I-metosis acidosis

I-Metabolic acidosis yimeko apho kukho i-asidi eninzi kulwelo lomzimba.

I-Metabolic acidosis ikhula xa i-asidi eninzi iveliswa emzimbeni. Inokwenzeka kwakhona xa izintso zingenakususa i-asidi eyaneleyo emzimbeni. Kukho iintlobo ezininzi ze-metosis acidosis:

• Isifo seswekile (esikwabizwa ngokuba sisifo seswekile ketoacidosis kunye ne-DKA) sikhula xa izinto ezibizwa ngokuba yimizimba ye-ketone (ene-asidi) eyakha ngexesha lesifo seswekile esingalawulwayo.
• I-Hyperchloremic acidosis ibangelwa kukuphulukana ne-sodium bicarbonate eninzi emzimbeni, enokwenzeka xa kukho urhudo oluqatha.
• Isifo sezintso (i-uremia, i-distal renal tubular acidosis okanye i-proximal renal tubular acidosis).
• Lactic acidosis.
• Ityhefu yi-aspirin, i-ethylene glycol (efumaneka kwi-antifreeze), okanye i-methanol.
• Ukuphelelwa ngamandla emzimbeni.

I-Lactic acidosis iphuma kulwakhiwo lwe-lactic acid. I-Lactic acid iveliswa ikakhulu kwiiseli zemisipha kunye neeseli ezibomvu zegazi. Yenzeka xa umzimba wophula iikhabhohayidrethi uzisebenzisele amandla xa amanqanaba eoksijini ephantsi. Ingabangelwa ngu:

• Umhlaza
• Ityhefu yecarbon monoxide
• Ukusela kakhulu utywala
• Ukuzivocavoca ngamandla ixesha elide
• Ukungaphumeleli kwesibindi
• Iswekile esezantsi yegazi (hypoglycemia)
• Amayeza, afana ne-salicylates, i-metformin, ii-anti-retrovirals
• I-MELAS (isifo esingaqhelekanga semfuza yemithachondrial esichaphazela ukuveliswa kwamandla)
• Ukungabikho kwexesha elide kweoksijini kukothuka, ukusilela kwentliziyo, okanye i-anemia ebukhali
• Ukuxhuzula

Uninzi lweempawu zibangelwa sisifo esisisiseko okanye imeko ebangela i-metabolic acidosis. I-Metabolic acidosis ngokwayo idla ngokubangela ukuphefumla ngokukhawuleza. Ukwenza ukubhideka okanye ukudinwa kakhulu nako kunokwenzeka. Ukuchaneka kwe-acidosis kungakhokelela kukothuka okanye ekufeni. Kwezinye iimeko, i-acidosis ye-metabolic inokuba yimeko enobulali, eqhubekayo (engapheliyo).

Ezi mvavanyo zinokunceda ekuchongeni i-acidosis. Banokufumanisa ukuba unobangela yingxaki yokuphefumla okanye ingxaki yemetabolism. Uvavanyo lunokubandakanya:

• Irhasi yegazi ejikelezayo
• Iphaneli yokuSisiseko ye-metabolic, (iqela leemvavanyo zegazi ezilinganisa amanqanaba akho esodium kunye nepotassium, ukusebenza kwezintso, kunye nezinye iikhemikhali kunye nemisebenzi
• Iiketoni zegazi
• Uvavanyo lweLactic acid
• Iiketoni zomchamo
• Umchamo pH

Olunye uvavanyo lunokufuneka ukumisela unobangela we-acidosis.

Unyango lujolise kwingxaki yezempilo ebangela i-acidosis. Ngamanye amaxesha, isodium bicarbonate (ikhemikhali ekwisoda yokubhaka) inokunikwa ukunciphisa iasidi yegazi. Rhoqo, uya kufumana amanzi amaninzi ngomthambo wakho.

Imbonakalo iya kuxhomekeka kwisifo esisisiseko esibangela imeko.

Ukuchaphazeleka kakhulu kwe-acidosis kungakhokelela kukothuka okanye ekufeni.

Funa uncedo kwezonyango ukuba unempawu zaso nasiphi na isifo esinokubangela i-metabolic acidosis.

I-ketoacidosis yeswekile inokuthintelwa ngokugcina uhlobo lweswekile phantsi kolawulo.

Acidosis - ukutya

• Imveliso ye-insulin kunye neswekile

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IPalmer BF. I-metosis acidosis. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, ii-eds. I-Clinical Nephrology epheleleyo. Umhla wesi-6. IPhiladelphia, PA: Elsevier; I-2019: isahluko 12.

Seifter JL. Ukuphazamiseka kwesiseko se-Acid. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 110.