Whakamātautau creatinine: te awhe noa, te creatinine teitei, me te tikanga o tō hua

He para te creatinine ka hangaia ina whakamahi ō uaua i te pūngao. Ka hangaia i te tere āhua ū, ka kawea e te toto, ā, ka tātaria e ngā whatukuhu ki te mimi.

I te mea ka hanga ū te tinana, ā, ka whakawātea ngā whatukuhu, ko te taumata i tō toto he aratohu pai o ia rā mō te pai o te tātari a ngā whatukuhu. Ina pōturi te tātari, ka kohi te creatinine, ka piki te tau.

Ka kīia te whakamātautau toto ko te serum creatinine, ko te S. creatinine rānei, ā, he wāhanga o te whakamātautau mahi whatukuhu (kidney function test, KFT, RFT rānei) me te urea, te BUN, te konutai (sodium) me te pāhare (potassium). He whakamātautau urine creatinine (creatinine mimi) anō, ka whakamahia i te nuinga hei tātai i te ōwehenga albumin-ki-te-creatinine o te mimi, e rapu ana i te pūmua e turuturu ana ki te mimi.

Ko te creatinine anake ka hāngai ki te nui o ō uaua, tō pakeke me tō ira tangata, nō reira ko te tau kotahi he noa mō tētahi, he teitei mō tētahi atu. Koia i hurihia ai e ngā taiwhanga hei eGFR: he whakatau tata mō te maha o ngā mitarita (millilitres) toto ka tātaria e ō whatukuhu ia meneti, kua whakaritea ki tētahi rahi tinana paerewa.

Ko te nuinga o ngā taiwhanga ināianei e whakamahi ana i te whārite CKD-EPI 2021, e whakamahi ana i te creatinine, te pakeke me te ira tangata (kua kore e whakamahia te iwi). Ko te eGFR 90 neke atu he noa; ko te 60 ki te 89 ka noa pea mō tētahi kaumātua; ko te raro iho i te 60 mō te toru marama neke atu, he mate whatukuhu mau tonu.

He iti iho te tika o te eGFR mēnā he tino nui, he tino iti rānei ō uaua, kei te hapū koe, kua tapahia tētahi wāhanga o tō tinana (amputation), kei te whai koe i tētahi kai kaimanga tino ū, i tētahi kai pūmua tino nui rānei, kei te tere panoni rānei te mahi a ō whatukuhu. Ka whakamahi pea ngā rata i tētahi whakamātautau cystatin C anō.

Ko te hua neke atu i te awhe a tō taiwhanga, ka ahu mai pea i ngā mea kāore e pā ana ki te mate whatukuhu:

• Te matewai (dehydration): kāore i rawaka te inu, te wera, te ruaki, te korere rānei
• He nui ngā uaua, he korikori taumaha i te rā kotahi, i ngā rā e rua rānei i mua i te whakamātautau, he pire creatine rānei
• He kai nui o te mīti kua tunua i ngā hāora i mua i te whakamātautau
• Ētahi rongoā, tae atu ki ētahi rongoā mamae (NSAIDs pērā i te ibuprofen), ētahi rongoā pēhanga toto me ētahi patu huakita (antibiotics). Kaua rawa e whakamutu i tētahi rongoā kua tuhia i a koe anō; pātai ki te rata nāna i tuhi.

Ka tohu anō pea he iti iho te tātari a ngā whatukuhu:

• Whara whatukuhu ohorere (acute kidney injury): he hekenga ohorere, i te nuinga me te matewai, he pokenga taumaha, he ārainga rānei
• Mate whatukuhu mau tonu (chronic kidney disease): he hekenga pōturi, i te nuinga nā te mate huka, nā te pēhanga toto teitei rānei kua roa e mau ana
• He ārainga i te ara mimi, pērā i te repe prostate kua rahi, i ngā kōhatu whatukuhu rānei

I te nuinga o te wā ka whakamātautau anō te rata, ka titiro ki tō eGFR, ka whakatairite ki ngā hua o mua. He tino rerekē te hua ū i tētahi e tere piki ana.

