Qhov Tseem Ceeb Qhov txawv - GFR vs eGFR
Glomerular Filtration Rate (GFR) yog ib qho kev sim siv los ntsuas qib ntawm lub raum ua haujlwm. Yeej, nws ntsuas cov ntshav ntau npaum li cas los ntawm glomeruli txhua feeb. Kwv yees Glomerular Filtration Rate (eGFR) yog xam tus nqi raws li qhov sib txawv GFR txhais. Qhov no yog qhov sib txawv tseem ceeb ntawm GFR thiab eGFR; kev sib txawv ntxiv yuav raug sau tseg hauv kab lus no.
Dab tsi yog Glomerular Filtration Rate (GFR)?
GFR yog suav tias yog qhov muaj txiaj ntsig zoo tshaj plaws ntawm lub raum kev ua haujlwm hauv kev noj qab haus huv thiab kab mob. Nws raug xa mus rau qhov ntim ntawm cov kua dej lim tawm los ntawm lub raum glomerular capillaries mus rau hauv Bowman's capsule ib lub sijhawm. Pom tus nqi nyob ntawm cov ntshav siab sib txawv tsim los ntawm vasoconstriction ntawm cov tswv yim piv rau vasoconstriction ntawm cov zis. GFR tuaj yeem ntsuas los ntawm kev tshem tawm cov txheej txheem siv ob qho tib si endogenous (creatinine, urea) lossis exogenous (inulin, iothalamate) pom cov cim. Hauv kev xyaum kho mob, GFR feem ntau ntsuas raws li cov ntshav creatinine concentrations.
Basic physiologic mechanisms of the raum
Tus kwv yees Glomerular Filtration Rate (eGFR) yog dab tsi?
eGFR (Kev kwv yees Glomerular Filtration Rate) yog tus nqi xam raws li cov cim pom (qhov tseeb, ntshav creatinine) concentration los ntsuas lub raum ua haujlwm. Kwv yees GFR tuaj yeem sib txawv raws hnub nyoog txawm tias nyob hauv cov neeg noj qab haus huv. Hnub nyoog raws li qhov nruab nrab eGFR rau cov neeg noj qab haus huv muaj npe hauv qab no
| hnub nyoog | Average eGFR |
| 20-29 | 116 |
| 30-39 | 107 |
| 40-49 | 99 |
| 50-59 | 93 |
| 60-69 | 85 |
| 70+ | 75 |
eGFR yog qhov pib ua rau kuaj mob CKD (Cov Kab Mob Raum Ntev) thiab tam sim no nws tau muab faib ua tsib theem raws li eGFR raws li kev pom zoo los ntawm cov kws tshaj lij cov lus qhia.
| Stage | Kev piav qhia | eGFR |
| 1 | raum puas nrog raum ua haujlwm | ≥90 |
| 2 | raum puas nrog raum tsis ua haujlwm me ntsis | 89 to 60 |
| 3a | me me mus rau nruab nrab poob lub raum ua haujlwm | 59 to 44 |
| 3b | mob raum tsis ua haujlwm hnyav | 44 to 30 |
| 4 | poob raum ua haujlwm hnyav | 29 to 15 |
| 5 | raum tsis ua haujlwm | < 15 |
Kev sib npaug rau xam eGFR
Yav dhau los, 24-teev creatinine tshem tawm tau raug suav tias yog txoj hauv kev ntsuas lub raum ua haujlwm. Tab sis vim muaj kev txwv tsis pub sau cov zis kuaj raws sij hawm thiab tsis tuaj yeem sau tag nrho cov qauv, National Kidney Foundation Disease Outcomes Quality Initiative (K-DOQI) pom zoo kom siv eGFR xam los ntawm kev kwv yees sib npaug raws li cov ntshav / ntshav creatinine.
