Yintoni i-nephrotic syndrome? Oonobangela, iimpawu kunye nonyango
Imfundo yezeMpiloZininzi izifo ezihambelana nomsebenzi ongalunganga wezintso. Ukuba uqala ukuqaphela ukuba amaqatha akho ayadumba, unesicaphucaphu, okanye unengxaki yokulala-kunokuba nzima ukuphawula ukuba kutheni umzimba wakho ungasebenzi kungcono. Le yimiqondiso nje embalwa yokonakaliswa kwezintso, kwaye zininzi izizathu ezinokubakho. I-Nephrotic syndrome yenye yazo. Yintoni i-nephrotic syndrome? Funda ngokufunda unobangela, iimpawu zonyango, kunye nonyango.
Yintoni i-nephrotic syndrome?
I-Nephrotic syndrome ivela xa inkqubo yakho yokucoca izintso ingasebenzi kakuhle njengoko kufanelekile. Lo monakalo wezintso uvumela iproteni efumaneka kwi-plasma yegazi lakho ukuba lichitheke kumchamo. Iziphumo ziiprotein ezininzi kumchamo wakho (proteinuria) kunye neproteyini encinci egazini lakho. Ukuphulukana neprotein ephuma egazini kuvumela ulwelo oluthi luhlale lubambe endaweni ukuze luvuze emzimbeni, lubangele ukudumba (okwaziwa ngokuba yi-edema).
Yimeko enqabileyo echaphazela nje 5 kwi-100,000 yabantu , kodwa xa ingalawulwa, inokonakalisa ezinye iinkqubo zomzimba. Iingxaki ze-nephrotic syndrome zibandakanya ukwanda komngcipheko wamahlwili egazi, i-cholesterol ephezulu, uxinzelelo lwegazi oluphezulu, i-anemia, kunye nokuchaphazeleka kosulelo. I-Nephrotic syndrome i-autoimmune-esekwe kwimeko ezithile, kodwa ayizizo zonke. Ngonyango olufanelekileyo, ukuxela kwangaphambili kulungile. Xa iyekwe inganyangwa, inokuba nzima kwaye ibangele ukusilela kwezintso okanye ukufa.
Oonobangela
Kukho izihloko zemithambo yegazi encinci (ebizwa ngokuba yi-glomeruli) kwizintso zakho ezihluza igazi lakho njengoko lidlula kweli lungu. Ukonakala kwe-glomeruli sesona sizathu siphambili se-nephrotic syndrome. Nangona kunjalo, zininzi iimeko ezinokubangela ukonakala kwe-glomerular, kubandakanya:
- Isifo sesifo seswekile yaziwa ngokuba yi-nephropathy yeswekile. Malunga ikota yabo bonke abanesifo seswekile (zombini udidi 1 kunye nohlobo 2) ekugqibeleni bahlakulele isifo sezintso esinokonakalisa i-glomeruli.
- Utshintsho oluncinci lwezifo sisifo se-idiopathic syndrome, esithetha ukuba unobangela womsebenzi ongaqhelekanga awunakumiselwa. Ifumana igama layo kuba utshintsho kwizintso lincinci kakhulu alufumaneki kwi-biopsy yezintso. Ngoyena nobangela uqhelekileyo we-nephrotic syndrome ebantwaneni, onoxanduva olungaphezulu kwama-90% abantwana abaxilongweyo. Uninzi lwabantwana luphuma ngaphandle kwesifo esincinci, kodwa abanye basizisa ebudaleni. Akuqhelekanga kubantu abadala, kubandakanya kuphela i-10% -15% yamatyala e-nephrotic syndrome. Nangona unobangela uhlala ungaziwa, unokubangelwa zizifo zentsholongwane, iziyobisi ezichasayo (ii-NSAID), amathumba, kunye nezinye izinto ezingahambisiyo komzimba.
- Icandelo le-glomerulosclerosis (FSGS) yecandelo sisifo esiqhubela phambili esijolise kwiindawo ezithile, zezahlulo zezintso. Kubo bonke abantu abadala abane-nephrotic syndrome, ii-akhawunti ze-FSGS ze Iipesenti ezingama-40 zazo . Kubantwana, iiakhawunti ze-FSGS ze-20% yamatyala. I-FSGS inokubangelwa sisifo se-sickle cell, usulelo, ukuhlangana neziyobisi, ukutyeba kakhulu, izinto ezinetyhefu, kwaye (kunqabile) njengelifa lokuzalwa elingaqhelekanga. Umdlali we-NBA u-Alonzo Mourning wafumana ugcino lwezintso kwi-FSGS, eyamenza ukuba athathe umhlala-phantsi kwiligi ngo-2003.
