Tangoganizirani, dokotala wanu akuganiza kuti muli ndi vuto ndi impso zanu. Ndiye, akukupemphani kuti muyeze magazi kuti muwone momwe impso zanu zimagwirira ntchito. Mungadabwe ngati angakuuzeni kuti chiwerengero cha zomwe zili mu lipotilo chimasiyana malinga ndi mtundu wanu, sichoncho? "Kodi ntchito ya impso zanga imasiyana bwanji malinga ndi mtundu wanga?" Mwina mukudabwa. Ili ndi vuto lalikulu lomwe lakhala likuchitika mdziko la zamankhwala kwa nthawi yayitali, ndipo tsopano likukonzedwa. Lero tikambirana za izi.
Kodi equation iyi yomwe imayesa ntchito ya impso ndi iti?
Impso zathu zili ngati zosefera ziwiri zamphamvu kwambiri m'thupi. Ntchito yayikulu ya impso ndikusefa zinyalala zosafunikira kuchokera m'magazi ndikusunga thupi loyera. Chifukwa chake, chimodzi mwazoyezera zazikulu zomwe madokotala amagwiritsa ntchito poyesa thanzi la impso ndi eGFR . Izi zikutanthauza kuti Glomerular Filtration Rate ikuyembekezeka .
Mwachidule, imayesa momwe impso zanu zikuyeretsera magazi anu mwachangu komanso moyenera. Chifukwa n'zovuta kuyeza izi mwachindunji, timayesa pogwiritsa ntchito njira ya masamu yomwe imagwiritsa ntchito zinthu monga kuchuluka kwa zinyalala zotchedwa creatinine m'magazi anu, zaka zanu, komanso jenda lanu.
Kutsika kwa eGFR kumasonyeza kuti impso zikulephera kugwira ntchito. Kuchuluka kumeneku ndi chinthu chofunikira chomwe chimathandiza madokotala kusankha ngati munthu akufunika kuyamba dialysis kapena kuikidwa impso.
Kodi vuto linayambira pati? Kodi 'mtundu' unakhala bwanji vuto lalikulu?
Kwa kanthawi, panali kusintha kodabwitsa mu equation iyi ya eGFR: 'mtundu' . Koma izi sizinagwire ntchito pa mitundu yonse. Zinkagwira ntchito pokhapokha ngati wina wadziwika kuti ndi "munthu wakuda."
Ndiko kuti, munthu woyera ndi munthu wakuda wa msinkhu womwewo, jenda, ndi creatinine analandira ma values awiri a eGFR. Ngati munthu wakuda anali munthu woyera, equationyo inakweza mtengo umenewo mwadala.
Chachitika ndi chiyani? EGFR inasonyeza kuti ntchito ya impso ya munthu wakuda inali yabwino kuposa momwe inalili. Chifukwa cha zimenezi, anachedwa kulandira chithandizo chomwe amafunikira, monga kuyamba dialysis kapena kuikidwa pamndandanda wa anthu oti aike impso. Ichi chinali chisalungamo chachikulu chomwe sichinachitikepo.
| Chiyerekezo chakale cha eGFR (kuphatikiza mtundu) | Chiyerekezo chatsopano cha eGFR (chopanda fuko) |
|---|---|
| Mulingo wa creatinine, zaka, jenda ndi 'mtundu' (kaya wakuda kapena ayi) zinaganiziridwa powerengera. | 'Mpikisano' wachotsedwa kwathunthu pa kuwerengera. Tsopano mulingo wa creatinine, zaka ndi jenda zokha ndi zomwe zikuganiziridwa. |
| Zinawonetsedwa kuti kuchuluka kwa eGFR mwa odwala akuda kunawonjezeka mwachinyengo. | Amawerengera eGFR mofanana, pogwiritsa ntchito muyeso womwewo kwa odwala amitundu yonse. |
| Izi zachititsa kuti pakhale kusalingana komanso kuchedwa kupereka chithandizo ndi kukonza nthawi yoti impso zilowedwe. | Zimathandiza kuchepetsa kusiyana kwa anthu otumizidwa kuchipatala. |
N’chifukwa chiyani mawu oti ‘dziko’ anagwiritsidwa ntchito kuyambira pachiyambi?
Izi zili choncho chifukwa cha kafukufuku yemwe anachitika m'zaka za m'ma 1990. Kafukufuku yemwe anachitika panthawiyo (Modification of Diet in Renal Disease - MRRD study) adapeza kuti anthu akuda anali ndi creatinine yambiri m'magazi kuposa anthu oyera. Iwo anati izi zimachitika chifukwa cha chikhulupiriro chakale, chomwe tsopano chikutsutsidwa ndi sayansi chakuti "anthu akuda nthawi zambiri amakhala ndi minofu yambiri kuposa anthu oyera."
Pa nthawiyo, kuphatikiza anthu akuda mu kafukufuku kunkaonedwa ngati nkhani yaikulu, koma masiku ano tikumvetsa kuti 'mtundu' si chinthu chachilengedwe, koma ndi chikhalidwe cha anthu.
