Ukwehluleka kwezinso okungapheli emakati

Kuyini ukwehluleka kwezinso okungapheli

Isifo sezinso esingamahlalakhona (CKD (igama elidala - ukwehluleka kwezinso okungapheli, CRF) yisifo esikhula kancane, esihambisana nokuphazamiseka kwesakhiwo kanye / noma ukusebenza kwezinso.

Itholakala kaningi emakatini eneminyaka engu-5-15, akukho hlobo noma ubulili.

Izimbangela

Izinto ezicatshangelwayo zokuthuthukiswa kwe-CKD yizi:

• Ukulimala kwezinso okukhulu kwangaphambilini (ubuthi, ukugcinwa komchamo oyingozi, njll.)
• I-Congenital pathologies yezinso
• Ukulimala kwemishini ezinso
• Ezinye izifo zesistimu yomchamo (cystitis, urolithiasis, izifo).
• I-Genetic pathologies, ngokwesibonelo, isifo sezinso se-polycystic sasePheresiya, exotic, amakati ase-Abyssinian kanye nama-mestizos awo
• Izifo ze-oncological
• Izifo ezithathelwanayo ezingapheli, njenge-viral leukemia kanye ne-immunodeficiency
• Ubuthi obungapheli. Ngokwesibonelo, ukudla njalo izitshalo zasendlini ezinobuthi
• Ukusetshenziswa isikhathi eside kwezidakamizwa ze-nephrotoxic
• Ukukhuluphala
• Diabetes
• Ukudla okungenakulinganisela, ukuphakela ikhwalithi ephansi noma ukudla okungokwemvelo okungafanelekile, ukuphakela ukudla okuvela etafuleni lakho
• Ukusetshenziswa kwamanzi okuphansi 
• Uneminyaka engaphezu kwengu-7

Izimpawu kanye nezinkinga

Izimpawu zokwehluleka kwezinso okungamahlalakhona, ikakhulukazi esigabeni sokuqala aziqondile, zingalungiswa. Ezinye izifo zingase zenzeke ngesithombe somtholampilo esifanayo. Ukwehluleka kwezinso okungapheli akuyona inqubo yosuku olulodwa; izimpawu ezicacile ze-malaise zingavela lapho ngaphezu kwe-75% yezicubu zezinso sezivele zilimele. Yingakho umnikazi edinga ukuqapha ngokucophelela impilo yekati lakhe futhi athintane nodokotela ngesikhathi.

Izimpawu zokwehluleka kwezinso emakati zihlanganisa:

• Ukungathandi ukudla, okungase kwenziwe iphutha ngezifo zesisu noma ukucobeka
• Ukwenyuka kokusetshenziswa kwamanzi
• Ukuchama kaningi futhi ngezinye izikhathi okungasebenzi
• Umchamo ungase ucishe ungabi nambala, ucace, ube namafu noma ube negazi.
• Ukuhlanza, ukungasebenzi, amathe noma ukudla, izikhathi eziningana ngosuku
• Ukuwohloka koboya, ukufiphala, ukunamafutha noma ukoma
• Edema
• Isimo sokucindezeleka, ukusabela okubuthakathaka ku-stimuli
• Ukuncipha kwesisindo, ukukhathala
• Iphunga elingathandeki elivela emlonyeni, ngokuvamile i-ammonia
• Izilonda emlonyeni womlomo, i-stomatitis, ulwelwesi lwamafinyila olomile
• ukuqunjelwa

Ngokwemvelo yenkambo, ukwehluleka kwezinso kuyi-acute (ARF) kanye ne-chronic (CRF). 

• Ifomu elibukhali likhula ngokushesha, zonke izimpawu zivela ngesikhathi esifushane.
• Ifomu elingamahlalakhona likhula isikhathi eside futhi ingozi yalo isekutheni ekuqaleni, lapho isilwane sisengasizwa, azikho izimpawu zalesi sifo. Zivela kuphela uma ngaphezu kwe-2/3 yezinso zonakalisiwe.

