I-Glomerular Filtration Rate (GFR): iyini, ungayinquma kanjani nokuthi ingashintshwa nini

-Delile

• I-GFR inqunywa kanjani
• Amanani ajwayelekile we-GFR

Izinga lokuhlunga le-glomerular, noma i-GFR elula, yisilinganiso selabhorethri esivumela udokotela ojwayelekile kanye nephrologist ukuthi ahlole ukusebenza kwezinso zomuntu, okuyisinyathelo esibalulekile sokuxilongwa nokuqinisekiswa kwesigaba sesifo esingapheliyo sezinso (CKD) , okwenza i-GFR ibaluleke futhi ekusunguleni ukwelashwa okuhle kakhulu, uma kunesidingo.

Ukuze kubalwe isilinganiso sokuhlunga se-glomerular, kuyadingeka ukuthi kubhekwe ubulili bomuntu, isisindo nobudala, njengoba kuyinto ejwayelekile ukuthi i-GFR yehle njengoba umuntu esemdala, hhayi lokho okukhombisa ukulimala kwezinso noma izinguquko.

Kunezibalo eziningana eziphakanyisiwe ukuthola isilinganiso se-glomerular filtration, kepha okusetshenziswa kakhulu ekwenziweni kwemitholampilo yilokho okucabangela inani le-creatinine egazini noma inani le-cystatin C, okufundwa kakhulu namuhla, kusukela inani I-creatinine ingahle iphazanyiswe ezinye izinto, kufaka phakathi ukudla, ngaleyo ndlela kungabi umaki ofanele wokuhlonza nokuqapha i-CKD.

I-GFR inqunywa kanjani

Izinga lokuhlunga le-glomerular linqunywa elabhoratri kusetshenziswa izibalo okufanele zibhekele ikakhulu iminyaka yomuntu nobulili, njengoba lezi zinto ziphazamisa umphumela. Kodwa-ke, ukuze kubalwe i-GFR, kufanele kuqoqwe isampula yegazi ukuze kukalwe i-creatinine noma i-cystatin C, ngokwesincomo sikadokotela.

Izinga lokuhlunga kwe-glomerular lingabalwa kokubili kucatshangelwa ukugxila kwe-creatinine kanye nokuhlungwa kwe-cystatin C. Yize i-creatinine isetshenziswa kakhulu, ayifanele kakhulu, ngoba ukuhlushwa kwayo kungaphazanyiswa ezinye izinto, njengokudla, ukuvivinya umzimba, izifo ezivuthayo kanye nenani lemisipha futhi ngenxa yalokho akumele kusebenze ukusebenza kwezinso.

Ngakolunye uhlangothi, i-cystatin C ikhiqizwa ngamaseli we-nucleated futhi ihlungwa njalo ezinso, ukuze ukugxila kwalesi sakhi egazini kuhlobene ngqo ne-GFR, ngaleyo ndlela kube uphawu olungcono lomsebenzi wezinso.

Amanani ajwayelekile we-GFR

Izinga lokuhlunga le-glomerular lihlose ukuqinisekisa ukusebenza kwezinso, njengoba kucatshangelwa umthamo wezinto ezihlungiwe ezinso futhi ezingabuyiselwa egazini, zisuswe emchameni. Endabeni ye-creatinine, ngokwesibonelo, le phrotheni ihlungwa yizinso bese kuthi inani elincane liphinde lifakwe egazini, ukuze ngaphansi kwezimo ezijwayelekile, ukugxila kwe-creatinine emchameni kuphakeme kakhulu kunegazi.

Kodwa-ke, lapho kunezinguquko ezinso, inqubo yokuhlunga ingashintshwa, ukuze kuncishiswe i-creatinine ngezinso, okuholele ekugxilweni okuphezulu kwe-creatinine egazini kanye nokwehla kwezinga lokuhlunga kwe-glomerular.

Njengoba isilinganiso sokuhlunga se-glomerular singahluka ngokuya ngobulili nobudala bomuntu, amanani we-GFR uma kubalwa kwenziwa nge-creatinine yilezi:

• Jwayelekile: mkhulu noma ulingana no-60 mL / min / 1.73m²;
• Ukungasebenzi kahle kwezinso: ngaphansi kuka-60 mL / min / 1.73m²;
• Ukwehluleka okukhulu kwezinso noma ukwehluleka kwezinso: lapho ingaphansi kwe-15 mL / min / 1.73m².

Ngokuya ngeminyaka, amanani ajwayelekile e-GFR ngokuvamile:

• Phakathi kweminyaka engama-20 nengama-29: 116 ml / min / 1.73m²;
• Phakathi kweminyaka engama-30 nengu-39: 107 ml / min / 1.73m²;
• Phakathi kweminyaka engama-40 nengama-49: 99 mL / min / 1.73m3;
• Phakathi kweminyaka engama-50 nengama-59: 93 ml / min / 1.73m²;
• Phakathi kweminyaka engama-60 nengama-69: 85 ml / min / 1.73m²;
• Kusukela eminyakeni engama-70 ubudala: 75 ml / min / 1.73m².

Amanani angahluka ngokuya kwelabhorethri, kepha lapho i-GFR ingaphansi kwenani elijwayelekile lesethenjwa lobudala, kubhekwa ukuthi kungenzeka isifo sesifo sezinso, kunconywa ukwenziwa kokunye ukuhlolwa ukuze kuphothulwe ukuxilongwa. njengezivivinyo ze-imaging kanye ne-biopsy. Ngaphezu kwalokho, ngokuya ngamanani atholakele i-GFR, udokotela angabheka isigaba sesifo futhi, ngaleyo ndlela, akhombise ukwelashwa okufanele kakhulu.