He onge te āwangawanga mō te creatinine iti. I te nuinga o te wā ka whakaata i te iti iho o ngā uaua: i ngā kaumātua, i te hunga he tinana iti, i muri i tētahi māuiui roa, i te hekenga taumaha rānei, i te kai tipu te nuinga rānei.

He noa anō te heke i te hapūtanga, nā te mea ka nui ake te tātari a ngā whatukuhu. Ko ngā taumata tino iti, ka haere tahi pea me te korenga o te kai tōtika, te mate ate taumaha, ngā mate e memeha ai ngā uaua rānei, ka rapua e te rata mēnā he tohu kē.

Kotahi te mahanga: mēnā he iti ngā uaua, ko te creatinine e āhua "noa" ana ka huna pea i te hekenga o te mahi whatukuhu. Ko tētahi take tēnā i whakamahia ai te eGFR, ā, i ētahi wā he whakamātautau cystatin C.

• He tauira toto iti mai i tētahi ia toto (vein). Kāore e hiahiatia te nohopuku i te nuinga o te wā, ki te kore e hiahiatia mō ētahi atu whakamātautau i taua toronga anō.
• Kaua e korikori taumaha mō te rā kotahi i mua, ā, kaua e kai i tētahi kai nui o te mīti kua tunua i te ahiahi i mua, nā te mea ka whakapiki ēnei e rua i te hua.
• Inu pērā i te tikanga. Mā te matewai ka piki pea te creatinine.
• Kōrero ki te taiwhanga, ki tō rata rānei mō ngā pire creatine, mō ngā rongoā katoa e kai ana koe, ā, mēnā kei te hapū koe.
• Ka hoki mai ngā hua i taua rā anō. He maha ngā pūrongo ka whakauru i te eGFR, te urea me te BUN i te taha.

He wāhanga te creatinine o te nuinga o ngā tirotiro hauora auau. Ka auau ake te tirotiro mēnā he:

• Mate huka (diabetes), pēhanga toto teitei rānei tōu: kotahi i te tau neke atu, me tētahi whakamātautau albumin mimi, nā te mea koinei ngā take e rua e tino kitea ana o te mate whatukuhu
• Mate whatukuhu mau tonu tōu: mai i te kotahi i te tau ki ia marama torutoru, e ai ki te wāhanga
• Rongoā e pā ana ki ngā whatukuhu: ina tīmata, ā, i ngā wā ka whakaritea e tō rata
• Mate manawa tōu, he mate whatukuhu i tō whānau, kua neke atu rānei koe i te 60 tau

• Kia noho tō pēhanga toto me tō huka toto ki roto i tō awhe whāinga. Koinei ngā mea e rua tino nui mō te hauora whatukuhu mō te wā roa.
• Inu kia rawaka te wai mō tō āhuarangi me tō korikori, ki te kore tō rata i kī kia whakaitihia ngā wai.
• Kia āta te kai rongoā mamae. Whakamahia ngā NSAIDs pērā i te ibuprofen anake kia rite ki ngā tohutohu, ā, pātai ki tētahi kaiwhakarite rongoā (pharmacist) mēnā he auau tō kai.
• Whakaitia te tote me ngā kai tukatuka tino tote; ka āwhina i te pēhanga toto me ngā whatukuhu.
• Kaua e kai paipa, kia korikori tonu, ā, kia ora te taumaha.
• Pātai i mua i ngā pire āpiti, rongoā otaota rānei, inarā mēnā he iti tō eGFR.
• Mā tō rata e whakatau ngā rongoā me ngā panoni kai mō te mate whatukuhu. Ko ētahi me iti iho te inenga ina heke te mahi whatukuhu, nō reira me kōrero i ngā wā katoa ki ia rata, kaiwhakarite rongoā rānei tō eGFR.