Renal Function দেখার জন্যে important দুইটা investigation হচ্ছে Serum Urea এবং Serum Creatinine.
দুইটাই GFR সম্পর্কে আমাদেরকে ধারণা দেয়: urea বা creatinine বেড়ে যাওয়া মানে GFR কমে যাওয়া।
প্রশ্ন হচ্ছেঃ এই দুইটার মধ্যে ভালো কোনটা? কোনটা GFR সম্পর্কে আমাদেরকে accurate idea দিবে?
উত্তর হচ্ছেঃ
Serum Creatinine.
কেন creatinine ভাল?
এটা না বলে আমরা বরং ব্যাখ্যা করি কেন Serum Urea খারাপ।
কারণ হচ্ছে GFR ছাড়াও আরো কিছু ফ্যাক্টর আছে যেগুলো বাড়লে কমলে Urea Level বেড়ে বা কমে যেতে পারে।
যেমনঃ
Urea Level may increase in:
– increased protein intake
– following GI bleeding
– in catabolic states
Urea Level may decrease in:
– Chronic liver disease
– anorexia
– malnourished patients
তাই একটা রোগীর Upper GI Bleeding এর রোগীর Urea level বেশী পেলে আপনি শিউর হতে পারবেন না এই urea লেভেল বাড়ার কারণ কি reduced GFR নাকি bleeding. আপনাকে Creatinine করে দেখতেই হবে।
তাই, Creatinine > Urea.
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