Isifo sezinso esiphelile (ESRD) simele isigaba esibalulekile sesifo esingapheli sezinsipho lapho izinso zilahlekelwa cishe yonke imisebenzi yazo, okudinga izindlela zokubuyisela izinso njengokuhlanzwa kwegazi. Ukuhlanzwa kwegazi okunamandla aphezulu (High-flux dialysis) kuvele njengentuthuko ebalulekile ekuphathweni kwe-ESRD, okuchazwa ngama-dialyzer anama-membrane anokungena kalula asusa kahle izinto ezinkulu ezine-molecular weight kanye nama-molecules aphakathi uma kuqhathaniswa nama-dialyzer aphansi (low-flux) endabuko. Le ngeniso ihlose ukuthuthukisa inqubo yokukhipha ubuthi ngesikhathi sokuhlanzwa kwegazi, ngaleyo ndlela ingathuthukisa imiphumela yezokwelapha kanye nempilo yabaguli.

I-Hemodialysis esebenzisa ama-dialyzer aphezulu kakhulu ilungele kakhulu iziguli ezihlupheka ngokuhluleka kwezinso okungazelelwe noma okungapheli, inikeza ukususwa okungcono kwe-β2-microglobulin nezinye izinto ezilimaza umzimba ezivela egazini ezisuswa kancane ngama-membrane aphansi. Ngenxa yokuphazamiseka okuyinkimbinkimbi kwe-ESRD nokugula okwengeziwe okuhambisana nokuqoqeka kwezinto ezilimaza umzimba, ukuthuthukisa izindlela zokwelapha nge-dialysis kuhlala kuyinto ebalulekile ocwaningweni nasekuphathweni kwezempilo. Ukuthuthukiswa kobuchwepheshe obuphezulu buyintuthuko ethembisayo kulo mongo.

Isingeniso samalaphu e-high-flux ekwelashweni nge-dialysis siye sasekelwa ukuqhubeka kobuchwepheshe ekwenziweni kwamalaphu nasekuvumelaneni komzimba. Lamalaphu enza ukususa izinto eziningi ngenkathi kuncishiswa ukusabela okubangela ukugula okubangelwa ukuxhumana kwegazi namalaphu. Ngenxa yalokho, iziguli ezithola i-high-flux dialysis zingase zibe nezingozi ezimbalwa nempilo engcono ngokujwayelekile.

Lesi sihloko sihluza ukubaluleka kwekhwalithi yokuphila (QoL) ezigulini ze-hemodialysis, sihlola izivivinyo ezibalulekile zezokwelapha eziqhathanisa ama-dialyzer e-high-flux kanye ne-low-flux, futhi sixoxa ngemiphumela yezinto ezitholakele ezintsha ekunakekelweni kweziguli. Ngaphezu kwalokho, kugqanyiswa indima ye-Stellar Biotech Limited ekuhlinzekeni ngamadivayisi ezokwelapha ahambisana nemithetho asekelayo ukwelashwa okuthuthukisiwe kwe-dialysis.

Ngokubuyekezwa okuningiliziwe kwezinhlelo zocwaningo, izimilo zeziguli, nemiphumela eyinhloko, sihlose ukuhlinzeka ngemininingwane ephelele kochwepheshe bezempilo, iziguli, nababambiqhaza bemboni abanesithakazelo esikhathini esizayo sokwelashwa kwe-dialysis nokunakekelwa okugxile esigulini.

Ikhwalithi yokuphila iyisici esibalulekile ekuphathweni kweziguli ezithola i-hemodialysis, njengoba i-ESRD ingagcini nje ngokubeka izinselele emzimbeni kodwa futhi ithinta kakhulu impilo yengqondo, yomphakathi, nokusebenza. Iziguli zivame ukuzwa ukukhathala, izinkinga zokuqonda, nemikhawulo emisebenzini yansuku zonke, okufaka isandla ekwehliseni kwe-QoL. Ngakho-ke, izindlela zokwelapha ezithuthukisa impilo yomzimba ngenkathi zisekela amandla engqondo nawokuzwela zibalulekile.

