I-NEPHROPATHY YESIFO SIKASHUKELA: IZIMPAWU NEZIBONAKALISO, IZINDLELA ZOKWELASHWA NOKUVIMBELA IZINKINGA ZESIFO SIKASHUKELA

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I-nephropathy yesifo sikashukela ukuhlulwa kwezingxenye eziyisisekelo zezinso (glomerunculi) nemikhumbi ebondla.

Lesi sifo singenye yezinkinga zesifo sikashukela. Ukufihlakala kwe-pathology kulele ekutheni isikhathi eside iqhubeka icishe inganakwa futhi ingaziveza kuphela esigabeni sokugcina (esibulalayo).

Okwamanje, ukusiza isiguli akwenzeki njalo. Kungakho kudingeka ukuthi ukwazi ukubona izimpawu zesifo sikashukela ngokuhamba kwesikhathi.

Izimbangela Zesifo Sikashukela kanye Nezici Ezingozini

Ushukela omningi ichitha ukuhlunga i-renal glomeruli (glomerunculi).

Ngokuhamba kwesikhathi, ziyafa, zithathelwe indawo izicubu. Kuyacaca ukuthi akakwazi ukuhlanza igazi. Amayunithi wokuhlunga angenampilo amancane aya ngokuya eba maningi, ukusebenza kubi kwezinso.

Kepha njengoba kunama-glomerunculi amaningi, isikhathi eside (iminyaka engaphezu kwe-10) asengasebenza ngokumelene nesizinda sokuthuthuka kwesifo sikashukela. Uma isifo sikashukela singalashwa, lapho-ke ubuthi obubucayi buqongelela emzimbeni wesiguli, kuthi ukugula kwe-renal (i-CRF) okungapheli (i-CRF) kuqale ukukhula.

Izici zobungozi, ngaphezu ushukela wegazi ophezulu, zifaka:

umfutho wegazi ophakeme njalo;
ukukhuluphala
cholesterol ephezulu;
umfutho okhuphukile we-nephron glomeruli;
ubudala
Isici esiyindlalifa: I-pathology yezinso yayisezihlotsheni.

Uhlobo 2 sikashukela lubonakala ngenkambo yamuva. Kungathatha iminyaka eminingana kuze kukhonjwe lapho. Futhi sonke lesi sikhathi, lesi sifo sibhubhisa umzimba, kubandakanya nezinso.

Izigaba

Kunezigaba ezi-5 kuphela. Futhi zincike kumanani wokuhlunga we-glomerular (ml / min):

okwejwayelekile - kusuka kuma-90 nangaphezulu;
ukwehla okuncane - 60-90;
kuncishiswe ngokulinganisela - kusuka kuma-30 kuye kwangama-60;
kuncishiswe kakhulu - 15-30;
ukwehluleka kwezinso - ngaphansi kuka-15.

Izimpawu nezimpawu zesifo sikashukela se-nephropathy

Izimpawu zokuqala eziyisixwayiso yilezi:

ubunzima bokuchama
igazi emchameni;
ukutheleleka ngethamo lomchamo.

Ngaphambi kokuba bafe, ama-nephrons aba "agcwele izimbobo." Baqala ukudlulisela amaprotheni emchameni, okungafanele ube lapho, okungukuthi, inani elikhulu le-albhamuin. Lapho okuqukethwe yile proteni kumchamo kwehluka kusuka kuma-20 kuye kwangama-300 mg / l, bakhuluma nge-microalbuminuria.

Lokhu kudalwa kwemithi kungalapheka. Kepha isigaba saso esibi kakhulu - i-proteinuria - sithathwa njengengaphenduki futhi sibonisa ukuthi ukwehluleka kwezinso sekuthuthukile. Ezinyangeni zokuqala, i-nephropathy yesifo sikashukela ene-microalbuminuria cishe ayizivezi.

Izimpawu zokuqala zale ndlela yokusebenza ziyefana kakhulu nokukhathala okubandayo noma okungapheli:

imilenze ivuvukala;
kugcina umfutho wegazi ophakeme;
ubuthakathaka
ukuchama njalo (kaningi ebusuku);
i-anemia

Zimbalwa iziguli ezingasho lezi zimpawu ngokungasebenzi kahle kwezinso. Futhi uma isifo sikashukela sivama ukudlula ekuhlolweni kwegazi nomchamo, khona-ke i-pathology itholakala sekwephuze kakhulu.

Kamuva, kuvela izimpawu zokudakwa

ukushuba kuyavela;
isikhumba esidonsayo kanye nemithambo;
ukuvuvuka kwamehlo;
izicubu zomsipha;
ukungazi kahle.

Izindlela zokuxilonga

I-nephropathy (NAM) yesifo sikashukela, ukuxilongwa okufika ngesikhathi kubaluleke kakhulu. Isiphetho sisuselwa ekuhlolweni okulula komchamo kanye negazi.

Njengoba kuhlangene nokulahleka kwekhono lokuhlunga, izinso azikwazi ukugcina ushukela kanye ne-protein, lezi zinto ziqala ukuvela kumchamo.

