I-nephropathy yesikhumbuzo

Imembranous nephropathy sisifo sezintso esikhokelela kutshintsho kunye nokudumba kwezakhiwo ngaphakathi kwezintso ezinceda ekucoceni inkunkuma kunye nolwelo. Ukudumba kunokukhokelela kwiingxaki zezintso.

I-nephropathy yesikhumba ibangelwa kukuqina kwenxalenye yelungu le-glomerular kwigumbi elingaphantsi. Inwebu yangaphantsi eglomerular yinxalenye yezintso ezinceda ukuhluza inkunkuma kunye nolwelo olongezelelweyo egazini. Isizathu ngqo soku ukuqina asaziwa.

Inwebu ejiyileyo ebunjiweyo ayisebenzi ngokwesiqhelo. Ngenxa yoko, izixa ezikhulu zeprotheyini zilahlekile kumchamo.

Le meko yenye yoonobangela abaqhelekileyo be-nephrotic syndrome. Eli liqela leempawu ezibandakanya iprotheni kumchamo, inqanaba eliphantsi leeproteni yegazi, amanqanaba aphezulu e-cholesterol, amanqanaba aphezulu e-triglyceride, kunye nokudumba. Imembranous nephropathy inokuba sisifo sezintso eziphambili, okanye inokudityaniswa nezinye iimeko.

Oku kulandelayo kwandisa umngcipheko wale meko:

• Umhlaza, ngakumbi umhlaza wemiphunga kunye nekholon
• Ukubonakaliswa kwityhefu, kubandakanya igolide kunye nemekyuri
• Usulelo, kubandakanya i-hepatitis B, isifo seengcongconi, igcushuwa, kunye ne-endocarditis
• Amayeza, kubandakanya ipenicillamine, i-trimethadione, kunye nezithambiso ezikhanyisa ulusu
• Inkqubo ye lupus erythematosus, isifo samathambo, isifo samangcwaba, kunye nezinye iingxaki zomzimba.

Esi sifo senzeka nangaliphi na ixesha, kodwa siqhelekile emva kweminyaka engama-40.

Iimpawu zihlala ziqala kancinci emva kwexesha, kwaye zinokubandakanya:

• I-Edema (ukudumba) nakweyiphi na indawo yomzimba
• Ukudinwa
• Ukubonakala kwegwebu lomchamo (ngenxa yexabiso elikhulu leprotheni)
• Ukutya okungafanelekanga
• Ukuchama, ukugqithisa ebusuku
• Ukutyeba kwakho

Uvavanyo lomzimba lunokubonisa ukudumba (i-edema).

Uvavanyo lokuchama lunokubonisa isixa esikhulu seprotein kumchamo. Kusenokubakho igazi elithile kumchamo.Izinga lokuhluza le-glomerular ("isantya" apho izintso zihlambulula igazi) lihlala liphantse liqheleke.

Olunye uvavanyo lunokwenziwa ukuze lubone ukuba zisebenza kakuhle kangakanani izintso kunye nokuba umzimba uhlengahlengisa njani kwingxaki yezintso. Oku kubandakanya:

• Ialbhamu - igazi nomchamo
• Igazi urea nitrogen (BUN)
• I-creatinine - igazi
• Ukucoca creatinine
• Iphaneli yeLipid
• Iiproteni - igazi kunye nomchamo

I-biopsy yezintso iqinisekisa ukuxilongwa.

Olu vavanyo lulandelayo lunokunceda ukumisela unobangela we-nephropathy ye-membranous:

• Uvavanyo lweentsholongwane zenyukliya
• I-anti-strand DNA, ukuba uvavanyo lweentsholongwane zenyukliya luhle
• Uvavanyo lwegazi ukukhangela i-hepatitis B, i-hepatitis C, kunye negcushuwa
• Gcwalisa amanqanaba
• Uvavanyo lweCryoglobulin

Injongo yonyango kukunciphisa iimpawu kunye nokunciphisa ukuqhubela phambili kwesi sifo.

