๐–๐š๐ฑ ๐ค๐š ๐Ÿ๐š๐ก๐š๐ง ๐ฌ๐ก๐š๐ฒ๐›๐š๐š๐๐ก๐ค๐š ๐ค๐ž๐ฅ๐ฒ๐š๐ก๐š ๐๐š๐ฒ๐›๐ญ๐š ๐Ÿ๐š๐š๐ W/Q:(Dr abdikarim D Hassan)

๐–๐š๐ฑ ๐ค๐š ๐Ÿ๐š๐ก๐š๐ง ๐ฌ๐ก๐š๐ฒ๐›๐š๐š๐๐ก๐ค๐š ๐ค๐ž๐ฅ๐ฒ๐š๐ก๐š ๐๐š๐ฒ๐›๐ญ๐š ๐Ÿ๐š๐š๐

๐’๐ก๐š๐ฒ๐›๐š๐š๐๐ก๐ค๐š ๐๐ก๐ข๐ข๐ ๐š:
Qofka kelyo xanuun looga shakiyo waa in shaybaadh dhiig loo sameeyo. Xanuuno tiro badna oo kelyaha ku dhaca ayaa dhiigga laga arki karaa; si kooban ayaynu mid walba u sharaxi doonaa si qofka ugu fududaato in uu fahmo shay-baadhka laga qaaday isaga ama qofka uu masโ€™uulka ka yahay.

๐™Ž๐™๐™–๐™ฎ๐™—๐™–๐™–๐™™๐™๐™ ๐™– ๐™†๐™ž๐™ง๐™ž๐™ฎ๐™–๐™ฉ๐™ž๐™ฃ๐™ž๐™ž๐™ฃ (๐™‹๐™ก๐™–๐™จ๐™ข๐™– ๐˜พ๐™ง๐™š๐™–๐™ฉ๐™ž๐™ฃ๐™ž๐™ฃ๐™š):
Kiriyatiniin waa maadad ay sameeyaan muruqyada jidhku markasta oo ay shaqo ku jiraan, hayaraato ama hawaynaato shaqadaasi. Waa maado ah qashin oo ay tahay in jidhka si degdeg ah looga saaro. Sida dadku ukala muruqyo badan yihiin ayay u kala Kiriyatiniin badan yihiin. Sidoo kale dadka ciyaara jimicsiyada muruqyada lagu dhiso iyo dadka soonka ama gaajadu ku badan tahay way ka Kiriyatiniin badan yihiin dadka inta kale. Qashin saarka Kiriyatiniin-ta waxa u xilsaaran kelyaha, sidaa darteed hadii kiritatiniintu jidhka ku badato waxa laga yaabaa in Kelyuhu aanay sifiican u sifayn.

๐‘ฟ๐’‚๐’…๐’Š๐’ˆ๐’‚ ๐’…๐’‚๐’ƒ๐’Š๐’Š๐’„๐’Š๐’ˆ๐’‚ ๐’‚๐’‰ ๐’†๐’† ๐‘ฒ๐’Š๐’“๐’Š๐’š๐’‚๐’•๐’Š๐’๐’Š๐’Š๐’(๐’„๐’“๐’†๐’‚๐’•๐’Š๐’๐’Š๐’๐’†) ๐’˜๐’–๐’™๐’–๐’– ๐’– ๐’…๐’‰๐’†๐’™๐’†๐’†๐’š๐’‚๐’‚: 0.6-1.3 ๐’Ž๐’ˆ/๐’…๐’/ ๐’“๐’‚๐’ˆ๐’ˆ๐’‚; ๐’…๐’–๐’Ž๐’‚๐’“๐’Œ๐’‚๐’๐’‚ 0.6-1.1 ๐’Ž๐’ˆ/๐’…๐’
Hadii hal-shaybaadh oo qofka laga qaaday uu sareeyo, waa in laba mar oo danbe lagu celiyo.

๐‘ช๐’“๐’†๐’‚๐’•๐’Š๐’๐’Š๐’๐’† ๐‘ช๐’๐’†๐’‚๐’“๐’‚๐’๐’„๐’† (๐‘ช๐’“๐‘ช๐’):
shaybaadh-kan wuxuu is barbar dhigayaa Kiriyatiniin-ta dhiiga ku jirta iyo Kiriyatiniin-ta kaadida soo raacday ee kelyuhu sifeeyeen. Farqiga labadaa u dhexeeya ayaa sheegaya in kelyuhu sifiican u shaqaynayaan iyo inkale. Xadiga dabiiciga ah ee shaybaadh-kani waxa uu u dhexeeyaa : 97-137 ๐’Ž๐’/๐’Ž๐’Š๐’ ๐’“๐’‚๐’ˆ๐’‚; ๐’…๐’–๐’Ž๐’‚๐’“๐’Œ๐’‚๐’๐’‚ ๐’˜๐’‚๐’‚ 88-128 ๐’Ž๐’/๐’Ž๐’Š๐’ ๐’…๐’–๐’Ž๐’‚๐’“๐’Œ๐’‚. Tirooyinkan macnahoodu waxa weeye, qofka dhalinyarada ah ee caafimaadka qaba, halkii daqiiqo kelidu waxay nadiifisaa 97 -137/ml oo dhiig ah, kaas oo ay ka saarto kiriyatiniintii ku jirtay. Dumarka in yar ayay raga kayara hooseeyaan, sababta oo ah way ka muruqyo yar yihiin, dhisma jidhkuna wuu kala duwan yahay. Hadaba, markasta oo intaas ay hoos uga dhacdo, waxay tilmaamaysaa in shaqadeedu hoos u dhacday.

