UMary Allen
Uma izinso ziyeka ukusebenza, kunengozi yemiphumela emibi yesikhathi eside. Ngakho-ke kubalulekile ukuhlonza nokwelapha ukwehluleka kwezinso okungapheli kusenesikhathi. Thola konke mayelana nezimpawu, ukuxilongwa, kanye nokwelashwa kokwehluleka kwezinso okungamahlalakhona emakatini lapha.
I-Chronic renal insufficiency (CRF) ichaza ukuwohloka kancane kwayo yonke imisebenzi yezinso. Lokhu kulahlekelwa kancane kancane kokusebenza kwezinso kungaqhubeka phakathi nezinyanga neminyaka ngaphandle kokuba umnikazi wekati abone izinguquko ekatini labo. Njengoba i-CKD iqhubeka, izicubu zezinso ezisebenza ngokwengeziwe ziyalahleka futhi esikhundleni salokho kuxhunywe izicubu.
Ukuphazamiseka kwe-metabolic kwenzeka kuphela lapho amaphesenti angama-75 noma ngaphezulu ezinso sezinso ecekeleke phansi futhi ikati libonisa izimpawu zesifo sezinso.
Isizathu sokuhluleka kwezinso okungapheli ukuvuvukala okungapheli, isizathu esivusayo esingakacaci.
Izimpawu Zokwehluleka Kwezinso Okungapheli Emakatini
Ngeshwa, izifo zezinso zivame ukutholakala sekwephuzile kakhulu. Kuphela uma izingxenye ezimbili kwezintathu zezinso sezicekeleke phansi lapho ikati libonisa khona izimpawu zokungasebenzi kahle kwezinso.
Ezigabeni zokuqala zokuhluleka kwezinso okungapheli, ikati liphuza kakhulu futhi likhiqiza umchamo omningi ngokufanele. Emakati asendlini, lokhu kubonakala lapho uhlanza ibhokisi likadoti. Abanikazi bamakati angaphandle ngokuvamile abanalo ithuba lokubona lezi zimpawu zokuqala, njengoba amakati angaphandle ethanda ukuthulula isinye ngaphandle futhi aphuze kakhulu lapho. Kuye ngekati, ezinye izimpawu zingase zivele njengoba lesi sifo siqhubeka. Lezi izi:
- ukukhathala
- ukulahlekelwa ukudla
- hlanza
- isifo sohudo
- uboya obuluhlaza
- umoya omubi
Kodwa-ke, njengoba lezi zimpawu zingase zibe uphawu lwezinye izifo ezifana nesifo sikashukela, kubalulekile ukuba ikati lihlolwe ngokucophelela ngudokotela wezilwane.
Nakhu ukubuka konke kwazo zonke izigaba zokwehluleka kwezinso okungapheli emakatini kanye nezimpawu:
Isigaba I: Ukuntuleka Kwezinso Okuqalayo
- i-creatinine ebangeni elijwayelekile, isilinganiso samaprotheni/i-creatinine sijwayelekile
- azikho izimpawu
- awukho umthelela empilweni yonke
Isigaba II: Ukwehluleka Kwangaphambi Kwezinso
- i-creatinine yenyuke kancane, isilinganiso samaprotheni/i-creatinine endaweni yomngcele
- amakati ambalwa kuphela asevele abonisa izimpawu zokuqala ezifana nokwanda kokuphuza
- isilinganiso seminyaka yokuphila ngaphandle kokwelashwa cishe iminyaka emi-3
Isigaba III: Ukwehluleka kwezinso ze-Uremic
- i-creatinine ngaphezu kobubanzi obujwayelekile, isilinganiso samaprotheni/i-creatinine senyuke, kwabhujiswa ama-75% ezinso zezinso
- izimpawu ezinjengokuphuza ngokweqile kanye nokulahlekelwa ukudla zibonakala;
- ukwanda kokwenzeka kwezinto zomchamo egazini
- isilinganiso seminyaka yokuphila ngaphandle kokwelashwa cishe iminyaka emi-2
Isigaba IV: Ukwehluleka Kwezinga Lokuphela Kwezinso
- kwandisa kakhulu isilinganiso se-creatinine kanye namaprotheni/i-creatinine
- ikati alisakwazi ukuchama
- ikati libonisa izimpawu ezinzima ezifana namajaqamba, ukuhlanza okukhulu, ukwenqaba ukudla, njll.