- I-nephropathy ephambili ye-membranous (PMN) ichaphazela ngokukodwa i-glomeruli yezintso. Xa iiprotein zanele zisefa kumchamo, abaguli bafumana isifo se-nephrotic syndrome. Inokwenzeka kuyo yonke iminyaka, kodwa esi sifo sijolise ikakhulu kubantu abaneminyaka engama-50-60. Yomelele 30% yezigulana nge-PMN bayakwazi ukuphucula imeko yabo ngaphandle konyango. Nangona kunjalo, enye i-30% inemeko eqhubekayo eya kuthi ekugqibeleni ifune i-dialysis okanye ukufakelwa kwezintso. Kulabo bangenaso isifo seswekile, i-PMN ngowona mthombo uqhelekileyo we-nephrotic syndrome kubantu abadala. Inqabile ebantwaneni. I-PMN inokubangelwa zizifo ezizimele, izifo zentsholongwane, amayeza kunye nezihlunu.
- Inkqubo ye lupus erythematosus (SLE) lolona hlobo luqhelekileyo lwe lupus. Sisifo esingapheliyo sokudumba esinokukhokelela ekonakaleni kwezintso. Ezinye iintlobo zelupus zisenokuba yimeko ye-nephrotic syndrome, njenge-lupus podocytopathy kunye ne-lupus nephritis.
- Amyloidosis kwenzeka xa kukho iprotein yokwakha ye-amyloid kwizitho zesigulana. Yiprotein engaqhelekanga kwaye inokwenziwa ngokudityaniswa kweeproteni.
I-Nephrotic syndrome ivela kubantwana nakubantu abadala, kodwa rhoqo ngenxa yezizathu ezahlukeneyo. Abantwana kunokwenzeka ukuba babhaqwe ukuba banesifo esitshintshayo. Abantu abadala bahlala befumana isifo se-nephrotic syndrome esivela kwisifo seswekile.
Imiba yomngcipheko
Zonke ezi zifo zonakalisa inkqubo yokuhluza kwizintso zomzimba. Ukongeza, kukho izinto ezonyusa umngcipheko wokuphuhlisa isifo se-nephrotic:
- Ukuxilongwa kwezonyango: Isifo seSickle cell, isifo seswekile, umhlaza, kunye ne-lupus zonke zenza ukuba kube lula ukuba ube nephrotic syndrome.
- Amayeza: Ii-NSAID, ii-antibiotics ezininzi, kunye namanye amayeza anyusa umngcipheko womonakalo wezintso. Ukungenisa izinto ezinobuthi kunokukhokelela ekonakaleni kwezintso.
- Usulelo: Intsholongwane kaGawulayo, i-hepatitis B, i-hepatitis C, kunye ne-malaria konke kwandisa umngcipheko we-nephrotic syndrome.
Ukuthatha isitokhwe seemeko zakho esele zikho kunokukunceda ubone ukuba ngaba usemngciphekweni wesifo se-nephrotic. Ukongeza, ukumisela ukuba yintoni ebangela umonakalo kunokunceda ababoneleli ngezempilo ukuba banyange abaguli babo.
Iimpawu
Ngaphandle kwezizathu ezahlukeneyo, zimbalwa iimpawu ezinokukukhokelela ekufumaneni isifo se-nephrotic. Xa uneegram ezintathu zeprotheyini kumchamo, kunye ne-cholesterol ephezulu, kunye nokudumba okanye i-edema, yiyo loo nto isifo se-nephrotic UAhmad Oussama Rifai, MD , i-nephrologist kunye nochwephesha woxinzelelo lweklinikhi kunye nomsunguli we-Virtual Nephrologist.
