Ireyithi yokuhluza yeGlomerular (GFR): iyintoni, ungayichonga njani kwaye ingatshintshwa nini

Umxholo

• Igqitywe njani i-GFR
• Amaxabiso aqhelekileyo eGFR

Izinga lokuhluza le-glomerular, okanye i-GFR ngokulula, ngumlinganiso waselebhu ovumela ugqirha jikelele kunye nephrologist ukuba ivavanye ukusebenza kwezintso zomntu, elingumlinganiso obalulekileyo wokuchongwa kunye nokuqinisekiswa kwenqanaba lesifo sezintso esinganyangekiyo (CKD) , eyenza i-GFR ikwabalulekile ekumiseleni olona nyango lulungileyo, ukuba kukho imfuneko.

Ukubala inqanaba lokuhluza le-glomerular, kufuneka kuthathelwe ingqalelo isini somntu, ubunzima kunye nobudala, njengoko kuyinto eqhelekileyo ukuba i-GFR yehle njengoko umntu esiba mdala, kunganyanzelekanga ukuba ibonakalise ukonakala kwezintso okanye utshintsho.

Kukho ubalo oluninzi olucetywayo lokumisela iqondo lokuhluzwa kwe-glomerular, nangona kunjalo ezona zisetyenziswayo kunyango zizinto ezithathela ingqalelo inani le-creatinine egazini okanye isixa se-cystatin C, esona sifundo sifundwayo namhlanje, ukusukela isixa I-creatinine inokuphazanyiswa zezinye izinto, kubandakanya ukutya, ngenxa yoko ingabi luphawu olufanelekileyo lokuchonga kunye nokubeka iliso kwi-CKD.

Igqitywe njani i-GFR

Izinga lokuhluza elimnandi limiselwa kwilabhoratri kusetyenziswa ukubala ekufuneka kuthathelwe ingqalelo ikakhulu ubudala kunye nesini somntu, njengoko ezi zinto ziphazamisa iziphumo. Nangona kunjalo, ukuze kubalwe i-GFR, kufuneka kuqokelelwe isampulu yegazi ukwenzela ukulinganisa i-creatinine okanye i-cystatin C, ngokwesindululo sikagqirha.

Izinga lokuhluza le-glomerular linokubalwa kokubini kuthathelwa ingqalelo uxinzelelo lwe-creatinine kunye nokuxinana kwe-cystatin C. Nangona i-creatinine isesona sisetyenzisiweyo, ayisiyiyo efanelekileyo, kuba ingxinano yayo inokufumana uphazamiseko kwezinye izinto, njengokutya, Umsebenzi womzimba, izifo ezivuthayo kunye nobungakanani bemisipha kwaye ke oko akuthethi ukuba umsebenzi wezintso.

Kwelinye icala, i-cystatin C iveliswa ziiseli ze-nucleated kwaye zihluzwa rhoqo kwizintso, ukuze uxinzelelo lwento egazini inxibelelene ngokuthe ngqo ne-GFR, yiyo loo nto ibe luphawu olungcono lomsebenzi wezintso.

Amaxabiso aqhelekileyo eGFR

Inqanaba lokuhluza le-glomerular lijolise ekuqinisekiseni ukusebenza kwezintso, njengoko ithathela ingqalelo idosi yezinto ezicociweyo kwizintso kwaye aziphinde zifakwe egazini, zisuswe kumchamo. Kwimeko ye-creatinine, umzekelo, le protein icocwa zizintso kwaye isixa esincinci siphinda sibuyiselwe egazini, ukuze phantsi kweemeko eziqhelekileyo, ukugxila kwe-creatinine kumchamo ophakame kakhulu kunoko kunegazi.

Nangona kunjalo, xa kukho utshintsho kwizintso, inkqubo yokuhluza inokutshintshwa, ukuze kuncitshiswe i-creatinine xa icocwa zizintso, nto leyo ekhokelela kugonyo oluphezulu lwe-creatinine egazini kunye nokwehla kwenqanaba lokuhluza i-glomerular.

Njengoko inqanaba lokucoca glomerular linokwahluka ngokwesini kunye nobudala bomntu, amaxabiso e-GFR xa kubalwa kwenziwa nge-creatinine zezi:

• Eqhelekileyo: ingaphezulu okanye ilingana ne-60 mL / min / 1.73m²;
• Ukungonelanga kwezintso: ngaphantsi kwe-60 mL / min / 1.73m²;
• Ukungaphumeleli kwezintso okanye ukusilela kwezintso: xa ingaphantsi kwe-15 mL / min / 1.73m².

Ngokweminyaka, amaxabiso aqhelekileyo e-GFR ahlala:

• Phakathi kweminyaka engama-20 nengama-29: I-116 mL / min / 1.73m²;
• Phakathi kweminyaka engama-30 nengama-39: I-107 mL / min / 1.73m²;
• Phakathi kweminyaka engama-40 nengama-49: 99 mL / min / 1.73m²;
• Phakathi kweminyaka engama-50 nama-59: I-93 mL / min / 1.73m²;
• Phakathi kweminyaka engama-60 nama-69: 85 ml / min / 1.73m²;
• Ukususela kwiminyaka engama-70 ubudala: 75 mL / min / 1.73m².

Ixabiso linokwahluka ngokwelabhoratri, nangona kunjalo xa i-GFR ingaphantsi kwexabiso eliqhelekileyo lobudala, imeko yesifo sezintso iyaqwalaselwa, kucetyiswa ukwenziwa kwezinye iimvavanyo ukuze kugqitywe ukuxilongwa. njengeemviwo zokucinga kunye ne-biopsy. Ukongeza, ngokusekwe kumaxabiso afunyenwe i-GFR, ugqirha unokujonga inqanaba lesifo kwaye, ke, abonise olona nyango lufanelekileyo.