Diagnostics

Akunakwenzeka ukwenza ukuxilongwa ngesisekelo sokuhlolwa okukodwa noma izimpawu eziningana. Ngakho-ke, udinga ukulungela ukuqhuba izifundo eziningi:

• Ukuhlolwa kwegazi kwe-biochemical kanye nomtholampilo jikelele. Okubaluleke kakhulu amanani e-urea, i-creatinine, i-phosphorus, amangqamuzana egazi abomvu, i-hemoglobin ne-hematocrit.
• I-Panoramic ultrasound yomgodi wesisu. Kunengqondo ukubona ngeso lengqondo isinye nezinso kuphela ku-dynamics. Ngesikhathi sokuhlolwa kokuqala, kuyadingeka ukukhomba izinguquko zesakhiwo kuzo zonke izitho, ngoba ikati lingase libe ne-pathologies ehlangene.
• Ukuhlolwa komchamo okuvamile kukuvumela ukuthi uhlole ukuthi ikhono lokuhlunga lezinso lisebenza kahle kangakanani, ukuthi zikhona yini izimpawu zokuvuvukala, i-urolithiasis.
• Isilinganiso samaprotheni/i-creatinine sisiza ukubona ukwehluleka kwezinso kusenesikhathi
• Isilinganiso sokucindezela. Ukwehluleka kwezinso okungapheli kuhambisana nomfutho wegazi ophakeme we-arterial. Uma ingcindezi iphakanyisiwe, ngakho-ke kuyadingeka ukuyinciphisa ngemithi ngokuqhubekayo. Ocwaningweni, kusetshenziswa i-tonometer yezilwane yezilwane.

Ukuxilongwa kwe-CKD akukwazi ukwenziwa ngokwanda kwenkomba eyodwa kuphela, isithombe sonke sihlolwa sisonke. Lesi sifo sinezigaba ezi-4. Zihlukaniswe ngokwemibandela, ngokusekelwe ezingeni le-creatinine egazini:

Isigaba 1 - i-creatinine engaphansi kuka-140 µmol/l

Isigaba 2 - i-creatinine 140-250 µmol / l

Isigaba 3 - i-creatinine 251-440 µmol / l

Isigaba 4 - i-creatinine engaphezu kuka-440 µmol / l

Ukwelashwa 

Kuyaphawuleka ukuthi akunakwenzeka ukwelapha ngokuphelele ikati lokuhluleka kwezinso okungapheli. Kungenzeka kuphela ukumisa okwesikhashana noma ukunciphisa inqubo. Ezigabeni 1-2, ukubikezela kuyathandeka, ku-3 - ngokuqapha, isigaba sesi-4 siyisiphetho, umzimba ungasekelwa kuphela.

Amaqhinga okwelapha ancike esithombeni somtholampilo, isimo esijwayelekile sekati, kanye nokuba khona kwe-pathologies ehambisanayo.

Udokotela wezilwane angase anikeze:

• Ukwelashwa kokudla kubaluleke kakhulu. Akunakwenzeka ukondla inyama kuphela noma ukudla kwesigaba somnotho. Kudingeka ukudla okukhethekile okune-phosphorus namaprotheni. Ukudla kwesifo sezinso kuyatholakala kubakhiqizi bokudla kwezilwane ezifuywayo abehlukene, futhi ungathola kokubili ukudla okomile nokumanzi okubhalwe ukuthi I-Renal udokotela wakho wezilwane azokuyala. 
• Nemithi Elwa Namagciwane
• Ama-Absorbents okususa ukudakwa (isibonelo, i-Enterosgel)
• Izidakamizwa zokwehlisa umfutho wegazi
• Izidakamizwa eziqukethe i-potassium 
• Ukunciphisa izinga le-phosphorus ne-urea, izithako zokudla okunomsoco zisetshenziswa, isibonelo i-Ipakitine
• Ukubuyisela ibhalansi yamanzi, inkambo ye-droppers inqunyiwe, futhi esikhathini esizayo kuyadingeka ukulawula ukungena kwamanzi ekati.

Ukuphumelela kokwelashwa kanye ne-prognosis kungahlolwa ngokuqhuba ukuhlolwa okuphindaphindiwe nezifundo, kanye nokusekelwe esimweni esijwayelekile sekati.

Uma isilwane singu-4, i-ESRD futhi singathuthuki phakathi nesonto lokuqala ukwelashwa okunamandla, khona-ke i-euthanasia yobuntu kufanele icatshangelwe.

Prevention

Ukuvimbela ukwehluleka kwezinso emakati ikakhulukazi kuhilela izinga, ukudla okulinganiselayo. Qiniseka ukuthi isilwane sakho siyakwazi ukuthola amanzi ahlanzekile. Uma ikati lingaphuzi kakhulu, khona-ke ingxenye yokudla kufanele ibe ngendlela yokudla okumanzi.

Kuyadingeka ukuvimbela ukulimala kanye nobuthi: ungavumeli isilwane sihambe sodwa, gcina amakhemikhali asekhaya, ubuthi, imithi kanye nezitshalo zendlu eziyingozi ngaphandle kokufinyelela kwekati.

Futhi, umnikazi kufanele aqhube njalo ukuhlolwa kwezokwelapha kwekati eliphakathi nendawo elidala futhi aqaphe isisindo sekati.