Cabanga nje, udokotela wakho usola ukuthi unenkinga ngezinso zakho. Ngakho-ke, ukucela ukuthi uhlolwe igazi ukuze kuhlolwe ukusebenza kwezinso zakho. Ubungamangala uma ekutshela ukuthi inani elikulowo mbiko liyahlukahluka kuye ngohlanga lwakho, akunjalo? "Ukusebenza kwezinso zami kuyahlukahluka kuye ngohlanga lwami?" Ungase uzibuze. Empeleni lokhu kuyinkinga enkulu ebilokhu iqhubeka ezweni lezokwelapha isikhathi eside, futhi manje iyalungiswa. Namuhla sizokhuluma ngayo.
Iyini le sibalo esilinganisa ukusebenza kwezinso?
Izinso zethu zifana nezihlungi ezimbili ezinamandla kakhulu emzimbeni. Umsebenzi oyinhloko wezinso ukuhlunga imfucuza engadingekile egazini nokugcina umzimba uhlanzekile. Ngakho-ke, esinye sezilinganiso eziyinhloko odokotela abazisebenzisayo ukuhlola impilo yezinso yi -eGFR . Lokho kusho izinga lokuhlunga le-Glomerular elilinganisiwe .
Kalula nje, ilinganisa ukuthi izinso zakho zihlanza igazi lakho ngokushesha nangendlela ephumelelayo kangakanani. Ngenxa yokuthi kunzima ukukala lokhu ngqo, sikulinganisa sisebenzisa isibalo sezibalo esisebenzisa izinto ezifana nezinga lomkhiqizo ongcolile obizwa ngokuthi i-creatinine egazini lakho, iminyaka yakho, kanye nobulili bakho.
Ukwehla kwenani le-eGFR kubonisa ukuthi izinso ziyahluleka ukusebenza. Leli nani liyisici esibalulekile esisiza odokotela ukuthi banqume ukuthi umuntu udinga ukuqala i-dialysis noma ukufakelwa izinso.
Inkinga yaqala kuphi? 'Uhlanga' lwaba kanjani yimbangela?
Okwesikhashana, kwakukhona ushintsho olumangalisayo kulesi sibalo se-eGFR: 'uhlanga' . Kodwa lokhu akusebenzanga kuzo zonke izinhlanga. Kwakusebenza kuphela uma othile ezibiza ngokuthi "umuntu omnyama."
Okusho ukuthi, umuntu omhlophe nomuntu omnyama abaneminyaka efanayo, ubulili, kanye nezinga le-creatinine bathole amanani amabili e-eGFR. Uma umuntu omnyama engumuntu omhlophe, i-equation yayikhuphula lelo nani ngokwenziwa.
Kwenzekani? I-eGFR ibonise ukuthi ukusebenza kwezinso zomuntu omnyama kwakungcono kunalokho okwakuyikho ngempela. Ngenxa yalokho, babambezeleka ekutholeni ukwelashwa ababekudinga, njengokuqala i-dialysis noma ukufakwa ohlwini lokufakelwa izinso. Lokhu kwakuwukungalungi okukhulu, okungahlosiwe.
| Isibalo esidala se-eGFR (kufaka phakathi uhlanga) | Isibalo esisha se-eGFR (asinabo ubuhlanga) |
|---|---|
| Izinga le-creatinine, ubudala, ubulili kanye 'nohlanga' (kungakhathaliseki ukuthi lumnyama noma cha) kwacatshangelwa ekubalweni. | 'Uhlanga' lususiwe ngokuphelele ekubalweni. Manje kubhekwa izinga le-creatinine, ubudala kanye nobulili kuphela. |
| Kwaboniswa ukuthi amanani e-eGFR ezigulini ezimnyama akhushulwe ngokwenziwa. | Ibala i-eGFR ngendlela elinganayo, isebenzisa isilinganiso esifanayo seziguli zazo zonke izinhlanga. |
| Lokhu kuholele ekungalinganini nasekubambezelekeni kokunikeza ukwelashwa kanye nokuhlela ukufakelwa izinso. | Kusiza ekunciphiseni ukungalingani ekudluliselweni kwezokwelapha. |
Kungani igama elithi 'isizwe' lafakwa kusukela ekuqaleni?
Lokhu kungenxa yocwaningo olwenziwe ngawo-1990. Ucwaningo olwenziwe ngaleso sikhathi (Ukuguqulwa Kokudla Kwesifo Sezinso - ucwaningo lwe-MRRD) luthole ukuthi abantu abamnyama babenamazinga aphezulu e-creatinine egazini kunabantu abamhlophe. Bathi lokhu kubangelwa yinkolelo endala, manje eseyinselele ngokwesayensi yokuthi “abantu abamnyama ngokuvamile banemisipha eminingi kunabantu abamhlophe.”
Ngaleso sikhathi, ukufaka abantu abamnyama ocwaningweni kwakubhekwa njengento enkulu, kodwa namuhla siyaqonda ukuthi 'uhlanga' akuyona into yemvelo, kodwa ukwakheka komphakathi.