Iimpawu eziphambili zibandakanya:
- I-Edema, okanye ukudumba, ngakumbi amaqatha, iinyawo, ubuso, kunye nesisu-kodwa kunokwenzeka kwenye indawo emzimbeni
- Umchamo we-foamy ubangelwa sisixa esigqithisileyo seprotheni kumchamo
- Ukugcina ulwelo olubangela ukutyeba
- Ukudinwa
- Ukuphelelwa ngumdla wokutya
- I-cholesterol ephezulu ebangelwa ngumzimba wakho uzama ukuzalisa iiprotheni ezilahlekileyo (ezinjengee-lipids okanye iiproteni ezichasayo)
- Rhoqo izifo
- Ukungondleki
Xa le miqondiso idityaniswa nenqanaba eliphantsi le-serum protein ekuthiwa yi-albin, sesinye isalathiso esiphambili se-nephrotic syndrome, ngokwe UBarry Gorlitsky, MD , I-nephrologist eCarolina Nephrology kunye ne-CEO ye-KidneyAide.
Nini ukubiza umboneleli wakho wezempilo
Ukuba uphawula umchamo omdaka, njengogwebu xa ugalela ibhiya, kwaye okanye ukwanda kokudumba, lixesha lokuba ubonane nogqirha, utshilo uGqirha Gorlitsky. Xa undwendwela umboneleli wezempilo, ugqirha wakho uya kuqhuba uvavanyo lwegazi kunye novavanyo lomchamo (okanye uvavanyo lokuchama).
Ugqirha Rifai ucacisa malunga nokuvavanywa: Ukuchongwa kweyona ndlela ibiza ixabiso eliphantsi kwezonyango kwimbali yoluntu nenani lolwazi ekunika lona. Luvavanyo lweedola olune- $ 0.07 ekunikeza ulwazi oluyi-10, kubandakanya neswekile, iprotein kumchamo, igazi kumchamo, i-bilirubin, isifo sesibindi, i-jaundice, ubuthathaka bemisipha. Isifo seNephrotic sisifo esinye esivavanywa ngumchamo ukunceda ukufumanisa. Olu vavanyo lunokwenziwa ekhaya okanye kwiofisi kagqirha.
I-biopsy yezintso inokunceda ekufumaneni oyena nobangela weempawu zakho. Ukuxilongwa kunokuba yinkqubo enzima xa i-biopsy yezintso inganiki lwazi lwaneleyo, okanye ikhokelela kwimicroscopy ekhanyayo (xa ungaboni nantoni na ebhalwe kwi-biopsy yesiqhelo). Emva koko, uGqirha Rafai ucacisa ukuba ugqirha unokwenza amabala akhethekileyo, i-electron microscopy, okanye i-immune microscopy. Ngokusekwe kuloo nto, siya kuthatha isigqibo sokuba yeyiphi i-etiology kunye nendlela yokuyiphatha le nto, utshilo uGqirha Rifai.
Ukuba ufumana ukuxilongwa kwesifo esincinci kwi-biopsy enye, unokufuna ukucela i-biopsy yesibini kwiqhekeza elithile leentso. Kungenxa yokuba i-FSGS (egxile kwicandelo, njengoko igama lisitsho) ivela kwezinye iindawo zezintso, kodwa hayi kwezinye.
UGqirha Rifai ufanisa izintso negadi, enokuba namacandelo ahlukeneyo ematyholo, iintyatyambo kunye nemithi. Uyongeza, Ukuba awunathamsanqa ngokwaneleyo ukuba ungathatha i-biopsy kwindawo yesiqhelo sezintso, uya kuthi uyibhale njengesi sifo esitshintshayo kodwa yona i-FSGS. Ngenxa yokuba i-FSGS iqhubela phambili, oku kunokuba yingozi.
Ezinxulumene: Uvavanyo lwe-creatinine, uluhlu oluqhelekileyo, kunye nendlela yokunciphisa amanqanaba
Ungayilawula njani i-nephrotic syndrome
Wonke umntu one-nephrotic syndrome wahlukile, kodwa njengoko zininzi izizathu, zininzi iindlela zonyango ezinokubakho.
- Vitamin D: Esi sondlo sinceda ukulawula ukusebenza kwezintso. Izigulana zesifo seNephrotic zihlala zisebenzisa izongezo zeVitamin D, ukongeza kwimithombo yendalo, ukubanceda kunyango lwabo.
- Utshintsho kwizidlo: Oogqirha bahlala becebisa uhlengahlengiso lwesondlo ukunciphisa iprotheni kumchamo kunye nokugcinwa okungaphezulu kolwelo. Ngokukodwa, abaguli banokuya kwisidlo esine-sodium ephantsi (ihlala ingaphantsi kwe-1,000 mg yesodium ngosuku) kunye nokunciphisa ukutya kweeprotein. Ikwangumbono olungileyo ukunciphisa ukusetyenziswa kwamafutha apheleleyo.
