Imajin, yu dɔktɔ tink se yu gɛt prɔblɛm wit yu kidni . So, i de aks yu fɔ tek blɔd tɛst fɔ chɛk aw yu kidni de wok. Yu go sɔprayz if i tɛl yu se di nɔmba we de na da ripɔt de kin difrɛn akɔdin to di trayb we yu kɔmɔt, nɔto so? "Aw mi kidni de wok difrɛn difrɛn wan dipen pan mi etnik grup?" Yu go de wɔnda. Dis na rili big prɔblɛm we dɔn de apin na di wɔl fɔ mɛrɛsin fɔ lɔng tɛm, ɛn naw dɛn de kɔrɛkt am. Tide wi go tok abaut am.
Wetin na dis ikwyulet we de mכsu di kidni fכ wok?
Wi kidni dɛn tan lɛk tu pan di filta dɛn we gɛt pawa pas ɔl na di bɔdi. Di men wok we di kidni dɛn de du na fɔ filta di dɔti tin dɛn we nɔ nid fɔ kɔmɔt na di blɔd ɛn mek di bɔdi klin. So, wan pan di men tin dɛn we dɔktɔ dɛn kin yuz fɔ chɛk di kidni dɛn wɛlbɔdi na eGFR . Dat tinap fɔ ɛstimat Glomerular Filtration Rate .
Fɔ tɔk am simpul wan, i de mɛzhɔ aw yu kidni dɛn de klin yu blɔd kwik ɛn fayn fayn wan. Bikɔs i at fɔ mɛzhɔ dis dairekt wan, wi kin ɛstimat am bay we wi de yuz wan mɛtemat ikwɛshɔn we de yuz tin dɛn lɛk di lɛvɛl we wan west prɔdak we dɛn kɔl kriaytinin de na yu blɔd, yu ej, ɛn yu jɛnɛral.
di eGFR valyu we de dכn de sho se di kidni dεm de fεl. Dis valyu na wan impɔtant tin we de ɛp dɔktɔ dɛn fɔ disayd if pɔsin nid fɔ bigin dayalaysis ɔ fɔ gɛt kidni transplant.
Usay di prɔblɛm bigin? Aw ‘rɛs’ bin bi sɔntin we pɔsin kin du?
fכ sכm tεm, wan sכprayz vεriεbul bin de na dis eGFR ikwyulet: ‘rεs’ . Bɔt dis nɔ bin apin to ɔl di rays dɛn. I bin de aplay nɔmɔ if pɔsin no se na "Blak pɔsin."
Dat min se, wan wayt pɔsin ɛn wan blak pɔsin we gɛt di sem ej, man ɔ uman, ɛn kriaytinin lɛvɛl bin gɛt tu eGFR valyu. If di blak pɔsin na bin wayt pɔsin, di iqwɔj bin de mek da valyu de bɔku.
Wetin apin? Di eGFR sho se blak pɔsin in kidni wok bɛtɛ pas aw i rili bi. Dis bin mek dɛn de te fɔ gɛt di tritmɛnt we dɛn nid, lɛk fɔ bigin dayalaysis ɔ fɔ put dɛn na di list fɔ transplant dɛn kidni. Dis na bin big big injɔstis we dɛn nɔ bin want fɔ du.
| Ol eGFR ikwyulet (inklud rays) . | Nyu eGFR ikwyulet (etnik-fri) . |
|---|---|
| Dɛn bin tek kriaytinin lɛvɛl, ej, jɛnɛral ɛn ‘rɛs’ (weda blak ɔ nɔ blak) insay di kɔlkyulɛshɔn. | ‘Race’ don komot komplit fo di kalkyuleshon. Naw na כnli kriaytinin lεvεl, εj εn jεnda dεn de kכnsidrε. |
| I sho se di eGFR valyu dɛn na blak pasɛnt dɛn bin artificially inkris. | Kalkul eGFR insay wan we we ikwal, yuz di sem mɛzhɔmɛnt fɔ pasɛnt dɛn we kɔmɔt na ɔl di etnik grup dɛn. |
| Dis dɔn mek pipul dɛn nɔ gɛt di sem rayt ɛn dɛn de delay fɔ gi tritmɛnt ɛn fɔ mek dɛn arenj fɔ transplant dɛn kidni. | I de ɛp fɔ ridyus difrɛns we de pan riferal fɔ mɛdikal kia. |
Wetin mek dɛn bin put di wɔd ‘neshɔn’ insay frɔm di biginin?
Dis na bikɔs ɔf di risach we dɛn bin du insay di 1990 dɛm. Wan stɔdi we dɛn bin du da tɛm de (Modification of Diet in Renal Disease – MDRD stɔdi) sho se blak pipul dɛn gɛt ay blɔd kriaytinin lɛvɛl pas wayt pipul dɛn. Dɛn bin se dis na bikɔs ɔf wan ol tin we sayɛnsman dɛn biliv naw, we se “bɔku tɛm blak pipul dɛn kin gɛt mɔ mɔsul pas wayt pipul dɛn.”
Da tɛm de, fɔ put blak pipul dɛn pan risach, dɛn bin de tek am se na big tin, bɔt tide wi ɔndastand se ‘rɛs’ nɔto bayolojikal tin, bɔt na sɔshal kɔnstrɔkshɔn.
