ILONDON | IGENEVA – Njengoba amazinga omhlaba wonke esifo sikashukela kanye nomfutho wegazi ophakeme eqhubeka ekhuphuka, odokotela bezifo ze-nephrologists baphendukela kakhulu ku-biomarker ebucayi eyaziwa ngokuthi i-Urinary Albumin (ALB) ukuze bathole ukulimala kwezinso eminyakeni eminingi ngaphambi kokuba ukuhlolwa kwendabuko kuhluleke. Ochwepheshe bezokwelapha manje bafuna ukusetshenziswa okubanzi, okuvamile kokuhlolwa kwe-ALB ezindaweni zokunakekelwa okuyisisekelo ukuze kuncishiswe ubhubhane oluthule lweSifo Sezinso Esingapheli (CKD).

I-albumin yomchamo ibhekisela ekubeni khona kweprotheyini ye-albumin emchameni. Ezinso eziphilile, i-glomeruli isebenza njengesihlungi esiyinkimbinkimbi, igcina amaprotheni abalulekile njenge-albumin egazini. Kodwa-ke, lapho lesi sivimbelo sokuhlunga sonakaliswa—ngokuvamile ngenxa yomfutho wegazi ophakeme noma ushukela wegazi ophakeme—i-albumin ivuza emchameni. Ngisho namanani amancane abonisa isigaba sokuqala sesifo sezinso, esaziwa ngokuthi i-microalbuminuria.

“Ukuhlolwa kwegazi okujwayelekile kwe-creatinine kuyanda kuphela ngemva kokulahlekelwa umsebenzi wezinso ongu-50%,” kuchaza uDkt. Helen Marquez, uchwepheshe wezinso e-European Kidney Health Institute. “Ukuhlolwa kwe-ALB, ngokuphambene nalokho, kusebenza njenge-alamu yentuthu. Kubona ukuvuza okuncane kakhulu lapho umonakalo usakwazi ukuguquka. Ezigulini ezinesifo sikashukela sohlobo 2 noma umfutho wegazi ophakeme, leli ithuba elisindisa ukuphila.”

Ukuhlolwa kwe-ALB kuvame ukwenziwa njengesilinganiso se-albumin-to-creatinine yomchamo (UACR) kusampula yomchamo eyodwa engahleliwe, okwenza kungabi yingozi futhi kube nezindleko eziphansi. Ngokungafani nokuqoqwa komchamo amahora angama-24, i-UACR ilungisa ukuhlushwa komchamo, inikeze imiphumela enembile ngokushesha. Iziqondiso zemitholampilo zamanje zincoma ukuthi bonke abantu abanesifo sikashukela noma umfutho wegazi ophakeme bahlolwe i-UACR okungenani minyaka yonke.

Izifundo ezinkulu zakamuva ziveze nokuthi i-Urinary Albumin ayiyona nje uphawu lwesifo sezinso kodwa iyisibonakaliso esinamandla sengozi yenhliziyo nemithambo yegazi. Amazinga aphezulu ahlobene kakhulu nokuhlaselwa yinhliziyo, ukufa uhlangothi, kanye nokwehluleka kwenhliziyo, ngisho nakubantu abangenaso isifo sikashukela. Lokhu kubaluleka okubili kuye kwashukumisela odokotela benhliziyo ukuba bamukele ukuhlolwa kwe-ALB njengengxenye yokuhlolwa kwenhliziyo njalo.

Naphezu kokubaluleka kwayo okuqinisekisiwe, amazinga okuhlolwa aphansi ngendlela eshaqisayo. Ucwaningo lomhlaba wonke olwanyatheliswa ngenyanga edlule ku-*The Lancet Nephrology* luthole ukuthi bangaphansi kuka-30% beziguli ezisengozini abathola ukuhlolwa kwe-albuminuria minyaka yonke. Izithiyo zifaka phakathi ukuntuleka kolwazi phakathi kodokotela abajwayelekile kanye neqiniso lokuthi i-CKD yokuqala ayibangeli zimpawu.

“Asinakuthembela endleleni isiguli esizizwa ngayo,” kusho uDkt. Marquez. “Uma kuvela ukuvuvukala noma ukukhathala, umonakalo wezinso awusalungiseki. Kudingeka senze ukuhlolwa kwe-ALB kube yinto evamile njengokuhlola umfutho wegazi.”

Izinhlelo zezempilo e-UK naseJalimane manje sezihlola izexwayiso ezizenzakalelayo kumarekhodi ezempilo kagesi ukukhumbuza odokotela ukuthi ba-ode izivivinyo ze-UACR zeziguli ezifanelekile. Okwamanje, amadivayisi amasha okunakekelwa akwazi ukuletha imiphumela ye-ALB ngemizuzu asetshenziswa emitholampilo yomphakathi.

Kubantu abayizigidi abaphila nesifo sezinso esithule, ukuhlolwa komchamo okulula kwe-albumin kunikeza ithemba elihle kakhulu lokulondoloza ukusebenza kahle nokugwema i-dialysis. Njengoba imikhankaso yezempilo yomphakathi iqina, umyalezo ucacile: hlola umchamo, vikela izinso.

Thina odokotela baseBaysen singakunikezaIkhithi yokuhlola okusheshayo ye-ALBukuze uthole isithunzi kusenesikhathi. Siyakwamukela ukuxhumana nathi ukuthola imininingwane eyengeziwe.