I doctor chuan i kal (kidney) -ah harsatna i nei tih a ringhlel ang tih han ngaihtuah teh . Chuvangin, i kal hnathawh dan enfiah turin thisen test turin a ti che a ni. Chu report-a number chu i hnam a zirin a inang lo tih a hrilh che chuan mak i ti hle ang a ni lawm ni? "Engtin nge ka kidney function hi ka hnam a zirin a danglam?" I ngaihtuah mai thei. Hei hi a takah chuan damdawi khawvelah hun rei tak atanga lo awm tawh harsatna lian tak a ni a, tunah chuan siamthat mek a ni. Vawiin hian kan sawi dawn a ni.
He kal hnathawh tehna equation hi eng nge ni?
Kan kal (kidney) hi taksaa filter chak ber pahnih ang a ni. Kidney hnathawh ber chu thisen atanga bawlhhlawh tul lo filter chhuah a, taksa thianghlim taka vawn hi a ni. Chuvangin, doctor-te’n kal hriselna enfiahna atana an hman thin tehfung lian ber pakhat chu eGFR hi a ni. Chu chu Glomerular Filtration Rate chhut a ni.
A awlsam zawngin, i kal (kidney)-in i thisen a tihfai chak dan leh a tihfai dan a teh a ni. Hei hi direct-a teh a harsat avangin, i thisena creatinine an tih bawlhhlawh level, i kum leh i gender ang chi thil hmanga mathematical equation hmangin kan chhut a ni.
eGFR value tlahniam chuan kal (kidney) a fail tih a tilang. He hlutna hi doctor-te’n mi pakhatin dialysis a tan a ngai em tih emaw, a kal (kidney transplant) a mamawh em tih emaw an ngaihtuah theihna tura puitu pawimawh tak a ni.
Khawi atanga intan nge buaina chu? Engtin nge ‘race’ hi factor a lo nih?
Hun engemaw chen chu he eGFR equation-ah hian thil mak tak mai a awm a: ‘race’ . Mahse hei hi hnam zawng zawngah a hman theih loh. Mi pakhatin "Mi dum" tia a inhriat chuan a hman theih chauh a ni.
Chu chu, mipa hring leh mipa dum, kum inang, mipa leh hmeichhia leh creatinine level inang te chuan eGFR value pahnih an dawng tihna a ni. Mihring dum chu mi var a nih chuan chu equation chuan chu hlutna chu artificial takin a tipung a ni.
Engnge thleng? eGFR atanga a lan dan chuan mipa dum (kidney) hnathawh dan chu a tak tak aiin a tha zawk a ni. Chuvang chuan an mamawh enkawlna, dialysis tan emaw, kidney transplant list-a dah emaw ang chi chu an dawng tlai hle. Hei hi thil dik lohna lian tak, tum loh tak a ni.
| eGFR equation hlui (race pawh tel) . | eGFR equation thar (chi hrang hrang awm lohna) . |
|---|---|
| Chhûtnaah hian Creatinine level, kum, mipa leh hmeichhia leh ‘hnam’ (mihring dum emaw, mipa dum lo emaw) te ngaihtuah a ni. | ‘Race’ chu chhut chhuah a\angin paih vek a ni tawh. Tunah chuan creatinine level, kum leh mipa leh hmeichhia chauh ngaihtuah a ni ta. |
| Mihring dum damlote eGFR value chu artificial-in a tisang tih hmuhchhuah a ni. | eGFR chu a dik zawkin a chhut a, hnam hrang hrang damlote tan tehna inang a hmang. |
| Hei hian enkawlna pek dan leh kal thlak hun tur ruahman danah inthlauhna leh tihkhawtlai a thlen a ni. | Damdawi lam enkawlna atana referral-a inthlauhna tihziaawmna turin a pui. |
Engvangin nge a tir atang khan ‘hnam’ tih thumal hi telh a nih?
Hei hi kum 1990 chhoa zirchianna an neih vang a ni. Chutih laia zirchianna an neih (Modification of Diet in Renal Disease – MDRD study) chuan mipa hring aiin thisenah creatinine level a sang zawk tih hmuhchhuah a ni. Chu chu “mihring dumte chuan a tlangpuiin mipa hring aiin taksa ruh an nei tam zâwk” tih rinna hlui, tûna science-in a dodâl tawh avângin an sawi a ni.
Chutih lai chuan research-a mipa hring telh hi thil lian takah ngaih a ni a, mahse vawiinah chuan ‘race’ hi biological thil ni lovin, social construct a ni tih kan hrethiam ta.