๐‘ฎ๐’๐’๐’Ž๐’†๐’“๐’–๐’๐’‚๐’“ ๐‘ญ๐’Š๐’๐’•๐’“๐’‚๐’•๐’Š๐’๐’ ๐‘น๐’‚๐’•๐’† (๐‘ฎ๐‘ญ๐‘น):
GFR waa qaaciido lagu raadiyo shaqada kelyaha, gaar ahaan marka qofka kelyo xannuun mudo dheer hayay ee la hubo in shaqadii kelyihiisu is-dhintay; markaas oo kale waxa la rabaa in la ogaado inta ay is dhimeen. Waxa kale oo la adeegsadaa marka qofka dawooyin lasiiyay ee la doonayo in la ogaado in ay wax u tareen oo kelyuhu kasoo raynayaan iyo in kale. GFR waxa lagu helayaa afar shay oo la isku xisaabiyo: kiriyanitiin-ta, daโ€™da (age) qofka, lab iyo dhedig midka uu yahay (sex) iyo cirqigiisa(race). Qofka caafimaadkiisu fiican yahay GFR-kiisu way ka sarreesaa 140๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ. laakiin wixii ka sareeya 90๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ waa natiijo caadi ah oo aan dhib lahayn. Iyadoo Shaybaadhkan la adeegsanayo ayaa kelyaha xanuunka yareeya shaqadda kelyaha loo qaybiyaa shan derajo oo ku salaysan sida ay u kala khatarsan yihiin:
1. Derajada koobaad (stage 1): deragaddan kelyahu way bukaan, dhaawacna wuu soo gaadhay laakiin sifiican ayay u shaqaynayaan fiican, wali dhiig sifayntooddu way ka sarraysaa 90๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ.
2. Derajada labaad (stage 2): shaqadii kelyauhu wax yar oo sahlan aya hoos u dhacday, waxaanay u dhexaysaa- 60 – 89๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ.
3. Derajada shadexaad (stage 3): shaqada kelyaha aad ayay hoos ugu dhacday, waxaanay u dhexaysaa- 45๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ- 59๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ.
4. Derajada afraad (stage 4): shaqada kelyaha si halis ah ah ayay hoos ugu dhacday, waxaanay maraysaa- 15๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Ž ยฒ- 29๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Ž ยฒ.
5. Derajada shanaad (stage 5): heerkan haday gaadhaan kelyuhu macnuhu waxa weeye way fadhiisteen kelyuhu, wax shaqo ah oo jidhka wax u tarana malaha โ‰ค15๐’Ž๐’/๐’Ž๐’Š๐’/1.73๐’Žยฒ. Tusaale hadii la yidhaa qofka GFR-kiisu waa 60ml/min/1.73mยฒ macnaheedu waxa weeye in qofkaa kelidiisu boqolkiiba lixdan shaqaynayso, afartanโ€™na is dhintay.

๐‘บ๐’‰๐’‚๐’š๐’ƒ๐’‚๐’‚๐’…๐’‰๐’Œ๐’‚ ๐‘ฉ๐’‚๐’“๐’๐’๐’•๐’Š๐’Š๐’๐’‚๐’…๐’…๐’‚:
Barootiinka ugu muhiimsan ee lagu saadaalin karo shaqada kelyaha waxa la yidhaa ๐˜”๐˜ช๐˜ค๐˜ณ๐˜ฐ-๐˜ข๐˜ญ๐˜ฃ๐˜ถ๐˜ฎ๐˜ชm, sababta oo ah waa barootiin xajmigiisu wayn yahay isla markaana ah barootiinka ugu badan ee dhiiga kujira. Qofka kelyahiisu fayow yihiin barootiin la dareemi karo masoo raaco kaadida. Waxa duruufaha qaar dhacda in xaddi ilaa xad yar oo aan saamayn ku lahayn jidhka uu kaadidda soo raaco (0-30mg/dl); balse haddii xaddiga kaadidda soo raacayaa gaadho 30-300๐’Ž๐’ˆ/๐’…๐’, waxay tilmaamaysaa kelyo bilaabay in ay dhintaan oo shaqadoodii gabay. Haddii albuminta kaadidda soo raacaysaa dhaafto xaddiga ka badan โ‰ฅ300mg/dl waxay tilmaamaysaa in kelyahaasi derajo hoosaysa marayaan isla markaana shaqadooddu gabaabsi tahay.

๐‘ฉ๐’๐’๐’๐’… ๐‘ผ๐’“๐’†๐’‚ ๐’๐’Š๐’•๐’“๐’๐’ˆ๐’†๐’ (๐‘ฉ๐‘ผ๐‘ต):
Jidhkeenu wuxuu sameeyaa maadada Urea marka uu burburiyo barotiinada kala duwan ee aynu cuno; maadaddan waxa jidhka ka saara kelyaha, waxayna ka mid tahay walxaha la qiyaaso si sawir fiican looga helo shaqadda kelyaha. . Shaybaadhkani wuxuu is dhinac dhigayaa Urea-da dhiigga ku jirta iyo Urea-da kaadida soo raacday ee kelyuhu soo sifeeyeen.
Arimo dhowr ah ayaa saamayn ku yeesha shaybaadhkan oo ay kamid tahay qofka oo aan cuninba barootiin badan, dhiig-bax caloosha dhexdeeda ah, xannuunadda wadna, sidoo kale waxa jira dawooyin shaybaadhkan natiijadiisa kor u qaadi kara. Arimahaas oo dhan waxa isku miisaami kara oo faham sax ah kasoo saari kara dhakhtarka. Blood urea nitrogen (BUN) dabiicig ah waxa lagu qiyaasaa inta u dhaxaysa 7-20mg/dl.

Xigasho:Dr abdikarim D Hassan

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