Teebereza omusawo wo ateebereza nti olina ekizibu mu nsigo . Kale, akusaba okwekebeza omusaayi okebere enkola y’ekibumba kyo. Wandiwuniikiridde singa akugamba nti ennamba eri ku lipoota eyo eyawukana okusinziira ku ggwanga lyo, si bwe kiri? "Enkola y'ekibumba kyange ekyukakyuka etya okusinziira ku ggwanga lyange?" Oyinza okuba nga weebuuza. Kino mu butuufu kizibu kinene ekibadde kigenda mu maaso mu nsi y’obusawo okumala ebbanga, era kati kitereezebwa. Leero tugenda kukyogerako.
Ennyingo eno epima enkola y’ekibumba kye ki?
Ensigo zaffe ziringa ebisengejja bibiri ebisinga amaanyi mu mubiri. Omulimu omukulu ogw’ensigo kwe kusengejja ebisasiro ebiteetaagisa okuva mu musaayi n’okukuuma omubiri nga muyonjo. Kale, ekimu ku bipimo ebikulu abasawo bye bakozesa okukebera obulamu bw’ensigo ye eGFR . Ekyo kitegeeza ekibalirirwamu Glomerular Filtration Rate .
Mu ngeri ennyangu, kipima engeri enkizi zo gye ziyonja omusaayi gwo mu bwangu era mu ngeri ennungi. Olw’okuba kizibu okupima kino butereevu, tukibalirira nga tukozesa ensengekera y’okubala ekozesa ebintu ng’omutindo gw’ekintu ekicaafu ekiyitibwa creatinine mu musaayi gwo, emyaka gyo, n’ekikula kyo.
Omuwendo gwa eGFR ogukendeera kiraga nti ensigo ziremereddwa. Omuwendo guno nsonga nkulu eyamba abasawo okusalawo oba omuntu yeetaaga okutandika okulongoosa ekibumba oba okukyusibwa ekibumba.
Obuzibu bwatandikira wa? ‘Eggwanga’ lyafuuka litya ensonga?
Okumala akaseera, waaliwo enkyukakyuka eyeewuunyisa mu nsengekera eno eya eGFR: ‘empaka’ . Naye kino tekyakwata ku mawanga gonna. Kyakolanga singa omuntu yeeyita "Omuntu Omuddugavu."
Kwe kugamba, omuzungu n’omuddugavu ow’emyaka gye gimu, ekikula kye kimu, n’omutindo gwa creatinine gwe gumu baafuna emiwendo gya eGFR ebiri. Singa omuddugavu yali muzungu, ensengekera eyo yafuuwa omuwendo ogwo mu ngeri ey’ekikugu.
Kiki ekyabaddewo? Ekipimo kya eGFR kyalaga nti enkola y’ekibumba ky’omuddugavu yali nnungi okusinga bwe yali. N’ekyavaamu, baalwawo okufuna obujjanjabi bwe baali beetaaga, gamba ng’okutandika okulongoosa ekibumba oba okuteekebwa ku lukalala lw’abasimbibwa ekibumba. Buno bwali butali bwenkanya bunene nnyo, nga tebugenderedde.
| Ennyingo ya eGFR enkadde (nga mw’otwalidde n’amawanga) . | Ennyingo empya eya eGFR (etaliimu mawanga) . |
|---|---|
| Omutindo gwa creatinine, emyaka, ekikula ky’omuntu ne ‘eggwanga’ (oba muddugavu oba nedda) byalowoozebwako mu kubala. | 'Race' eggiddwawo ddala mu kubala. Kati creatinine level, emyaka n’ekikula byokka bye bitunuulirwa. |
| Kyalagibwa nti emiwendo gya eGFR mu balwadde abaddugavu gyayongezebwa mu ngeri ey’ekikugu. | Ebala eGFR mu ngeri ey’obwenkanya, ng’ekozesa ekipimo kye kimu eri abalwadde ab’amawanga gonna. |
| Kino kivuddeko obutali bwenkanya n’okulwawo okuwandiika obujjanjabi n’okuteekawo enteekateeka y’okukyusa ekibumba. | Ayamba okukendeeza ku njawulo mu kusindikibwa mu bujjanjabi. |
Lwaki ekigambo ‘eggwanga’ kyazingirwamu okuva ku ntandikwa?
Kino kiva ku kunoonyereza okwakolebwa mu myaka gya 1990. Okunoonyereza okwakolebwa mu kiseera ekyo (Modification of Diet in Renal Disease – MDRD study) kwazuula nti abaddugavu baalina creatinine mu musaayi okusinga abazungu. Kino baakitadde ku nzikiriza enkadde, kati esoomoozebwa mu bya ssaayansi nti “okutwalira awamu abantu abaddugavu balina ebinywa bingi okusinga abazungu.”
Mu kiseera ekyo, okussa abaddugavu mu kunoonyereza kyatwalibwanga ng’ekintu ekinene, naye leero tutegedde nti ‘eggwanga’ si kintu kya biramu, wabula kizimbibwa kya mbeera z’abantu.