Iziguli ze-dialysis ngokuvamile zithola izikhathi eziningana ngeviki, ngayinye ihlala amahora amaningi, okwenza umthwalo wokwelashwa ube mkhulu. Ukuthuthukisa ukusebenza kahle kwe-dialysis ngaphandle kokwandisa isikhathi sokwelashwa noma imiphumela emibi kungathinta kakhulu ukwaneliseka kweziguli nendlela yokuphila. I-dialysis ye-high-flux, ngokuhlinzeka ngokucaciswa okungcono kakhulu kwamagciwane amakhulu, inganciphisa umthwalo wezimpawu futhi yandise amazinga amandla.

Ngaphezu kwemiphumela yezokwelapha, imiphumela ebikwe iziguli njengokusebenza komzimba, isimo sengqondo, nokuxhumana nomphakathi kuyizilinganiso ezibalulekile. Abahlinzeki bezempilo ngokuvamile babeka phambili le miphumela lapho bekhetha izindlela ze-dialysis, beqaphela ukuthi ukuphila isikhathi eside kuphela akwanele ngaphandle kokubhekana nezici ze-QoL.

Izifundo zibonise ukuthi ukususwa okuthuthukisiwe kwama-molecule aphakathi kanye nama-mediator avuvukalayo ngokusebenzisa i-dialysis ye-high-flux kungaholela ekunciphisweni kwezinkinga ezihlobene ne-dialysis, njenge-amyloidosis, nasekuqinisweni kwezempilo yenhliziyo nemithambo. Izinzuzo ezinjalo ziguqulela ekubandakanyekeni okunamandla kweziguli futhi kungase kube nokuncipha kwezinga lokulaliswa esibhedlela.

Ngakho-ke, ukuhlola ukuthuthukiswa kwe-QoL ezigulini ezisebenzisa ama-dialyzer e-high-flux uma kuqhathaniswa nalabo abasebenzisa izinketho ze-low-flux kubalulekile ukuze kuqondiswe izinqumo zezokwelapha nokwenza kahle izinhlelo zokwelapha eziqondene nomuntu.

Izivivinyo eziningi zezokwelapha senziwe ukuhlola ukusebenza kahle kokuqhathanisa kwama-dialyzer aphakeme kakhulu uma kuqhathaniswa nalawa aphansi, kugxilwe ezingeni lokusinda, imiphumela yezifo zenhliziyo nemithambo, kanye nezinga lezilinganiso zempilo. Lezi zifundo ziye zahlukahluka ngosayizi, ukwakheka, nokusabalala kwezindawo kodwa ngokubambisana zinikeza ubufakazi obusekela i-dialysis ephakeme kakhulu.

Izivivinyo ezinkulu eziqondisiwe, njenge-Hemodialysis (HEMO) Study kanye ne-Membrane Permeability Outcome (MPO) Study, zinikeze idatha ebalulekile mayelana nezinzuzo zesikhathi eside zamamembrane aphakeme kakhulu. Lezi zivivinyo zahlola iziphetho ezifaka ukufa, ukulaliswa esibhedlela, kanye neziguli ezibika izimpawu.

Imiphumela yalezi zivivinyo ibonisa ukuthi ama-dialyzer anomfutho ophakeme anganciphisa ukufa ngenxa yezifo zenhliziyo futhi athuthukise ukuhlanjululwa kwe-β2-microglobulin, okuxhunyaniswe ne-amyloidosis ehlobene ne-dialysis. Noma kunjalo, umthelela ekufeni okubangelwa yizizathu zonke uhlala uguquguquka, ugcizelela isidingo sokucwaninga okwengeziwe kanye nokucatshangelwa okukhethekile kwesiguli.

Ngokuya ngekhwalithi yokuphila, izifundo zihlala zibika ukuthuthuka ezindaweni ezifana nokusebenza ngokomzimba kanye nokunciphisa ukukhathala ezigulini ezithola i-dialysis enomfutho ophakeme. Le miphumela igcizelela amandla okukhethwa komgogodla ukuthonya imiphumela ephelele yesiguli ngaphezu kwezimpawu zamakhemikhali zodwa.