Ezinxulumene: Unyango oluphezulu lwe-triglyceride
- Amayeza: Kukho iintlobo ezininzi zamayeza anokubonelelwa ngumboneleli wakho wezempilo, kuxhomekeke kwizizathu eziphambili zeempawu zakho.
- I-Steroids ukunceda ukunciphisa ukudumba kwe-glomeruli yezintso
- Iimodareyitha zenkqubo yomzimba yokuzikhusela ukunceda ukulungisa iingxaki zesifo, ezinje nge lupus okanye amayeza eswekile
- I-Angiotensin-converting enzyme (ACE) inhibitors ukunciphisa uxinzelelo lwegazi
- I-diuretics, okanye iipilisi zamanzi, ukunciphisa ukugcinwa kwamanzi kunye nokuvuvukala
- Abacoci begazi, okanye ii-anticoagulants, ukunciphisa umngcipheko wokujiya
Kukho amachiza ambalwa kuphela athetha ngokukodwa isifo se-nephrotic. Uninzi lala mayeza asetyenziswa ngaphandle kwelebheli ukunciphisa iimpawu zelo meko.
| Amayeza aphatha isifo se-nephrotic | |||
|---|---|---|---|
| Igama leziyobisi | Iklasi yeziyobisi | Ingaba isebenza kanjani | Fumana isigqebhezana |
| IPrinivil, Qbrelis, iZestril (lisinopril) | I-ACE inhibitors | Yehlisa uxinzelelo lwegazi | Fumana isigqebhezana |
| ILotensin (benazepril) | I-ACE inhibitors | Yehlisa uxinzelelo lwegazi | Fumana isigqebhezana |
| IVasotec (i-captopril / enalapril) | I-ACE inhibitors | Yehlisa uxinzelelo lwegazi | Fumana isigqebhezana |
| I-Lasix (furosemide) | Womchamo | Ukunciphisa ukugcinwa kwamanzi ukunciphisa ukukhukhuma | Fumana isigqebhezana |
| IAldactone, iCarospir (spironolactone) | Abachasi abamkelayo | Ukunciphisa ukugcinwa kwamanzi ukunciphisa ukukhukhuma | Fumana isigqebhezana |
| Zaroxolyn (hydrochlorothiazide okanye metolazone) | AmaTiyazide | Ukunciphisa ukugcinwa kwamanzi ukunciphisa ukukhukhuma | Fumana isigqebhezana |
| Iilipitor (atorvastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| I-Lescol XL (i-fluvastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| I-Altoprev (lovastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| IPravachol(ipravastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| ICrestor(irosuvastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| IZocor(simvastatin) | I-HMG-CoA ukunciphisa i-inhibitors (i-statins) | Iyanciphisa i-cholesterol | Fumana isigqebhezana |
| Jantoven(iwarfarin) | Iintsholongwane | Inciphisa umngcipheko wegazi | Fumana isigqebhezana |
| Pradaxa(dabigatran) | I-thrombin inhibitors ngqo | Inciphisa umngcipheko wegazi | Fumana isigqebhezana |
| UEliquis(apixaban) | Inqaku Xa inhibitors | Inciphisa umngcipheko wegazi | Fumana isigqebhezana |
| Xarelto(Rivaroxaban ixabiso) | Inqaku Xa inhibitors | Inciphisa umngcipheko wegazi | Fumana isigqebhezana |
| Rituxan(rituximab) | Amachiza omzimba monoclonal | Yehlisa izilwa-buhlungu eziyingozi ezibangela ukudumba | Fumana isigqebhezana |
| IPrednisolone(kwangaphambili) | ICorticosteroids | Inceda uxolelo ngokusombulula iproteinuria | Fumana isigqebhezana |
Nokuba iimpawu zakho zilawulwa kakuhle kukutya, izongezo, kunye nonyango, kuya kufuneka uhlale uzilumkele iimpawu ezizayo. UGqirha Gorlitsky uthi, Amaxesha amaninzi siza kuqhubeka nokujonga rhoqo ukuze siqiniseke ukuba akukho ziphazamiso. Oku kunika abaguli kunye neqela labo lonyango ithuba lokulawula ezo flare-ups njengoko besiza.