Dr. Paul Palewski, pulezidenti w’ekitongole kya National Kidney Foundation agamba nti: “Bwe tuyigiriza abayizi baffe ab’obusawo ensengekera ezisinziira ku mawanga, tubasiga endowooza ey’obulimba nti amawanga ge gasalawo obulwadde mu biramu.Naye si bwe kiri.”
Olugendo lw'okutereeza ensobi eno
Ekirungi, mu myaka egiyise, abayizi b’obusawo, abasawo, abakugu mu by’ekibumba , n’abalwanirira eddembe ly’abalwadde batandise okubuusabuusa ensonga eno. “Bwe kiba nti kino tekirina musingi gwa biramu, lwaki tuyisa abaddugavu n’abatali baddugavu mu ngeri ya njawulo?” bwe baabuuzizza.
N’ekyavaamu , ekitongole kya National Kidney Foundation n’ekibiina kya American Society of Nephrology beegatta ne bakola ekibiina ekikola ku nsonga z’abalwadde, bannassaayansi, n’abasawo. Olw’okukola ennyo, mu 2021, ensengekera za eGFR empya bbiri zayingizibwa mu nsi yonna ezaggyawo ddala ensonga ya ‘empaka’ .
1. Ennyingo esooka: Y’emu n’enkadde, ng’okozesa omutindo gwa creatinine gwokka (naye nga temuli ‘race’).
2. Ennyingo eyokubiri: Ng’oggyeeko emiwendo gya creatinine, akabonero akalala ak’eddagala akayitibwa cystatin C nako kakozesebwa. Wadde nga kino kituufu nnyo, ensengekera esooka nayo esengekeddwa kubanga okukebera kwa cystatin C tekusangibwa mu laboratory zonna mu nsi era kwa bbeeyi.
Enkyukakyuka eno egenda mu maaso mangu nnyo mu by’obusawo okwetoloola ensi yonna. Mazima ddala kisanyusa nnyo nti enkyukakyuka emaze emyaka kkumi egenda mu maaso mu myezi mitono gyokka.
Lwaki enjawulo eno nkulu gye tuli?
Oyinza okulowooza nti, kino kizibu kya Amerika, kitukwatako ki? Naye eddagala kintu kya nsi yonna. Okumenya oba okutereeza kwa ssaayansi okubaawo mu kitundu ekimu eky’ensi kukosa ensi yonna.
- Obujjanjabi obw’obwenkanya: Kino kikakasa eddembe ly’omulwadde, wonna mu nsi era ow’eggwanga lyonna, okuzuulibwa mu ngeri ey’obwenkanya era entuufu.
- Okutereeza ensobi mu busawo: Kino kyakulabirako kikulu nnyo ku ngeri eddagala gye liri omulimu ogwezza obuggya buli kiseera n’okutereeza ensobi zaago.
- Okuwuliriza eddoboozi ly’omulwadde: Eddoboozi ly’omulwadde nalyo lyali nsonga ya maanyi mu kukola enkyukakyuka eno. Kino kiraga engeri gye kiri ekikulu okuwuliriza endowooza z’abalwadde, okusinga abasawo bokka okusalawo.
Kya lwatu nti okukyusa ensengekera eno tekijja kumalawo butali bwenkanya bwonna mu by’obulamu mu kiro kimu. Waliwo ensonga nnyingi ez’embeera z’abantu n’ebyenfuna eziziviirako. Naye lino ddaala lya maanyi nnyo era ddene mu kkubo eryo.
Bw’oba ggwe oba omuntu gw’omanyi alina obulwadde bw’ekibumba, yogerako mu lwatu n’omusawo wo ku by’okukeberebwa mu by’obujjanjabi n’obujjanjabi. Babuuze ku eGFR yo, kye kitegeeza, n’obujjanjabi obusinga obulungi gy’oli.
Obubaka Obutwala Awaka
- eGFR (estimated Glomerular Filtration Rate) kubala kukulu okupima enkola y’ekibumba.
- Ennyingo ya eGFR eyakozesebwa emabegako yassa ‘eggwanga’ (naddala eri abaddugavu) mu nsengekera eno, ekyavaamu okuyisibwa mu ngeri etali ya bwenkanya n’okulwawo eri abalwadde.
- Olw’okutegeera nti ‘eggwanga’ si nsonga ya biramu, wabula ndowooza ya mbeera z’abantu, kati ensengekera za eGFR empya, ezisinga okuba ez’obwenkanya zitongozeddwa ezitaliimu ‘ggwanga’.
- Enkyukakyuka eno ddaala ddene erikendeeza ku butali bwenkanya mu by’obulamu n’okuwa abalwadde bonna obujjanjabi obw’obwenkanya.
- Bw’oba olina ekikweraliikiriza ku biwandiiko byo eby’obujjanjabi n’obujjanjabi bwo, kikulu nnyo okubyogerako mu lwatu era mu bulambulukufu n’omusawo wo.
Obulwadde bw’ekibumba, eGFR, creatinine, okukebera ekibumba, obutafaanagana mu bulamu, eddagala, obulwadde bw’ekibumba
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