- isilinganiso seminyaka yokuphila ngaphandle kokwelashwa izinsuku ezingama-35
Ukutholwa Kwangaphambi Kwama-Nephritis Okungapheli Emakatini
Lapho ikati likhula, makhulu amathuba okuba libe nokuvuvukala kwezinso okungamahlalakhona. Lapho eseneminyaka engaphezu kweyishumi ubudala, aphakathi kwamaphesenti angu-30 kuya kwangu-40 awo wonke amakati ayathinteka. Abesilisa besilisa batholakala ngaphambi kwesikhathi, ngokwesilinganiso, eminyakeni eyi-12 kunabesifazane abaneminyaka eyi-15.
Udokotela wezilwane angenza kuphela ukuxilonga okuthembekile ngokuhlolwa kwegazi nomchamo elabhorethri. Amanani ezinso ze-urea, i-creatinine, ne-SDMA akhuphuka kakhulu kumakati agulayo. Ngaphezu kwalokho, amazinga e-phosphate egazini namazinga amaprotheni emchameni aphakeme kakhulu.
Umfutho wegazi wekati nawo kufanele uhlolwe njalo futhi welashwe uma kunesidingo, njengoba umfutho wegazi ophakeme ulimaza imithambo ezinso. Amaphesenti angaphezu kuka-60 awo wonke amakati anenkinga yezinso anomfutho wegazi ophakeme. Ngaphandle kokulimaza izinso, lokhu kubangela nesifo senhliziyo ekatini.
Kubalulekile ukuthi kuhlolwe amanani ezinso minyaka yonke kumakati angaphezu kweminyaka eyisikhombisa. Ikakhulukazi, inani le-SDMA libonisa izifo zezinso ezigabeni zokuqala. Ukwelashwa kungaqala ngaphambi kokuba ikati libe nezimpawu.
Ukudla Okufanelekile Kwamakati Anenkinga Yezinso Ezingamahlalakhona
Udokotela wezilwane kufanele aguqule kokubili ukwelashwa ngemithi kanye nokudla okudingekayo kokwehluleka kwezinso okungapheli ekatini kanye nezinga lesifo. Kufanele futhi ulandele imithetho yakhe njengendaba ephuthumayo. Eqinisweni, amaprotheni kanye ne-phosphorus okuqukethwe kokudla kokudla kufanele kuncishiswe uma kuqhathaniswa nokudla okujwayelekile kwekati. Ikati elinesifo sezinso akufanele linikezwe noma yiziphi ezinye ukudla okulula noma izithasiselo zamavithamini ngaphandle kokubonisana nodokotela wezilwane. Amanye amalungiselelo aqukethe i-phosphorus eningi.
Ukudla okukhethekile kwezinso sekuyatholakala kubakhiqizi abahlukene bokuphakelayo nangezinhlobo ezahlukene, ngakho-ke kulula manje ukuthola ukudla okudliwa yikati elithanda ukukudla. Kubalulekile ukwenza uguquko kancane kancane: Ekuqaleni, hlanganisa ukudla okudliwayo nokudla okuvamile nge-spoonful futhi ukwandise isilinganiso sesinyathelo ngesinyathelo.
Imiphumela Yokwehluleka Kwezinso Okungapheli Emakatini
Umsebenzi oyinhloko wezinso ukuhlunga izinto ezinobuthi emzimbeni. Lobu buthi bube sebudluliselwa emchameni, bushiye amaprotheni anempilo emzimbeni. Uma izinso zingasasebenzi kahle, umzimba wonke uyahlupheka. Izinto ezinobuthi okufanele empeleni zikhishwe ngomchamo azikwazi ukuhlungwa futhi zihlale emzimbeni. Nakuba i-urea ngokwayo ingenabo ubuthi, ingashintsha ibe ubuthi obuyingozi i-ammonia, obuhlasela ubuchopho. Yingakho kubaluleke kakhulu ukuhlonza i-CKD kusenesikhathi ukuze ikati likwazi ukuqhubeka nokuphila isikhathi eside, nengenazo izimpawu.