FAHAM GUUD: PROTEIN KA KAADIDA SOO RAACA.

 Maxaa aad ka fikirtaa Booratiin ayaa soo raacaya kaadidaada?

Inta aanan gudaha u galin aan ku fahansiiyo in yar ee akhri.

Kalyuhu waxa ay u shaqeeyaan qaab ah in ay jidhka ku celiyaan wixii muhiima ee jidhku u baahan yahah sida Boratiinka, Sonkorta IWM.  Laakiin mar mar ayaanay celin oo jidhka intii uu baahanaa in ka badan ay kalyaha timaad markaana waa la saaraa oo kaadida ayaa la soo raaciyaa. 

Halkaa marka aad fahanto waxa jira oo kale in mararka qaar kalyaha dhaawac soo gaadho gaar ahaan unugyada iyo xuubabka badh habaha ee kalyuhu leeyihiin ee loo yaqaan iyo unug shaqeedyada kalyaha (Glumerular Basement Membrane, Nephron)dhaawacaa oo kaga yimaad dhibaato joogto ah, sida sonkor saraysa marwalba, Dhiigkar sareeya Marwalba, cuntooyin ama daawooyin dhaawaca iyo Xanuuno gooni u ah xuubkaas oo dalooliya, ama shabagiisaa dhaawaca. 

Taasi waxa ay ka saartaa celintii jidhka lagu celinayay waxyaabihii Muhiimka ahaa caawa inagu Booratiin uun baan ka hadlaynaaye. 

Halkaa Marka ay wax marayaan waxa jira xaalado ama xanuuno keena in kaadida Booratiin soo raaco oo aan kalyaha dhibtu ka jirin jidhka kale ay ka jirto dhibtu si loo kala garto Booratiinkan wuxu yahay, waxa la socda, calaamadaha kale ee qofku leeyahay, iyo shaybaadho kale oo aad u baahan tahay si loo kala saaro in xanuunka keenay, sida uga bogsanayso iyo in ay iska baaba’ayso.

Hada waxa aad ila fahantay Booratiin baa kaadidaada la socdaa in aanay hawl yarayn sow maahan. 

Sidee lagu ogaadaa. 

 

1) waxa lagu ogaadaa shaybaadh fudud oo la yidhaa (Urine Dipstick ) ahna in kaadida la galiyo xaashi yar oo kaliyah midabkeedu is bedelo midabku hadba sida uu isku bedelo la raaciyo (1+Plus 2+ 3+ ) waxa la dhahaa oo kale (Macroproteinuria) shaybaadhkani kaliyah wuxuu sheegaa in kaadida Booratiin la socdo laakiin halkuu yimid, noocuu yahay, laguma garan karo waana ta ugu badan ee la baadho hadii lagu dhaho Booratiin 3plus ah ayaa kaadidaada la socda waa lagu tilmaamay uun laakiin waxba laguuma sheegin waa shaybaadh aan dhamaystirnayn. Una baahan dib in loogu noqdo si loo heli halka mushkiladu ku jirto jidhkaaga.

2) waa in la ogaado run inuu yahay, xadiga Booratiinka laba qaab ayaa loo tiriyaa 

          A) 24 saac waa In kaadida la ururiyaa oo la ogaado Xadiga soo raacaya Booratiin ee kaadida soo raacaya. 

           B)in kaadida laga tiriyo xadiga yaryar ee soo raacaya oo laga qaadaa shaybaadh la dhalo Microalbuminuria. 

3) xadiga Booratiinku wuxuu kala sheegaa xanuuno kala duwan Tusaale ahaan. 

•<500 mg/day → waxa keena in tuumbooyinka kalyaha qulqul badan imanayo (tubular or overflow causes)

•0.5–3.5 g/day → xadigan waxa keena xanuuno aan kalyaha ahayn  (non-nephrotic, think secondary causes)

•3.5 g/day → xadigana xanuuno kalyaha ku dhaca (nephrotic, raises red flags for glomerular pathology)

4) in xanuuno kale leeyahay qofku waa muhiim in la hubiyo Marka qofku yeesho Booratiin kaadida soo raacaya. 

A)in uu leeyahay Dhiig kar, Macaan

B)in uu leeyahay Xanuunada Infakshan keeno sida (HIV HBV HCV)

C) in uu qaato ama u socdaan daawooyinka in uu (NSAIDs, Penicillins, Gold ku sumoobay) 

D) kansarada (Malignant Cancers) 

5)kaadida Booratiinka soo raacayaa wuxuu la xidhiidha xanuunada Roomantisam ka 

Rheumatology clues

•Proteinuria + hematuria + low C3/C4 →  SLE nephritis

•Proteinuria + vasculitic rash + ANCA → ANCA vasculitis

•Proteinuria + neuropathy + eosinophilia → EGPA

•Proteinuria + arthritis/RA → secondary amyloidosis.

6) Calaamadaha khatarta ah ee degdeg ugu baahan in hadii ay u weheliyaan booratiinka kaadida soo raacaya ee u baahan in degdeg wax looga qabto sida in kalyaha laga qaado cad (biopsy) ama immunological study degdeg ah 

•hadii xadigu sareeyo gaadho xadiga loo yaqaan (Nephrotic range proteinuria)

•in Kiriyaatin degdeg ula kacdo ama kaadidaa booratiinku la socdo. (Rapid rise in creatinine)

•Kaadi booratiin la socdo oo qofku yeesho (Proteinuria + system Symptoms) (finan (rash), xumad (fever), kalagoysyada xanuuna (arthritis), canduuf dhiig le ama la socdo (hemoptysis)

Hadaba Marka lagu sheego Booratiin ayaa kaadida soo raacaya waa xaalad caafimaad oo ka fikir, Habraac, daawayn iyo kala garasho xanuunadii kugu keenay u baahan in la hubsado aan go’aan degdega berrina aad u waxyeelo kaa soo gaadhi karto la qaadan.  

Ha fudaydsan waa calaamad isku xidha Labo Dhakhtar oo kala takhasus ah. 

1)Internal Medicine   

2)Rhuematologist 

Xigasho: Dr barkhad mohamed hussein.