Qhov no tau muab txoj hauv kev yooj yim thiab siv tau rau kev suav eGFR los txiav txim siab txog yam xws li tus neeg mob lub hnub nyoog, poj niam txiv neej, qhov hnyav thiab haiv neeg (nyob ntawm seb hom kab zauv). Cov kev sib npaug uas feem ntau siv yog Kev Hloov Kho Kev Noj Qab Haus Huv Hauv Mob Raum [(MDRD) (1999)] thiab Kev Sib Raug Zoo Rau Raum Kab Mob Sib Kis [(CKD-EPI) (2009)
Rau kwv yees GFR hauv cov neeg mob hnub nyoog qis dua 18 xyoo, Bedside Schwartz sib npaug tuaj yeem siv.
MDRD Equation
MDRD eGFR=186 × [Plasma Creatinine (μmol/L) × 0.0011312]−1.154 ×[hnub (xyoo)]−0.203 ×[0.742 yog poj niam] × [1.212 yog tias dub
Units – mL/min/1.73m2
Qhov kev sib npaug no tau lees paub rau cov neeg mob ntshav qab zib hauv lub raum, cov neeg txais lub raum hloov pauv thiab cov neeg Asmeskas Asmeskas uas tsis muaj mob raum. Tab sis nws tsis tau lees paub rau cov menyuam yaus hnub nyoog qis dua 18 xyoo, cov poj niam cev xeeb tub thiab cov neeg mob hnub nyoog tshaj 70 xyoo.
CKD-EPI Equation
Dawb lossis lwm yam
Poj niam nrog Creatinine≤0.7mg / dL; siv eGFR=144×(Cr/0.7)^−0.329×(0.993)Age
Poj niam nrog Creatinine>0.7mg / dL; siv eGFR=144×(Cr/0.7)^−1.209×(0.993)Age
Txiv neej nrog Creatinine≤0.9mg / dL; siv eGFR=141×(Cr/0.9)^−0.411×(0.993)Age
Txiv neej nrog Creatinine>0.9mg / dL; siv eGFR=141×(Cr/0.9)^−1.209×(0.993)Age
Black
Poj niam nrog Creatinine≤0.7mg / dL; siv eGFR=166×(Cr/0.7)^−0.329×(0.993)Age
Poj niam nrog Creatinine>0.7mg / dL; siv eGFR=166×(Cr/0.7)^−1.209×(0.993)Age
Txiv neej nrog Creatinine≤0.9mg / dL; siv eGFR=163×(Cr/0.9)^−0.411×(0.993)Age
Txiv neej nrog Creatinine>0.9mg / dL; siv eGFR=163×(Cr/0.9)^−1.209×(0.993)Age
Units – mL/min/1.73m2
CKD-EPI kab zauv txo qis qhov kev kuaj mob ntawm CKD nrog MDRD kab zauv. Qhov no suav nrog cov cav ntshav creatinine qauv nrog poj niam txiv neej, haiv neeg thiab hnub nyoog ntawm cov nplais ntuj.
Qhov txawv ntawm GFR thiab eGFR yog dab tsi?
Definition
GFR: GFR yog tus nqi ntawm cov ntshav dhau los ntawm lub raum
eGFR: eGFR yog qhov tshwm sim uas tuaj yeem tau los ntawm GFR.
Siv
GFR: GFR ua raws li ib txoj hauv kev zoo tshaj plaws ntawm kev ntsuas lub raum ua haujlwm.
eGFR: eGFR muab tus nqi rau qhov ntawd.
Tus nqi no yog tag nrho raws li kev sib npaug validated ntawm cov xwm txheej sib txawv. Yog li qhov ua yuam kev tseem ceeb tuaj yeem ua tau rau cov neeg uas hnyav lub cev hnyav, cov poj niam cev xeeb tub, thiab menyuam yaus. Tsis tas li ntawd, feem ntau qhov sib npaug siv tau rau Asmeskas cov neeg mob dawb thiab Dub thiab yuav tsis sib haum nrog lwm haiv neeg.