“Uma sifundisa abafundi bethu bezokwelapha izibalo ezisekelwe kubuhlanga, sifaka kubo umbono ongamanga wokuthi uhlanga luyimbangela yezifo ngokwemvelo. Kodwa akunjalo,” kusho uDkt. Paul Palewski, umongameli weNational Kidney Foundation.
Uhambo lokulungisa leli phutha
Ngenhlanhla, eminyakeni yamuva nje, abafundi bezokwelapha, odokotela, odokotela bezinzwa , kanye nezishoshovu zamalungelo eziguli sebeqalile ukungabaza le nkinga. “Uma kungekho sisekelo sebhayoloji salokhu, kungani siphatha abamnyama nabangebona abamnyama ngendlela ehlukile?” babuza.
Ngenxa yalokho , i-National Kidney Foundation kanye ne-American Society of Nephrology bahlangana ukuze bakhe iqembu elisebenzayo leziguli, ososayensi, kanye nodokotela. Ngenxa yomsebenzi wabo onzima, ngo-2021, kwafakwa izibalo ezimbili ezintsha ze-eGFR emhlabeni ezasusa ngokuphelele isici 'sohlanga' .
1. Isibalo sokuqala: Sifana nesakudala, kusetshenziswa izinga le-creatinine kuphela (kodwa ngaphandle 'kohlanga').
2. Isibalo sesibili: Ngaphezu kwamazinga e-creatinine, kusetshenziswa esinye isiphawuli samakhemikhali esibizwa nge -cystatin C. Nakuba lokhu kunembe kakhulu, isibalo sokuqala siyanconywa ngoba ukuhlolwa kwe-cystatin C akutholakali kuzo zonke izindawo zokucwaninga emhlabeni futhi kuyabiza.
Lolu shintsho lwenzeka ngokushesha kakhulu emkhakheni wezokwelapha emhlabeni wonke. Kuyajabulisa ngempela ukuthi ushintsho oluthathe iminyaka eyishumi lwenzeka ezinyangeni ezimbalwa nje.
Kungani lo mehluko ubalulekile kithi?
Ungase ucabange ukuthi, lokhu kuyinkinga yaseMelika, yini ebalulekile kithi? Kodwa ezokwelapha ziyinto yomhlaba wonke. Intuthuko noma ukulungiswa kwesayensi okwenzeka engxenyeni ethile yomhlaba kuthinta umhlaba wonke.
- Ukwelashwa Okufanelekile: Lokhu kuqinisekisa ilungelo lesiguli, noma kuphi emhlabeni nakunoma yiluphi ubuzwe, lokuthola ukuxilongwa okufanelekile nokunembile.
- Ukulungisa amaphutha kwezokwelapha: Lesi yisibonelo esihle sendlela ezokwelapha ezivuselela ngayo njalo futhi zilungisa amaphutha azo.
- Ukulalela izwi lesiguli: Izwi lesiguli nalo libe yingxenye ebalulekile ekwenzeni lolu shintsho. Lokhu kukhombisa ukuthi kubaluleke kangakanani ukulalela imibono yeziguli, kunokuba umphakathi wezokwelapha wodwa owenze izinqumo.
Vele, ukushintsha lesi sibalo ngeke kuqede konke ukungalingani kwezempilo ngobusuku obubodwa. Kunezici eziningi zenhlalo nezomnotho ezifaka isandla kuzo. Kodwa lesi yisinyathelo esiqinile nesibalulekile kulokho.
Uma wena noma othile omaziyo enesifo sezinso, khuluma ngokukhululekile nodokotela wakho mayelana nokuhlolwa kwakho kwezokwelapha kanye nokwelashwa. Babuze nge-eGFR yakho, ukuthi isho ukuthini, kanye nezinketho zokwelapha ezingcono kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- I-eGFR (isilinganiso sokuhlunga se-Glomerular esilinganiselwe) iyisibalo esibalulekile esilinganisa ukusebenza kwezinso.
- I-eGFR equation eyayisetshenziswa ngaphambilini yafaka phakathi 'uhlanga' (ikakhulukazi kubantu abamnyama) kule equation, okwaholela ekuphathweni okungafanele kanye nokubambezeleka kweziguli.
- Ngokuqonda ukuthi 'uhlanga' akuyona into ebangelwa yizinto eziphilayo, kodwa umqondo wezenhlalo, izilinganiso ezintsha ze-eGFR ezingenayo 'uhlanga' seziqalisiwe manje.
- Lolu shintsho luyisinyathelo esibalulekile ekunciphiseni ukungalingani kwezokunakekelwa kwempilo kanye nokuhlinzeka ngokwelashwa okufanele kubo bonke iziguli.
- Uma unenkinga mayelana namarekhodi akho ezokwelapha kanye nokwelashwa, kubaluleke kakhulu ukukhuluma ngakho ngokukhululekile nangokucacile nodokotela wakho.
Isifo sezinso, i-eGFR, i-creatinine, ukuhlolwa kwezinso, ukungalingani kwezempilo, imithi, isifo sezinso
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