Isifo seNephrotic

I-Nephrotic syndrome liqela leempawu ezibandakanya iprotein kumchamo, amanqanaba aphantsi eproteni egazini, amanqanaba aphezulu e-cholesterol, amanqanaba aphezulu e-triglyceride, ukonyuka komngcipheko wegazi, kunye nokudumba.

I-Nephrotic syndrome ibangelwa ziziphazamiso ezahlukeneyo ezonakalisa izintso. Lo monakalo ukhokelela ekukhululweni kweprotein eninzi kumchamo.

Esona sizathu siqhelekileyo ebantwaneni sisifo esitshintsha kancinci. Imembranous glomerulonephritis sesona sizathu siqhelekileyo kubantu abadala. Kuzo zombini izifo, i-glomeruli kwizintso zonakalisiwe. IGlomeruli zizakhiwo ezinceda ukucoceka inkunkuma kunye nolwelo.

Le meko inokwenzeka kwakhona:

• Umhlaza
• Izifo ezinje ngeswekile, inkqubo lupus erythematosus, myeloma, kunye neamyloidosis
• Ukuphazamiseka kwemfuza
• Ukuphazamiseka komzimba
• Usulelo (njenge-strep throat, hepatitis, okanye i-mononucleosis)
• Ukusetyenziswa kwamachiza athile

Inokwenzeka ngezifo zezintso ezinje:

• Ingqwalaselo kunye necandelo le-glomerulosclerosis
• IGlomerulonephritis
• I-Mesangiocapillary glomerulonephritis

I-Nephrotic syndrome inokuchaphazela onke amaqela eminyaka. Kubantwana, ixhaphake kakhulu phakathi kweminyaka emi-2 kunye ne-6. Esi sifo senzeka ngokufuthi ngakumbi kumadoda kunabasetyhini.

Ukudumba (i-edema) lolona phawu luqhelekileyo. Inokwenzeka:

• Ebusweni nasekujikelezeni kwamehlo (ukudumba kobuso)
• Ezingalweni nasemilenzeni, ngakumbi iinyawo namaqatha
• Kwindawo yesisu (isisu esidumbileyo)

Ezinye iimpawu zibandakanya:

• Ukudumba kolusu okanye izilonda
• Ukubonakala kwegwebu komchamo
• Ukutya okungafanelekanga
• Ukutyeba (ngokungenanjongo) kugcino lwamanzi
• Ukuxhuzula

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Iimvavanyo zaselebhu ziya kwenziwa ukubona ukuba zisebenza kakuhle kangakanani izintso. Ziquka:

• Uvavanyo lwegazi lweAlbumin
• Uvavanyo lwe-chemistry yegazi, njengephaneli esisiseko yemetabolism
• Igazi urea nitrogen (BUN)
• I-Creatinine-uvavanyo lwegazi
• Ukucaciswa kwe-Creatinine-uvavanyo lomchamo
• Uhlalutyo lomchamo

Amafutha ahlala ekhona nasemchameni. I-cholesterol yegazi kunye namanqanaba e-triglyceride anokuphakama.

I-biopsy yezintso inokufuneka ukufumana unobangela wokuphazamiseka.

Iimvavanyo zokulawula izizathu ezahlukeneyo zinokubandakanya oku kulandelayo:

• Intshatsheli yomzimba
• Cryoglobulins
• Gcwalisa amanqanaba
• Uvavanyo lokunyamezelwa kweglucose
• Iintsholongwane ze-Hepatitis B kunye no-C
• Uvavanyo lwe-HIV
• Into yeRheumatoid
• Iprotheni yeprotein electrophoresis (SPEP)
• I-Syphilis serology
• Umchamo weprotein electrophoresis (UPEP)

Esi sifo sinokutshintsha iziphumo zolu vavanyo lulandelayo:

• Inqanaba leVitamin D
• Isinyithi seSerum
• Ukuphosa umchamo

Iinjongo zonyango kukukhulula iimpawu, ukuthintela iingxaki kunye nokulibaziseka komonakalo wezintso. Ukulawula i-nephrotic syndrome, ukuphazamiseka okubangela ukuba kunyangwe. Unokufuna unyango ubomi bakho bonke.

Unyango lunokubandakanya nayiphi na kwezi zilandelayo:

• Ukugcina uxinzelelo lwegazi kwi okanye ngaphantsi kwe-130/80 mm Hg ukulibazisa ukulimala kwezintso. I-Angiotensin-converting enzyme (ACE) inhibitors okanye i-angiotensin receptor blockers (ARBs) ngawona mayeza asetyenziswa rhoqo. Ii-ACE inhibitors kunye nee-ARBs zinokunceda ukunciphisa isixa seprotein elahlekileyo kumchamo.
• I-Corticosteroids kunye nezinye iziyobisi ezicinezela okanye zithule amajoni omzimba.
• Ukunyanga i-cholesterol ephezulu ukunciphisa umngcipheko weengxaki zentliziyo kunye nemithambo yegazi- Ukutya okunamafutha asezantsi, ukutya okune-cholesterol ephantsi kuhlala kungonelanga kubantu abane-nephrotic syndrome. Amayeza okunciphisa i-cholesterol kunye ne-triglycerides (ihlala i-statins) inokufuneka.
• Ukutya okune-sodium encinci kunokunceda ngokudumba ezandleni nasemilenzeni. Iipilisi zamanzi (i-diuretics) zinokunceda kule ngxaki.
• Ukutya okuneproteni encinci kunokuba luncedo. Umboneleli wakho unokucebisa ukutya okuphakathi kweprotein (i-1 gram yeproteyin ngekhilogram ubunzima bomzimba ngosuku).
• Ukuthatha isongezelelo se-vitamin D ukuba i-nephrotic syndrome ihlala ixesha elide kwaye ayiphenduli kunyango.
• Ukuthatha iziyobisi ezincinci zegazi ukunyanga okanye ukunqanda amahlwili egazi.

Iziphumo ziyahluka. Abanye abantu bayachacha kule meko. Abanye bahlakulela isifo sesifo sexesha elide kwaye bafuna i-dialysis kwaye ekugqibeleni ukufakelwa kwezintso.

Iingxaki zempilo ezinokubangelwa yi-nephrotic syndrome zibandakanya:

• Ukungaphumeleli kwezintso
• Ukuqina kwemithambo kunye nezifo zentliziyo ezinxulumene noko
• Isifo sezintso esinganyangekiyo
• Ukugcwala kwamanzi, ukungaphumeleli kwentliziyo, ulwelo olwakhiwe kwimiphunga
• Usulelo, kubandakanya i-pneumococcal pneumonia
• Ukungondleki
• I-vein vein thrombosis

Fowunela umnikezeli wakho ukuba:

• Wena okanye umntwana wakho uvelisa iimpawu zesifo se-nephrotic, kubandakanya ukudumba ebusweni, isisu, okanye iingalo nemilenze, okanye izilonda kulusu.
• Wena okanye umntwana wakho uphathwa i-nephrotic syndrome, kodwa iimpawu aziphucuki
• Iimpawu ezintsha zikhula, kubandakanya ukukhwehlela, ukwehla kwemveliso yokuchama, ukungathandeki ngokuchama, umkhuhlane, intloko ebuhlungu

Yiya kwigumbi lexakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba uxhuzula.

Ukunyanga iimeko ezinokubangela isifo se-nephrotic kunganceda ukukhusela isifo.

INephrosis

• I-anatomy yezintso

Isifo sika-Erkan E. Nephrotic. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahlulo 545.

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.