Ua ʻike anei ʻoe i kahi waiwai i kapa ʻia ʻo eGFR ke nānā ʻoe i kahi hōʻike koko? Malia paha ua haʻi aku kāu kauka iā ʻoe e pili ana i ia mea. ʻOiai he mea paʻakikī iki ia i nā poʻe he nui, he hoʻāʻo koʻikoʻi loa ia e ana i ka hana maikaʻi o ko mākou mau puʻupaʻa. I kēia lā, e kamaʻilio maʻalahi a me ke akahai mākou e pili ana i ke ʻano o kēia eGFR, kona manaʻo, a me ke ʻano o kēlā mau waiwai.
I ka ʻōlelo maʻalahi, he aha ka eGFR?
ʻO ke manaʻo piha o eGFR ʻo ia ka Estimated Glomerular Filtration Rate . Mai makaʻu, he nui nā huaʻōlelo, akā he maʻalahi loa ka moʻolelo.
E noʻonoʻo he miliona mau kānana liʻiliʻi ko loko o kou mau puʻupaʻa. Ua like lākou me kahi kānana kī. Kānana kēia mau kānana i nā huahana ʻōpala i makemake ʻole ʻia i loko o ko mākou koko, hoʻomaʻemaʻe iā ia, a laila hoʻokuke aku i kēlā mau huahana ʻōpala mai ko mākou kino i loko o ka mimi. I ka lāʻau lapaʻau, kapa mākou i kēia mau kānana liʻiliʻi he glomeruli .
No laila, ʻo eGFR kahi waiwai e helu ana i ka nui o ke koko i hoʻomaʻemaʻe ʻia i hoʻokahi minuke e kēia mau kānana i kapa ʻia ʻo glomeruli. ʻAʻole i ana pololei ʻia kēia, akā ua helu ʻia kēia waiwai (kuhikuhi ʻia) ma ke ana ʻana i ka creatinine i loko o kahi hāpana o kou koko a hoʻokomo iā ia i loko o kahi ʻano me nā mea e like me kou makahiki, ke kāne, a pēlā aku. ʻO ia ke kumu i kapa ʻia ai ʻo "Estimated" GFR.
ʻO kēia hoʻokolohua e hiki ai i nā kauka ke ʻike i nā hōʻailona mua o nā pilikia me kāu hana puʻupaʻa, ʻoiai ka maʻi puʻupaʻa mau loa (CKD) .
No ke aha e noi ai ke kauka e nānā i ka waiwai eGFR?
ʻO ka maʻamau, e nānā ʻia kāu eGFR ma ke ʻano he ʻāpana o kahi hoʻāʻo koko maʻamau, hana pinepine ʻia i kēlā me kēia makahiki. Eia kekahi, inā loaʻa iā ʻoe kekahi o nā kumu pilikia i helu ʻia ma lalo nei, hiki i kāu kauka ke ʻōlelo aku i kahi hoʻāʻo eGFR e nānā i ke olakino o kou puʻupaʻa.
- Inā loaʻa iā ʻoe ka maʻi diabetes .
- Inā he koko kiʻekiʻe kou (hypertension) .
- Inā he maʻi puʻuwai kou .
- Inā he moʻolelo maʻi puʻupaʻa ko kekahi o ka ʻohana (makuahine, makuakāne, kaikaina).
- Inā ʻoi aku ka nui o ke kino (BMI) ma mua o 25 (kaumaha nui).
- Inā loaʻa pinepine iā ʻoe nā maʻi ʻōpū mimi (UTI) a i ʻole nā mea e ālai ai ke ala mimi.
- Inā he mau maʻi hānau kou e hoʻopilikia ai i nā puʻupaʻa.
- Inā ua loaʻa iā ʻoe kahi hoʻoili puʻupaʻa.
I ia mau hihia, kiʻekiʻe ka pilikia o ka hōʻino ʻia ʻana o nā puʻupaʻa. No laila, ʻo ka pahuhopu o ke kauka ke nānā mau i ka waiwai eGFR a ʻike i nā pilikia i ka wā mua.
He aha nā Creatinine a me Cystatin C?
Ua kamaʻilio mākou e pili ana i ke ʻano o ka helu ʻana i ka eGFR. ʻO ka mea nui i hoʻohana ʻia no kēlā, ʻo ia ka creatinine.