Ubufakazi obuhlanganisiwe busekela ukwamukelwa kwe-dialysis enomfutho ophakeme njengendlela ephumelelayo yokuthuthukisa kokubili imingcele yezokwelapha kanye nekhwalithi yokuphila, ikakhulukazi ezigulini ezinesikhathi eside se-dialysis noma lezo ezisengcupheni enkulu yezinkinga.

Uhlolo lwezokwelapha oluqondene nokuhlanzwa kwegazi okusezingeni eliphezulu ngokuvamile lusebenzisa izindlela ezihleliwe, ezilawulwayo ukuze kuncishiswe ukungathathi hlangothi futhi kuvunyelwe ukuqhathanisa okunamandla. Iziguli ngokuvamile zihlanganisa abadala abane-ESRD abahlanza igazi njalo, abahlukaniswe ngokobudala, izifo ezihambisana nazo, kanye nesikhathi sokuhlanza igazi.

Izimiso zokubhalisa zigxile ezigulini ezihlanza igazi ngendlela ejwayelekile, futhi izifundo ngokuvamile zilinganisa izinto ezithinta amakhemikhali egazini (ukuhlanjululwa kwe-urea, amazinga e-β2-microglobulin), imiphumela yezokwelapha (izinkinga zenhliziyo nemithambo, ukulaliswa esibhedlela), kanye nezinga lempilo ngokusebenzisa imibuzo eqinisekisiwe njengomshini weKidney Disease Quality of Life (KDQOL).

Inani lezampula liyahlukahluka, izivivinyo eziningi ezibandakanya amakhulu ezinkulungwane zeziguli ukuqinisekisa amandla ezibalo. Izikhathi zokulandela umkhondo zisukela unyaka munye kuya eminyakeni embalwa, okwenza kube lula ukuhlola imiphumela yesikhathi esifushane nesikhathi eside yokungena komswakama we-dialyzer membrane.

Ukuhlaziywa kwezibalo zabantu kuvame ukudalula isibonelo sabantu abane-ESRD abavela ezizweni ezahlukene, okubonisa umthwalo womhlaba wonke wezifo zezinso. Lokhu kuhlukahluka kubalulekile ukuze kutholwe imiphumela ezindaweni ezahlukene zokunakekelwa kwezempilo namaqembu abantu abahlukene.

Imiklamo yocwaningo enjalo eqinile ibeka ubufakazi obuseqophelweni eliphezulu ukwazisa imihlahlandlela yezokwelapha nokusekela ukuhlanganiswa kwama-dialyzer aphakeme ekusebenzeni okuvamile.

Ubufakazi obuvela ezivivinyweni zezokwelapha kanye nezifundo zokubuka njalo bubonisa ukuthi i-dialysis ephakeme ithuthukisa izici eziningi zekhwalithi yokuphila phakathi kweziguli ze-ESRD. Ukukhishwa okuthuthukisiwe kwezixazululo kunciphisa ukuvuvukala komzimba wonke kanye nokuqoqeka kotshwala, okuholela ekunciphisweni kokukhathala, ukuthuthukiswa komsebenzi wokucabanga, kanye nokuzinza okungcono kwezinhliziyo nemithambo.

Iziguli zibika amazinga aphezulu kagesi kanye nobuhlungu obuncane bemisipha namathambo, okwenza ukuthi zibambe iqhaza kakhulu emisebenzini yomphakathi neyomsebenzi. Ngaphezu kwalokho, ukuncipha kwezinkinga ezihlobene ne-dialysis njenge-amyloidosis kunomthelela ekuthuthukisweni kokunethezeka komzimba nempilo yesikhathi eside.