Futhi ku-plasma kunamanani aphezulu we-creatine ne-nitrogen yomchamo. Inkomba eyinhloko yalesi sifo ezinyangeni zokuqala okuqukethwe yi-albhamuin kumchamo.. Kumuntu ophilile, inani layo alikho ngaphezu kwe-20 mg / l.

Ukwanda kokuhlushwa kwayo ku-200 mg / l kubonisa ukuthuthukiswa kwe-nephropathy yesifo sikashukela. Izinguquko ezenzeka nge-albhamuin kumchamo zingaqashwa ngokuzimela kusetshenziswa imichilo yokuhlola.

Ngaphambi kokuphasa izivivinyo (ukuthola imiphumela ethe xaxa), akufanele uphuze utshwala futhi ungabongi ngokweqile izinsuku ezingama-2-3.

Ezigabeni zakamuva, isimo esiyinhloko ukuphathwa kwe-proteinuria. Kusukela esikhathini sokukhula kwayo kuze kube sekupheleni kwesigaba esibulalayo se-NAM, kuzodlula eminye iminyaka engama-7-8.

Izimiso zokwelashwa kwe-nephropathy kushukela

Umnyombo wokwelashwa ukuvimbela nokubambezeleka ukukhula okuqhubekayo kwe-pathology ukwehluleka okungapheli kwe-renal. Ngaphambili kungumsebenzi wokwehlisa amanani kashukela egazi, ukubuyisela izinqubo ze-metabolic, nokulawula umfutho wegazi.

Kwezidakamizwa, ama-inhibitors e-ACE asetshenziswa ngokuyinhloko: I-Trandolapril, i-Enalapril ne-AT1 receptor blockers: ILosartan, i-Irbesartan.

I-Enalapril

Emazingeni okugcina e-pathology, ukwelashwa kwe-detoxification kanye nokusetshenziswa kwama-sorbents kuyadingeka. I-Amlodipine noma iBisoprolol yengezwe kule mithi engenhla. Uma isiguli sinokuvuvukala okuphezulu, kunconywa ukuqokwa kweFurosemide.

Ngokungasebenzi ngempumelelo kwalokhu okungenhla kokugula kanye nokuhluleka kwe-renal kuhlonzwe, kuphakama umbuzo wenqubo yokudayela noma (ezimweni ezimbi kakhulu) ukufakelwa kwezinso.

Esigabeni se-microalbuminuria, udokotela unikeza ukudla okuncane okunamaprotheni nokudla okungenawo usawoti.

Ukudla okunconyiwe kufaka phakathi: okusanhlamvu, imifino kanye namasobho abo, imikhiqizo yobisi nezithelo.

Inyama ithathelwa indawo nge-soy. Kepha kufanele ikwazi ukukhetha ngobuhlakani: umkhiqizo oguqulwe ngofuzo ngeke usebenze.

Ungazindli. Ezinso, lokhu kuyingozi enkulu kakhulu.

Akunakwenzeka ukwelapha izinso ezilinyazwe yisifo sikashukela ngezindlela zabantu. Itiye elinobisi lizolimaza kakhulu ngoba linoshukela. Itiye elithandayo letiye eliningi le-hibiscus alisizi ngalutho kunamanzi ajwayelekile.

Isimo sezulu nezinyathelo zokuvimbela

Ukwelashwa kwe-insulin kwe-nephropathy yesifo sikashukela yikhona okusebenzayo kakhulu. Inani lokufa lehliswa kakhulu ngesikhathi sokwelashwa ngama-ACE inhibitors. Isigaba okuwukuphela kwaso esiphindayo se-DN yi-microalbuminuria.

Isifo sikashukela se-nephropathy kanye nokwehluleka kwezinso okungamahlalakhona (ngenxa yalokho) kuyizinkomba zokwelashwa okubuyiselwa esikhundleni: ukufakelwa kwezinso noma ukuvuvukala kwezinso. I-CRF ibalelwa ku-15% yabo bonke abashona kuhlobo lwesifo sikashukela sokuqala esingaphansi kweminyaka engama-50.

Ngakho-ke, ukuvimbela i-DN kubaluleke kakhulu:

umchamo, igazi nokuhlolwa okukhethekile kokuhlunga kwe-glomerular kufanele kuhlolwe njalo.
lawula ushukela wegazi;
qaphela umfutho wegazi ne-cholesterol;
thatha ngokungatheleleki kwezifo zamgciwane we-urin: thintana nodokotela ngokushesha;
wehlise isisindo;
ungabhemi;
sebenza ngokomzimba;
ngaphandle kotshwala.

Amavidiyo ahlobene

Mayelana nokwelashwa kwe-nephropathy yesifo sikashukela kuvidiyo:

Ngokushesha lapho kutholakala inkinga yezinso, udokotela uzonquma ngokushesha ukudla okunamaphrotheni aphansi ukwehlisa umthwalo entweni yokuhlunga. Uma ngabe le ndlela inganikezi umphumela omuhle, ukwelashwa kwezidakamizwa kuxhunyiwe. Umgomo wayo ukuguqula ukwakhiwa kwamafutha kwegazi.

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