Vuto la Kusungunuka kwa Glomerular (GFR): ndi chiyani, momwe mungazindikire komanso kuti zingasinthidwe liti

Zamkati

• Momwe GFR imadziwira
• Makhalidwe abwinobwino a GFR

Kuchuluka kwa kusefera kwa glomerular, kapena GFR chabe, ndi njira ya labotale yomwe imalola kuti dokotala komanso nephrologist awone momwe impso za munthuyo zimagwirira ntchito, chomwe ndichofunikira kwambiri pakuzindikira komanso kutsimikizira gawo la matenda a impso (CKD) , zomwe zimapangitsa GFR kukhala yofunikira pakukhazikitsa chithandizo chabwino kwambiri, ngati kuli kofunikira.

Kuti muwerenge kuchuluka kwa kusefera kwa glomerular, ndikofunikira kuzindikira zakugonana, kunenepa komanso msinkhu wake, chifukwa si zachilendo kuti GFR ichepe pomwe munthu ali ndi zaka zambiri, sizikutanthauza kuwonongeka kwa impso kapena kusintha.

Pali zowerengera zingapo zomwe zikufunsidwa kuti mudziwe kuchuluka kwa kusefera kwa glomerular, komabe zomwe zimagwiritsidwa ntchito kwambiri pachipatala ndizo zomwe zimaganizira kuchuluka kwa creatinine m'magazi kapena kuchuluka kwa cystatin C, yomwe imaphunziridwa kwambiri masiku ano, kuyambira kuchuluka kwake wa creatinine atha kusokonezedwa ndi zinthu zina, kuphatikiza zakudya, motero osakhala chisonyezo choyenera chakuzindikira ndikuwunika kwa CKD.

Momwe GFR imadziwira

Kuchuluka kwa kusefera kwa glomerular kumatsimikiziridwa mu labotale pogwiritsa ntchito kuwerengera komwe kumafunikira makamaka zaka za munthu ndi jenda, chifukwa izi zimasokoneza zotsatira zake. Komabe, kuti GFR iwerengedwe, magazi amayenera kusonkhanitsidwa kuti athe kuyeza creatinine kapena cystatin C, malinga ndi zomwe adokotala ananena.

Mlingo wa kusefera kwa glomerular ukhoza kuwerengedwa poganizira kuchuluka kwa creatinine komanso kuchuluka kwa cystatin C. Ngakhale kuti creatinine ndi yomwe imagwiritsidwa ntchito kwambiri, siyabwino kwambiri, chifukwa kutsekemera kwake kumatha kusokonezedwa ndi zinthu zina, monga chakudya, zolimbitsa thupi, matenda otupa komanso kuchuluka kwa minofu motero sizimayimira kugwira ntchito kwa impso.

Kumbali inayi, cystatin C imapangidwa ndi ma cell a nucleated ndipo imasefedwa nthawi zonse mu impso, kotero kuti kusungunuka kwa chinthuchi m'magazi kumayenderana ndi GFR, potero kukhala chodziwitsa bwino impso.

Makhalidwe abwinobwino a GFR

Mulingo wosefera wa glomerular umafuna kutsimikizira kugwira kwa impso, chifukwa umaganizira kuchuluka kwa zinthu zomwe zimasefedwa mu impso zomwe sizinakonzedwenso m'magazi, zomwe zimachotsedwa mkodzo. Pankhani ya creatinine, mwachitsanzo, puloteni iyi imasefedwa ndi impso ndipo pang'ono zimabwezeretsedwanso m'magazi, kotero kuti munthawi zonse, kuchuluka kwa creatinine mumkodzo wokwera kwambiri kuposa magazi kumatha kutsimikiziridwa.

Komabe, pakakhala kusintha kwa impso, kusefera kumatha kusinthidwa, kotero kuti creatinine yocheperako imasefedwa ndi impso, zomwe zimapangitsa kuchuluka kwa creatinine m'magazi ndikuchepetsa kusefera kwa glomerular.

Momwe kuchuluka kwa kusefera kwama glomerular kumatha kusiyanasiyana kutengera mtundu wa munthu ndi zaka zake, GFR imayamikira kuwerengera komwe kumapangidwa ndi creatinine ndi:

• Zachibadwa: choposa kapena chofanana 60 mL / min / 1.73m²;
• Kulephera kwaimpso: zosakwana 60 mL / mphindi / 1.73m²;
• Kulephera kwa impso kapena impso kulephera: osakwana 15 mL / min / 1.73m².

Malinga ndi msinkhu, zoyenera za GFR nthawi zambiri zimakhala:

• Pakati pa 20 ndi 29 zaka: 116 mL / mphindi / 1.73m²;
• Pakati pa zaka 30 ndi 39: 107 mL / mphindi / 1.73m²;
• Pakati pa zaka 40 ndi 49: 99 mL / mphindi / 1.73m²;
• Pakati pa zaka 50 ndi 59: 93 mL / mphindi / 1.73m²;
• Pakati pa zaka 60 ndi 69: 85 mL / mphindi / 1.73m²;
• Kuyambira zaka 70: 75 mL / mphindi / 1.73m².

Zomwe zimakhalapo zimatha kusiyanasiyana malinga ndi labotale, komabe GFR ikakhala yocheperako poyerekeza ndi zaka, kuthekera kwa matenda a impso kumaganiziridwa, kulimbikitsidwa ndikuchita mayeso ena kuti athe kumaliza matendawa. monga kuyerekezera koyerekeza komanso kusanthula. Kuphatikiza apo, kutengera zomwe zimapezeka ku GFR, adokotala amatha kuwona momwe matendawa aliri ndipo, motero, akuwonetsa chithandizo choyenera kwambiri.