Izinzuzo zengqondo nazo ziyabonakala, okubandakanya izimpawu zokukhathazeka nokudangala ezincishisiwe, okungenzeka kungenxa yempilo yonke engcono nokugonywa okuncane ezibhedlela. Lezi zithuthukisi eziphelele zihambisana nezinqubomgomo zokunakekelwa okugxile esigulini futhi zigcizelela ukubaluleka kokukhetha izindlela ze-dialysis ezisekela inhlalakahle.

Ama-membrane aphezulu ahlobene nokuthuthukiswa kwesimo sokudla okunomsoco kanye nokuncipha kokumelana ne-erythropoietin, zombili zinomthelela ekuthuthukisweni kwamandla esiguli. Umphumela wokuhlanganiswa walezi zici uholela ekukhuphukeni okulinganisekayo emaphuzwini ekhwalithi yokuphila kusetshenziswa amathuluzi okuhlola ajwayelekile.

Ngakho-ke, abanakekeli bezempilo bayakhuthazwa ukuthi bacabange nge-dialysis ephakeme hhayi kuphela ngokombono wokusebenza kahle kwezempilo kodwa nangokuthi iyindlela yokuthuthukisa kakhulu izinga lempilo lesiguli.

Ukwamukelwa kwe-dialysis ephakeme kuthwala iziphumo ezibalulekile ekwenzeni ngcono ukunakekelwa kweziguli ekuphathweni kwe-ESRD. Ngokuthuthukisa ukususwa kwezinto ezinobuthi nokunciphisa ukugula okuhlobene ne-dialysis, ama-dialyzer aphakeme anikela ekwelashweni okusebenza kahle, okwenziwe ngezifiso.

Odokotela kufanele bahlole izinto ezithinta isiguli njengezimo ezihambisanayo, iminyaka yokusebenzisa i-dialysis, kanye nengozi ye-amyloidosis lapho bekhetha ama-membrane e-dialyzer. Ukufaka ubuchwepheshe be-high-flux kunganciphisa amazinga okugonwa esibhedlela futhi kuthuthukise imiphumela ye-cardiovascular, ekugcineni kunciphise izindleko zezempilo nokusetshenziswa kwezinsiza.

Imfundo yesiguli mayelana nezinzuzo ze-dialysis ephakeme ibalulekile ekukhuthazeni ukuthobela nokuzibandakanya ezinhlelweni zokwelashwa. Ukuqonda amathuba okuthuthukisa izinga lempilo kungakhuthaza iziguli nabalondolozi ukuthi bafune izinketho ze-dialysis ezithuthukisiwe.

Ngaphezu kwalokho, izinhlelo zezempilo kufanele ziqinisekise ukufinyelela ezintweni zokwelapha ze-dialysis ezisezingeni eliphezulu, ezithobelayo ezihlangabezana namazinga ombuso wamazwe omhlaba. Le ndlela isekela ukulethwa kokwelashwa okuphephile nokusebenzayo futhi ihambisana neziqondiso ezihamba phambili.

Ukuhlanganisa lezi zinto ezicubungulwayo ezisebenzeni ezijwayelekile zezokwelapha kuthuthukisa umuzwa wokwelapha wonke futhi kungase kube nomthelela ekuthuthukiseni ukusinda kanye nokwaneliseka kweziguli.

I-Stellar Biotech Limited, inkampani yezempilo yomhlaba wonke enezindawo zayo e-Singapore nase-Hong Kong, idlala indima ebalulekile ekuhlinzekeni ngamadivayisi ezokwelapha ahambisana nemithetho futhi anesitifiketi se-GMP, okubandakanya ama-dialyzer athuthukisiwe afanele izindlela zokwelapha ze-hemodialysis ezi-high-flux. Ngobuchwepheshe ekungeniseni imikhiqizo ezifundeni ezahlukene, ukucwaninga nokuthuthukisa, kanye nokuthengisa imikhiqizo yezemithi namadivayisi ezokwelapha, i-Stellar Biotech isekela abahlinzeki bezempilo emhlabeni wonke ekutholeni izixazululo ezintsha, eziqinisekisiwe ngekhwalithi.