Ukulawula uxinzelelo lwegazi yeyona ndlela ibalulekileyo yokulibazisa ukulimala kwezintso. Injongo kukugcina uxinzelelo lwegazi okanye ngaphantsi kwe-130/80 mm Hg.

I-cholesterol yegazi ephezulu kunye namanqanaba e-triglyceride kufuneka anyangwe ukunciphisa umngcipheko we-atherosclerosis. Nangona kunjalo, ukutya okunamafutha asezantsi, ukutya okune-cholesterol ephantsi kuhlala kungeloncedo kubantu abane-membranous nephropathy.

Amayeza asetyenziselwa ukunyanga nephropathy ye-membranous ibandakanya:

• I-Angiotensin-converting enzyme (ACE) inhibitors kunye ne-angiotensin receptor blockers (ARBs) ukunciphisa uxinzelelo lwegazi
• I-Corticosteroids kunye nezinye iziyobisi ezicinezela amajoni omzimba
• Amayeza (amaxesha amaninzi ama-statins) ukunciphisa amanqanaba e-cholesterol kunye ne-triglyceride
• Iipilisi zamanzi (umchamo) ukunciphisa ukudumba
• Abacoci begazi ukunciphisa umngcipheko wamahlwili egazi emiphungeni nasemilenzeni

Ukutya okuneproteni encinci kunokuba luncedo. Ukutya okunomlinganiselo ophakathi (1 gram [gm] weproteyin ngekhilogram ubunzima bomzimba ngosuku) kunokucetyiswa.

I-Vitamin D inokufuna ukubuyiselwa endaweni ukuba i-nephrotic syndrome ihlala ixesha elide (engapheliyo) kwaye ayiphenduli kunyango.

Esi sifo sonyusa umngcipheko wamahlwili egazi emiphungeni nasemilenzeni. Abacoci begazi banokumiselwa ukuthintela ezi ngxaki.

Imbonakalo iyahluka, kuxhomekeke kubungakanani bokulahleka kweproteni. Kunokubakho amaxesha angenazimpawu kunye namaxesha athile okuqhambuka. Ngamanye amaxesha, imeko iyahamba, kunye okanye ngaphandle kwonyango.

Uninzi lwabantu abanesi sifo luya kuba nomonakalo wezintso kwaye abanye abantu baya kuba nesifo se-renal.

Iingxaki ezinokubangelwa sesi sifo zibandakanya:

• Ukusilela okungapheliyo kwezintso
• I-thrombosis enzulu yemithambo
• Isifo se-renal sokugqibela
• Isifo seNephrotic
• Ukudibanisa iipulmonary
• I-vein vein thrombosis

Biza ixesha lokubonana nomboneleli wakho wezempilo ukuba:

• Unempawu ze-nephropathy ye-membranous
• Iimpawu zakho ziba zimbi okanye ungahambi
• Uba neempawu ezintsha
• Ukwehlisile ukuphuma komchamo

Ukunyanga ngokukhawuleza ukuphazamiseka kunye nokuthintela izinto ezinokubangela ukungasebenzi kakuhle komzimba kunokunciphisa umngcipheko.

Isikhumba glomerulonephritis; Isikhumbuzo se-GN; I-glomerulonephritis eyandisiweyo; I-Glomerulonephritis - inwebu yangaphakathi; MGN

• I-anatomy yezintso

URadhakrishnan J, iAppel GB. Ukuphazamiseka kweGlomerular kunye nephrotic syndromes. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl 113.

USaha MK, iPendergraft WF, uJennette JC, uFalk RJ. Isifo esisisiseko se-glomerular. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahl 31.

Isaldi DJ, Cattran DC. I-nephropathy yesikhumbuzo. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, ii-eds. I-Clinical Nephrology epheleleyo. Umhla wesi-6. IPhiladelphia, PA: Elsevier; I-2019: isahluko 20.