"Tikamaphunzitsa ophunzira athu azachipatala za mafuko, timawaphunzitsa lingaliro lolakwika lakuti fuko ndi chinthu chomwe chimayambitsa matenda mwachibadwa. Koma sichoncho," akutero Dr. Paul Palewski, purezidenti wa National Kidney Foundation.
Ulendo wokonza cholakwika ichi
Mwamwayi, m'zaka zaposachedwapa, ophunzira zachipatala, madokotala, akatswiri a matenda a mitsempha , ndi omenyera ufulu wa odwala ayamba kukayikira nkhaniyi. "Ngati palibe chifukwa chachilengedwe cha izi, n'chifukwa chiyani timachitira anthu akuda ndi omwe si akuda mosiyana?" anafunsa.
Motero , bungwe la National Kidney Foundation ndi bungwe la American Society of Nephrology adagwirizana kuti apange gulu la odwala, asayansi, ndi madokotala. Chifukwa cha ntchito yawo yolimba, mu 2021, ma equation awiri atsopano a eGFR adayambitsidwa padziko lonse lapansi omwe adachotsa kwathunthu 'mtundu' .
1. Equation yoyamba: Mofanana ndi yakale, imagwiritsa ntchito mulingo wa creatinine wokha (koma popanda 'mtundu').
2. Equation yachiwiri: Kuwonjezera pa kuchuluka kwa creatinine, chizindikiro china cha mankhwala chotchedwa cystatin C chimagwiritsidwanso ntchito. Ngakhale izi ndi zolondola kwambiri, equation yoyamba imalimbikitsidwanso chifukwa mayeso a cystatin C sapezeka m'ma laboratories onse padziko lapansi ndipo ndi okwera mtengo.
Kusintha kumeneku kukuchitika mofulumira kwambiri m'magawo azachipatala padziko lonse lapansi. N'zosangalatsa kwambiri kuti kusintha kwa zaka khumi kukuchitika m'miyezi yochepa chabe.
N’chifukwa chiyani kusiyana kumeneku n’kofunika kwa ife?
Mungaganize kuti, ili ndi vuto la ku America, kodi likutikhudza bwanji? Koma mankhwala ndi nkhani yapadziko lonse. Kupita patsogolo kwa sayansi kapena kukonza komwe kumachitika mbali imodzi ya dziko lapansi kumakhudza dziko lonse lapansi.
- Chithandizo Cholungama: Izi zimatsimikizira ufulu wa wodwala, kulikonse padziko lapansi komanso wa fuko lililonse, wopeza matenda oyenera komanso olondola.
- Kukonza zolakwika mu zamankhwala: Ichi ndi chitsanzo chabwino cha momwe mankhwala alili gawo lomwe limadzikonzanso lokha nthawi zonse ndikukonza zolakwika zake.
- Kumvera mawu a wodwalayo: Mawu a wodwalayo nawonso anali chinthu champhamvu kwambiri pakusintha kumeneku. Izi zikusonyeza kufunika komvera maganizo a odwala, m'malo momvera madokotala okha omwe amapanga zisankho.
Zachidziwikire, kusintha kwa equation iyi sikungachotse kusalingana konse kwa thanzi mwadzidzidzi. Pali zinthu zambiri zachikhalidwe ndi zachuma zomwe zimathandizira izi. Koma iyi ndi sitepe yolimba komanso yofunika kwambiri panjira imeneyo.
Ngati inu kapena munthu amene mumamudziwa ali ndi matenda a impso, lankhulani momasuka ndi dokotala wanu za mayeso anu azachipatala ndi chithandizo. Mufunseni za eGFR yanu, tanthauzo lake, ndi njira zabwino kwambiri zochizira matenda.
Uthenga Wopita Nawo Kunyumba
- eGFR (chiwerengero choyezera kufinyira kwa Glomerular) ndi kuwerengera kofunikira komwe kumayesa kugwira ntchito kwa impso.
- Equation ya eGFR yomwe idagwiritsidwa ntchito kale idayika 'mtundu' (makamaka wa anthu akuda) mu equation, zomwe zidapangitsa kuti odwala asamalandire chithandizo chosayenera komanso kuchedwa.
- Pomvetsetsa kuti 'mtundu' si chinthu chachilengedwe, koma lingaliro la chikhalidwe cha anthu, ma equation atsopano komanso abwino a eGFR tsopano ayambitsidwa omwe saphatikizapo 'mtundu'.
- Kusintha kumeneku ndi sitepe yofunika kwambiri pochepetsa kusalingana mu chisamaliro chaumoyo ndikupereka chithandizo choyenera kwa odwala onse.
- Ngati muli ndi nkhawa iliyonse yokhudza mbiri yanu ya zachipatala ndi chithandizo, ndikofunikira kwambiri kukambirana za izi momasuka komanso momveka bwino ndi dokotala wanu.
Matenda a impso, eGFR, creatinine, mayeso a impso, kusalingana kwa thanzi, mankhwala, matenda a impso
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