- Creatinine: I ka ʻōlelo maʻalahi, he huahana ʻōpala kēia i hana ʻia i ka wā e hana ai ko kākou mau ʻiʻo. Ke hele mākou, holo, a hana paha i kekahi hana, hoʻohana mākou i ka ikehu o nā ʻiʻo. ʻO ka huahana ʻōpala i kapa ʻia ʻo creatinine i hana ʻia i loko o kēia kaʻina hana e hōʻiliʻili i loko o ke koko. Kānana nā puʻupaʻa olakino iā ia mai ke koko a hoʻokuʻu iā ia i loko o ka mimi. Eia naʻe , i ka wā e hana pono ʻole ai nā puʻupaʻa, hoʻomaka kēia creatinine e hōʻiliʻili i loko o ke koko ma kahi o ka kānana ʻia ʻana. ʻO ka piʻi ʻana o ka pae o ka creatinine i loko o ke koko ʻo ia hoʻi ua nāwaliwali ke kaʻina kānana o nā puʻupaʻa.
- Cystatin C: I kekahi manawa, ʻoi aku hoʻi i ka poʻe ʻelemakule a i ʻole ka poʻe me ka nui o nā ʻiʻo, ʻaʻole paha e hāʻawi ka creatinine wale nō i kahi kiʻi pololei. Hoʻopilikia ʻia nā pae Creatinine e nā mea e like me ka nui o nā ʻiʻo, ka makahiki, a me ka ʻai. I ia mau hihia, e nānā nā kauka i ka pae o kahi protein i kapa ʻia ʻo Cystatin C i loko o ke koko. Hana ʻia kēia e nā cell i loko o ko mākou kino, no laila ʻaʻohe hopena koʻikoʻi o ka nui o nā ʻiʻo.
Pono anei iaʻu e hoʻomākaukau ma mua o ka hoʻāʻo eGFR?
ʻAe. He hoʻāʻo koʻikoʻi loa kēia. No laila, no ka loaʻa ʻana o ka heluhelu pololei loa, pono ʻoe e hahai pololei i nā ʻōlelo a kāu kauka. E noi ʻia paha ʻoe e:
- E hoʻokē ʻai no kekahi mau hola (hiki iā ʻoe ke inu wai wale nō).
- E ho'ōki i ka ʻai ʻana i ka ʻiʻo i hoʻokahi a ʻelua paha lā ma mua o ka hoʻāʻo ʻana.
- E ho'ōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau āu e lawe nei no kekahi manawa (e kamaʻilio me kāu kauka e pili ana i kēia).
Inā ʻaʻole ʻoe e hahai pono i kēia mau kuhikuhi, hewa paha kāu heluhelu eGFR. No laila, e hahai pololei i nā kuhikuhi a kāu kauka. Hana pinepine ʻia ka hoʻāʻo ma ka lawe ʻana i kahi koko liʻiliʻi mai kahi aa koko ma kou lima. He hana maʻalahi ia e lawe wale i kekahi mau minuke.
He aha nā mea a nā waiwai eGFR e haʻi mai ai iā mākou? Nā hihia o ka maʻi puʻupaʻa
ʻAe, e hele kākou i nā mea nui. He aha ke ʻano o ka waiwai eGFR i loko o kāu hōʻike?
ʻO ka awelika eGFR o kahi pākeke olakino ma kahi o 100. He mea maʻamau ka emi mālie ʻana o kēia waiwai i ko kākou ʻelemakule ʻana, ʻoiai inā ʻaʻohe maʻi.
ʻO ka mea nui loa, inā noho kāu eGFR ma lalo o 60 no nā mahina ʻekolu a ʻoi , hiki i ke kauka ke ʻike iā ia he maʻi puʻupaʻa mau loa (CKD).