Dɔktɔ Pɔl Palewski, we na di prɛsidɛnt fɔ di Nashɔnal Kidni Fɔdayshɔn, bin tɔk se: “We wi de tich wi mɛdikal studɛnt dɛn di iqwɔshɔn dɛn we dɛn kin yuz fɔ mek dɛn gɛt difrɛn kɔlɔ, wi kin put lay lay tin insay dɛn se rays na sɔntin we kin mek pɔsin gɛt sik. Bɔt nɔto so i bi.”
Di joyn fɔ kɔrɛkt dis mistek
Bɔt gud tin na dat, insay di las ia dɛn, di wan dɛn we de stɔdi bɔt mɛrɛsin, dɔktɔ dɛn, di wan dɛn we de stɔdi bɔt di bɔdi , ɛn di wan dɛn we de fɛt fɔ di rayt fɔ di pɔsin we sik dɔn bigin fɔ aks kwɛstyɔn bɔt dis. “If no biyolojikal besis nɔ de fɔ dis, wetin mek wi de trit blak pipul ɛn pipul dɛn we nɔto blak pipul dɛn difrɛn we?” dɛn aks.
Dis bin mek di Nashɔnal Kidni Fɔdayshɔn ɛn di American Society of Nephrology bin jɔyn an fɔ mek wan task fɔs we gɛt pasɛnt dɛn, sayɛnsman dɛn, ɛn dɔktɔ dɛn. As a rizulyt of dεn had wok, insay 2021, tu nyu eGFR ikwyulet dεm bin introdכks to di wכl we kכmplitli pul di ‘rεs’ fכktכ .
1. Fɔs ikwɛshɔn: Na di sem lɛk di ol wan, i de yuz kriaytinin lɛvɛl nɔmɔ (bɔt i nɔ gɛt ‘rɛs’).
2. Sεkכn ikwyulet: apat frכm di kriaytinin lεvεl dεm, dεn de yuz כda kεmikכl mak we dεn k כl sistatin C bak. pan ɔl we dis kin kɔrɛkt mɔ, dɛn kin advays bak fɔ mek di fɔs iqwɔj bikɔs di sistatin C tɛst nɔ de na ɔl di lɛbɔretri dɛn na di wɔl ɛn i dia.
Dis chenj de apin kwik kwik wan na di mɛdikal fild ɔlsay na di wɔl. I rili fayn fɔ no se chenj we dɔn de fɔ tɛn ia de apin insay jɔs sɔm mɔnt.
Wetin mek dis difrɛns impɔtant to wi?
Yu kin tink se, dis na Amɛrika prɔblɛm, wetin i impɔtant to wi? Bɔt mɛrɛsin na tin we de ɔlsay na di wɔl. Wan sayɛns we de chenj ɔ kɔrɛkt we apin na wan pat na di wɔl kin afɛkt di wan ol wɔl.
- Tritmɛnt we Fayn: Dis de mek shɔ se pɔsin we sik, ɛnisay na di wɔl ɛn ɛni kɔntri, gɛt rayt fɔ gɛt di rayt ɛn kɔrɛkt diagnosis.
- Fɔ kɔrɛkt mistek dɛn na mɛrɛsin: Dis na fayn ɛgzampul bɔt aw mɛrɛsin na wok we de ridyus insɛf ɔltɛm ɛn kɔrɛkt in yon mistek dɛn.
- Fɔ lisin to di pɔsin in vɔys: Di pɔsin in vɔys na bin strɔng tin bak fɔ mek dis chenj. Dis de sho aw i impɔtant fɔ lisin to wetin di sik pipul dɛn de tink, pas fɔ mek di dɔktɔ dɛn nɔmɔ disayd fɔ du sɔntin.
Na tru se if yu chenj dis ikwal, dat nɔ go pul ɔl di wɛlbɔdi biznɛs we nɔ ikwal wan de. Bɔku soshal ɛn ikɔnomi tin dɛn de we kin mek dɛn gɛt dɛn. Bɔt dis na tin we rili strɔng ɛn impɔtant fɔ du dat.
If yu ɔ pɔsin we yu sabi gɛt kidni sik, tɔk to yu dɔktɔ opin wan bɔt yu mɛrɛsin tɛst ɛn tritmɛnt. Aks dɛm bɔt yu eGFR, wetin i min, ɛn di bɛst tritmɛnt fɔ yu.
Mɛsej we dɛn kin kɛr go na os
- eGFR (estimated Glomerular Filtration Rate) na imכtant kכlkyulshכn we de mכsu di kidni fכnshכn.
- Di eGFR iqwɔj we dɛn bin dɔn yuz bifo tɛm bin factor ‘rɛs’ (espɛshali fɔ blak pipul dɛn) insay di iqwɔj, we rili mek dɛn nɔ trit dɛn fayn ɛn dɛn de delay fɔ di pasɛnt dɛn.
- wit di כndastandin se ‘rεs’ nכto bayolojikal fכktכ, bכt na soshal kכnsεpt, nyu, mכr fayn eGFR ikwyulet dεm dεn introdכks naw we nכ inklud ‘rεs’.
- Dis chenj na impɔtant step fɔ ridyus di nɔ ikwal we de na wɛlbɔdi biznɛs ɛn fɔ gi fayn tritmɛnt to ɔl di sik pipul dɛn.
- If yu gɛt ɛnitin fɔ wɔri bɔt yu mɛdikal rɛkɔd ɛn tritmɛnt, i rili impɔtant fɔ tɔk bɔt am opin wan ɛn klia wan wit yu dɔktɔ.
Kidni sik, eGFR, kriaytinin, kidni tɛst, wɛlbɔdi inɛkwaliti, mɛrɛsin, kidni sik
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