National Kidney Foundation president Dr. Paul Palewski chuan, “Kan medical zirlai te chu hnam hrang hranga equation kan zirtir hian an rilruah hnam hi natna tidanglamtu biological determinant a ni tih ngaihdan dik lo kan tuh a ni. Mahse, chutiang chu a ni lo,” tiin National Kidney Foundation president Dr. Paul Palewski chuan a sawi.
He tihsual siamthat tura zinkawng
Vanneihthlak takin tun hnaiah medical zirlai, doctor, nephrologist , leh patient rights activist-te chuan he thu hi an zawtfiah tan ta a ni. “Hei hi biological basis a awm loh chuan engvangin nge mipa hring leh mipa dum ni lote hi kan enkawl dan a inang lo?” tiin an zawt a.
Chumi avang chuan National Kidney Foundation leh American Society of Nephrology te chuan damlo, scientist leh doctor te awmna task force an din ta a ni. An thawhrimna avang hian kum 2021 khan khawvelah eGFR equation thar pahnih siam chhuah a ni a, chu chuan ‘race’ factor chu a tibo vek a ni .
1. Equation hmasa ber: Hmanlai ang bawkin, creatinine level chauh a hmang (mahse ‘race’ tel lovin).
2. Second equation: Creatinine level bakah hian chemical marker dang cystatin C an tih pawh an hmang bawk. Hei hi dik zawk mahse, equation hmasa ber pawh hi a tha hle a, a chhan chu khawvela laboratory zawng zawngah cystatin C test hi a awm vek lo va, a man pawh a to hle.
Khawvel hmun hrang hrangah damdawi lam kawngah hian he inthlak danglamna hi a thleng chak hle a ni. Thla tlemte chhung chauhvin kum sawm chhung zet inthlak danglamna a thleng ta hi a lawmawm tak zet a ni.
Engvangin nge he danglamna hi kan tan a pawimawh?
I ngaihtuah mai thei, hei hi American buaina a ni a, kan tan eng nge a pawimawh? Mahse damdawi lam hi khawvel pum huap thil a ni. Khawvel hmun khata science lama hmasawnna emaw siamthatna emaw chuan khawvel pum a nghawng a ni.
- Enkawlna dik zawk: Hei hian damlo, khawvel hmun hrang hrangah leh hnam eng pawh ni se, dik zawk leh dik zawka enfiah theihna tur dikna a tichiang a ni.
- Damdawi lama tihsual siamthat: Hei hi damdawi lam hi a insiam thar reng a, mahni tihsual siamthat zel a nih dan entir nan a tha hle.
- Damlo aw ngaihthlak: Damlo aw pawh hi he inthlak danglamna thlentu chak tak a ni. Hei hian damdawi lam pawl chauhin thutlukna siam ai chuan damlote ngaihdan ngaihthlak a pawimawh zia a tilang chiang hle.
Dik tak chuan he equation hi thlak danglam chuan hriselna inthlauhna zawng zawng hi zan khat thil thuah a ti bo vek dawn lo. Khawtlang leh sum leh pai lama thil tam tak a awm a. Mahse hei hi chutiang lam hawia hmalakna chak tak leh pawimawh tak a ni.
Nangmah emaw, i hriat miin emaw kal natna a neih chuan i doctor nen in medical test leh inenkawl dan tur chu zalen takin sawipui rawh. I eGFR chungchang te, a awmzia te, i tana enkawlna tha ber ber te zawt rawh.
Take-Home Thuchah a ni
- eGFR (estimated Glomerular Filtration Rate) hi kal hnathawh tehna atana chhut pawimawh tak a ni.
- Tun hmaa eGFR equation hman tawh khan ‘race’ (a bik takin mipa hring tan) chu equation-ah hian a factor a, hei hian damlote tan dik lo taka enkawl leh tihkhawtlai a thlen a ni.
- ‘Hnam’ hi biological factor ni lovin, social concept a ni tih hriatthiamna nen, tunah chuan ‘race’ tel lo eGFR equation thar, dik zawk siam a ni ta a ni.
- He inthlak danglamna hi hriselna lama inthlauhna tihziaawmna tur leh damlo zawng zawngte enkawlna dik pekna kawngah hmalakna pawimawh tak a ni.
- I medical record leh enkawl dan chungchangah harsatna i neih chuan i doctor nen zalen tak leh chiang taka sawipui a pawimawh hle.
Kal natna, eGFR, creatinine, kal test, hriselna inthlauhna, damdawi, kal natna
💬 Comments (0)
Comment a la awm lo. Hetah hian i comment hi a vawikhatna atan add rawh.
I comment kha add rawh