I-portfolio yenkampani ihlanganisa imikhiqizo engaphezu kuka-1,100 enesitifiketi se-GMP, okwenza kube lula ukutholwa okusheshayo nokuhambisana nemithetho ezinkampanini zemithi zomhlaba wonke kanye neziteshi zezempilo. Izinsizakalo eziphelele ze-Stellar Biotech ziqinisekisa ukuthi abahlinzeki be-dialysis banokufinyelela okuthembekile kuma-dialyzer aphezulu kakhulu ahlangabezana nezimfuneko eziqinile zemithetho.

Ngokubambisana ne-Stellar Biotech, izikhungo zezempilo zingathuthukisa amakhono azo okwelapha nge-dialysis, ekugcineni kuthuthukise imiphumela yeziguli nokuhambisana namazinga aphezulu omhlaba wonke ezokuphepha. Lokhu kubambisana kugcizelela ukuzibophezela kwenkampani ekuthuthukiseni impilo yomhlaba wonke ngobuchwepheshe nokuhambisana nemithetho.

Ngeminye imininingwane ngemikhiqizo kanye nezinsizakalo, sicela uvakashele i-Imikhiqizo ikhasi. Ukuzinikela kweStellar Biotech ekuqinisweni kwekhwalithi kanye nokuqanjwa kabusha kubenza babenguzakwethu abathembekile endaweni eguquguqukayo yokunakekelwa kwe-ESRD.

Ubuchwepheshe babo ekuzuleni kwezimiso kanye nokuhweba kwezwe lonke kuvumela ukwethulwa okungenamihawu kobuchwepheshe bokuhlanzwa igazi obuphezulu obuhambisana nezimakethe ezahlukahlukene, kusekela odokotela ekunikezeni ukunakekelwa kweziguli okungcono kakhulu.

Ukuhlanzwa igazi okuphezulu kubonisa intuthuko ebalulekile ekuphathweni kwe-ESRD, okunikeza ukuthuthukiswa okulinganisekayo ekuqinisweni kwekhwalithi yokuphila kweziguli ngokukhishwa okuthuthukisiwe kwamamolekyuli aphakathi kanye nokuncishiswa kwezinkinga ezihlobene nokwelashwa. Ngokomtholampilo, ama-dialyzer aphezulu abonisa imiphumela emihle empilweni yenhliziyo nemithambo kanye nomthwalo wezimpawu, aqinisa indima yawo ekuhlanzweni kwegazi kwesimanje.

Kucelwa ucwaningo olwengeziwe ukuba luqhubeke nokuveza izinzuzo zesikhathi eside zamamembrane aphezulu kubantu abahlukahlukene, futhi luhlanganise ubuchwepheshe obusha njenge-hemodiafiltration eku-inthanethi. Izindlela zokuhlanzwa kwegazi ezenziwe ngendlela efanele ezihlanganisa izintandokazi zeziguli namaphrofayili ezokwelapha zizoba yisikhungo esikhulayo emasu okubhekana nokunakekelwa.

Ukubambisana phakathi kwabahlinzeki bezempilo nabathengisi bemishini yezokwelapha abathobelayo njengeStellar Biotech Limited kuqinisekisa ukufinyelela kubuchwepheshe obuphezulu bokuhlanzwa kwegazi obuhlangabezana namazinga omhlaba wonke, kusekela ukulethwa kokwelashwa okwenziwe ngendlela efanele okugxile esigulini.

Ngokufingqa, ukuhlanzwa kwegazi okuphezulu akuthuthukisi nje kuphela iziphetho zamakhemikhali nezokwelapha, kodwa futhi kuphakamisa ikhwalithi yokuphila iyonke yeziguli ezine-ESRD, okuyenza ibe yingxenye ebalulekile yokwelashwa kwamanje kokubuyiselwa kwezinso.

Ukuze ufunde kabanzi mayelana nokuzibophezela kweStellar Biotech ekuthuthukiseni izixazululo zezempilo kanye nokuthobela imithetho, sicela uvakashele i-Ikhaya ikhasi.