Ua māhele ʻia ka maʻi puʻupaʻa mau (CKD) i 5 mau pae nui e pili ana i ka eGFR. E nānā kākou i ko lākou ʻano.
| Kahua | ka waiwai eGFR | Manaʻo |
|---|---|---|
| Pae 1 | Ma luna o 90 | ʻOiai inā ua hōʻino iki ʻia nā puʻupaʻa, hana maikaʻi nō lākou a ʻaʻole hōʻike pinepine i nā hōʻailona. |
| Pae 2 | Ma waena o 60 - 89 | Ua hoʻonui iki ʻia ka pōʻino o nā puʻupaʻa, akā ke hana maikaʻi nei lākou. |
| Pae 3 | Ma waena o 30 - 59 | Ua emi nui ka hana o nā puʻupaʻa. I kēia manawa, hiki ke ʻike ʻia kekahi mau hōʻailona (e like me ka luhi a me nā wāwae pehu). |
| Pae 4 | Ma waena o 15 - 29 | Ua emi nui ka hana o nā puʻupaʻa. He maʻi koʻikoʻi kēia. |
| Pae 5 | Ma lalo o 15 | Ua kapa ʻia kēia he hāʻule ʻana o nā puʻupaʻa . Ke hana nei nā puʻupaʻa ma lalo o 15% o ka hiki. Pono ka dialysis a i ʻole ka hoʻoili puʻupaʻa e mālama i ke ola. |
He aha ka mea e hiki mai ana inā ʻano ʻē ka waiwai eGFR?
Inā haʻahaʻa kāu eGFR, e haʻi aku kāu kauka iā ʻoe ʻaʻole e hopohopo a e kauoha aku i kekahi mau hoʻokolohua hou aʻe e ʻike i ke kumu pololei.
- ʻIke mimi: Ke nānā nei kēia hoʻāʻo i ka protein (ʻoi aku ka albumin) a i ʻole ke koko i loko o ka mimi. Hiki i kēia ke lilo i mau hōʻailona mua o ka hōʻino ʻia o nā puʻupaʻa.
- ʻO ke Kidney Ultrasound/CT Scan: Kōkua kēia mau hoʻokolohua e ʻike i ka nui a me ke ʻano o nā puʻupaʻa, a inā he mau pōhaku a he mau puʻupuʻu paha.
- Biopsy Kidney: I kekahi manawa, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupaʻa a nānā ʻia ma lalo o kahi microscope. Kōkua kēia i ka hoʻoholo pono ʻana i ke ʻano o ka maʻi a me ke koʻikoʻi o ia mea.
He aha nā hōʻailona e pono ai ke ʻike ʻana i ke kauka?
ʻAʻole hōʻike pinepine ka maʻi puʻupaʻa i kekahi mau hōʻailona i nā pae mua. ʻO ia ke kumu he mea nui nā hoʻokolohua e like me eGFR. Akā i ka holomua ʻana o ka maʻi, e ʻike paha ʻoe i kēia mau mea. Inā loaʻa iā ʻoe kēia mau mea, e ʻike koke i kāu kauka.
- Manaʻo e like me ʻoe e mimi ana ma mua o ka maʻamau.
- ʻIli maloʻo a ʻānai.
- Ka luaʻi a me ka luaʻi.
- Ka pehu ʻana o nā lima, nā wāwae, a me nā kuʻekuʻe wāwae.
- Paʻakikī ka hanu ʻana.
- ʻŪmiʻi ʻiʻo.
- Ka ʻeleʻele ʻana o ka ʻili.
Hiki i kēia mau hōʻailona ke lilo i mau hōʻailona o nā maʻi ʻē aʻe. No laila, ʻoi aku ka maikaʻi o ka hopohopo ʻole a ʻimi i ke kōkua lapaʻau e hoʻoholo i ke kumu pololei.
Leka Lawe-Home
- He hoʻāʻo koko maʻalahi ka eGFR e ana i ka maikaʻi o ka hoʻomaʻemaʻe ʻana o kou mau puʻupaʻa i kou koko.
- ʻO kahi waiwai olakino ma kahi o 100. He mea maʻamau ke emi iki ʻana o kēia waiwai me ka ʻelemakule.
- Inā noho ka waiwai eGFR ma lalo o 60 no nā mahina ʻekolu a ʻoi, he hōʻailona paha ia o ka maʻi puʻupaʻa mau loa (CKD).
- He mea nui loa i ka poʻe me ka maʻi diabetes, ke koko kiʻekiʻe, ka maʻi puʻuwai, a me ka mōʻaukala ʻohana o ka maʻi puʻupaʻa e nānā mau i kā lākou eGFR.
- Inā he mau nīnau kāu e pili ana i kāu waiwai eGFR, e kamaʻilio me kāu kauka e pili ana i ia mea. Mai hana i kāu mau hoʻoholo ponoʻī e pili ana i kou olakino ma muli o ka ʻike i loaʻa ma ka Pūnaewele.
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