Isifo seswekile

Isifo seswekile i-insipidus (DI) yimeko engaqhelekanga apho izintso zingakwaziyo ukuthintela ukuphuma kwamanzi.

I-DI ayifani nesifo seswekile kunye ne-1 kunye ne-2. Nangona kunjalo, ukunganyangwa, zombini i-DI kunye neswekile zibangela ukoma rhoqo kunye nokuchama rhoqo. Abantu abanesifo seswekile baneswekile eninzi yegazi (iswekile) kuba umzimba awukwazi ukusebenzisa iswekile yegazi ukwenza amandla. Abo bane-DI banamanqanaba aqhelekileyo eswekile yegazi, kodwa izintso zabo azikwazi ukulinganisa ulwelo emzimbeni.

Emini, izintso zakho zihluza lonke igazi lakho amaxesha amaninzi. Ngokwesiqhelo, uninzi lwamanzi luphinda lubuyiselwe kwakhona, kwaye kuphela sisixa esincinci somchamo oxineneyo okhutshiweyo. I-DI yenzeka xa izintso zingakwazi ukugxila kumchamo ngesiqhelo, kwaye isixa esikhulu somchamo wokungxengxeza sikhutshiwe.

Isixa samanzi esikhutshwe kumchamo silawulwa yihomoni ye-antidiuretic hormone (ADH). I-ADH ibizwa ngokuba yi-vasopressin. I-ADH iveliswa kwinxalenye yengqondo ebizwa ngokuba yihypothalamus. Iyagcinwa ize ikhutshwe kwincindi yebhinqa. Le yindlala encinci engezantsi kwesiseko sobuchopho.

I-DI ibangelwa kukunqongophala kwe-ADH ibizwa ngokuba yi-insipidus yeswekile. Xa i-DI ibangelwa kukusilela kwezintso ukuphendula kwi-ADH, imeko ibizwa ngokuba yi-nephrogenic diabetes insipidus. I-Nephrogenic ithetha inxulumene nezintso.

I-Central DI inokubangelwa ngumonakalo kwi-hypothalamus okanye kwi-pituitary gland ngenxa:

• Iingxaki zemfuza
• Ukwenzakala entloko
• Usulelo
• Ingxaki ngeeseli ezivelisa i-ADH ngenxa yesifo esizimele
  
• Ukuphulukana nokunikezelwa kwegazi kwi-pituitary gland
• Utyando kwindawo ye-pituitary gland okanye i-hypothalamus
• Izidumba ngaphakathi okanye kufutshane nedlala yebhinqa

I-Nephrogenic DI ibandakanya isiphene kwizintso. Ngenxa yoko, izintso aziphenduli kwi-ADH. Njengombindi we-DI, i-nephrogenic DI inqabile. I-Nephrogenic DI inokubangelwa ngu:

• Amayeza athile, afana ne-lithium
• Iingxaki zemfuza
• Inqanaba eliphezulu le-calcium emzimbeni (hypercalcemia)
• Isifo sezintso, esifana nesifo sezintso se-polycystic

Iimpawu ze-DI zibandakanya:

• Unxano olugqithisileyo olunokuba lukhulu okanye lungalawuleki, ihlala inesidingo sokusela isixa esikhulu samanzi okanye ukunqwenela amanzi e-ice
• Umthamo womchamo ogqithisileyo
• Ukuchama okugqithisileyo, kuhlala kufuna ukuchama iyure yonke imini nobusuku
• Ngxenga kakhulu, umchamo oluthuthu

Umboneleli wezempilo uya kubuza malunga nembali yakho yonyango kunye neempawu.

Uvavanyo olunoku-odolwa lubandakanya:

• Igazi lesodium kunye ne-osmolality
• Umceli mngeni we-Desmopressin (DDAVP)
• I-MRI yentloko
• Uhlalutyo lomchamo
• Umchamo woxinzelelo kunye ne-osmolality
• Iziphumo zomchamo

Umboneleli wakho unokubona ugqirha ogxile kwizifo zepituitary ukunceda ukufumanisa i-DI.

Unobangela wale meko uyakunyangwa xa kunokwenzeka.

Umbindi we-DI unokulawulwa nge-vasopressin (desmopressin, DDAVP). Uthatha i-vasopressin njengenaliti, ukutshiza ngeempumlo, okanye iipilisi.

Ukuba i-nephrogenic DI ibangelwa liyeza, ukumisa amayeza kunokunceda ekubuyiseleni ukusebenza kwezintso okuqhelekileyo. Kodwa emva kweminyaka emininzi yokusetyenziswa kwamayeza athile, njenge-lithium, i-nephrogenic DI inokuhlala isigxina.

I-Hereditary nephrogenic DI kunye ne-lithium-indved nephrogenic DI inyangwa ngokusela ulwelo olwaneleyo ukuhambelana nokukhupha umchamo. Amayeza asezantsi okuvelisa umchamo nawo kufuneka athathwe.

I-Nephrogenic DI inyangwa ngamayeza a-notshisa kunye ne-diuretics (iipilisi zamanzi).

Iziphumo zixhomekeke kwisifo esisisiseko. Ukuba iyanyangwa, i-DI ayibangeli iingxaki ezinzima okanye ibangele ukusweleka kwangethuba.

Ukuba umzimba wakho unxaniwe uqhelekile kwaye uyakwazi ukusela ulwelo olwaneleyo, akukho ziphumo zibalulekileyo kulwelo lomzimba okanye ukulingana kwetyuwa.

Ukungaseli ngokwaneleyo ulwelo kunokukhokelela ekuphelelweni ngamanzi emzimbeni kunye nokungalingani kwe-electrolyte, okunokuba yingozi kakhulu.

Ukuba i-DI inyangwa nge-vasopressin kwaye ukomelela komzimba wakho akuqhelekanga, ukusela ulwelo oluninzi kunokuba iimfuno zomzimba wakho kunokubangela ukungalingani kwe-electrolyte eyingozi.

Tsalela umnikezeli wakho ukuba uphuhlisa iimpawu ze-DI.

Ukuba unayo i-DI, nxibelelana nomboneleli wakho ukuba uchama rhoqo okanye ubuya kakhulu.

• Amadlala endocrine
• Uvavanyo lwe-Osmolality

UHannon MJ, uThompson CJ. IVasopressin, isifo seswekile i-insipidus, kunye nesifo se-antidiuresis esingafanelekanga. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahl 18.

I-Verbalis JG. Ukuphazamiseka kokulinganisela kwamanzi. Ku: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-10. IPhiladelphia, PA: Elsevier; 2016: isahluko 16.