙalubalanci kimiyya cewa "baƙar fata galibi suna da tsoka fiye da fararen fata."
A wancan lokacin, haɗa baƙaƙen fata a cikin bincike an ɗauke shi a matsayin babban abu, amma a yau mun fahimci cewa 'kabila' ba abu ne na halitta ba, amma gina al'umma ce.
"Lokacin da muke koya wa ɗaliban likitancinmu lissafi bisa ga launin fata, muna cusa musu ra'ayin ƙarya cewa launin fata wani abu ne da ke ƙayyade cututtuka a cikin halitta. Amma ba haka ba ne," in ji Dr. Paul Palewski, shugaban gidauniyar koda ta ƙasa.
Tafiya don gyara wannan kuskuren
Abin farin ciki, a cikin 'yan shekarun nan, ɗaliban likitanci, likitoci, likitocin jijiyoyi , da masu fafutukar kare haƙƙin marasa lafiya sun fara tambayar wannan batu. "Idan babu wani tushe na halitta game da wannan, me yasa muke mu'amala da baƙar fata da waɗanda ba baƙar fata daban?" suka tambaya.
Sakamakon haka , Gidauniyar Koda ta Ƙasa da Ƙungiyar Nazarin Cututtukan Jijiyoyi ta Amurka sun haɗu don kafa ƙungiyar aiki ta marasa lafiya, masana kimiyya, da likitoci. Sakamakon aikinsu mai kyau, a cikin 2021, an gabatar da sabbin lissafin eGFR guda biyu ga duniya wanda ya kawar da abin da ya shafi 'kabila' gaba ɗaya .
1. Daidaito na farko: Kamar tsohon, yana amfani da matakin creatinine kawai (amma ba tare da 'tseren' ba).
2. Daidaito ta biyu: Baya ga matakan creatinine, ana kuma amfani da wani alamar sinadarai mai suna cystatin C. Duk da cewa wannan ya fi daidai, ana kuma ba da shawarar daidaiton farko saboda gwajin cystatin C ba ya samuwa a duk dakunan gwaje-gwaje a duniya kuma yana da tsada.
Wannan sauyi yana faruwa cikin sauri a fannin likitanci a duk faɗin duniya. Abin farin ciki ne cewa sauyi na tsawon shekaru goma yana faruwa cikin 'yan watanni kacal.
Me yasa wannan bambancin yake da muhimmanci a gare mu?
Za ka iya tunanin, wannan matsala ce ta Amurka, me ya shafe mu? Amma magani abu ne na duniya baki ɗaya. Ci gaban kimiyya ko gyara da ke faruwa a wani ɓangare na duniya yana shafar duniya baki ɗaya.
- Maganin Adalci: Wannan yana tabbatar da haƙƙin majiyyaci, a ko'ina cikin duniya da kuma kowace ƙasa, na samun ingantaccen ganewar asali.
- Gyara kurakurai a fannin likitanci: Wannan babban misali ne na yadda magani fanni ne da ke sabunta kansa koyaushe kuma yana gyara kurakuran da ya yi.
- Sauraron muryar majiyyaci: Muryar majiyyaci ita ma ta kasance wani muhimmin abu wajen yin wannan sauyi. Wannan yana nuna muhimmancin sauraron ra'ayoyin majiyyaci, maimakon ma'aikatan lafiya su kaɗai su yanke shawara.
Ba shakka, canza wannan lissafin ba zai kawar da duk rashin daidaiton lafiya cikin dare ɗaya ba. Akwai abubuwa da yawa na zamantakewa da tattalin arziki da ke ba da gudummawa ga su. Amma wannan mataki ne mai ƙarfi da mahimmanci a wannan al'amari.
Idan kai ko wani da ka sani yana da cutar koda, ka yi magana a fili da likitanka game da gwaje-gwajen lafiyarka da maganinka. Ka tambaye su game da eGFR ɗinka, ma'anarsa, da kuma mafi kyawun hanyoyin magani a gare ka.
Saƙon Ɗauka Gida
- eGFR (ƙiyasin ƙimar tacewa ta Glomerular) muhimmin lissafi ne wanda ke auna aikin koda.
- Lissafin eGFR da aka yi amfani da shi a baya ya yi nuni da 'kabila' (musamman ga baƙar fata) a cikin lissafin, wanda ya haifar da rashin adalci da jinkiri ga marasa lafiya.
- Da fahimtar cewa 'kabila' ba abu ne na halitta ba, amma ra'ayi ne na zamantakewa, an gabatar da sabbin daidaiton eGFR masu adalci waɗanda ba su haɗa da 'kabila' ba.
- Wannan sauyi muhimmin mataki ne na rage rashin daidaito a fannin kiwon lafiya da kuma samar da adalci ga dukkan marasa lafiya.
- Idan kana da wata damuwa game da bayanan lafiyarka da maganinka, yana da matukar muhimmanci ka yi magana a fili da kuma a sarari da likitanka.
Cutar koda, eGFR, creatinine, gwajin koda, rashin daidaito a lafiya, magani, cutar koda
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