I-acidosis ye-renal ye-renal eyahlukileyo

I-distal renal tubular acidosis sisifo esenzeka xa izintso zingazisusi ngokufanelekileyo ii-acid egazini ukuya kumchamo. Ngenxa yoko, iasidi eninzi isala egazini (ebizwa ngokuba yiasidiosis).

Xa umzimba wenza imisebenzi yawo yesiqhelo, uvelisa iasidi. Ukuba le asidi ayisuswanga okanye ayiphelanga, igazi liya kuba neasidi kakhulu. Oku kunokukhokelela kukungalingani kwe-electrolyte egazini. Inokubangela iingxaki ngokusebenza kwesiqhelo kwezinye iiseli.

Izintso zinceda ukulawula inqanaba lomzimba weasidi ngokususa iasidi egazini kwaye ikhuphe nasemchameni.

I-distal renal tubular acidosis (uhlobo I-RTA) ibangelwa sisiphene kwimibhobho yezintso ebangela ukuba i-asidi yakhe egazini.

Uhlobo I-RTA lubangelwa ziimeko ezahlukeneyo, kubandakanya:

• I-Amyloidosis, iprotein engaqhelekanga, ebizwa ngokuba yi-amyloid, kwizicwili nakwizitho zomzimba
• Isifo se-Fabry, isakhiwo esingaqhelekanga emzimbeni wohlobo oluthile lwento enamafutha
• Inqanaba eliphezulu le-calcium egazini
• Isifo seSickle cell, iiseli ezibomvu zegazi ezihlala zimile njengediski zithatha irhengqa okanye imilo yecrescent
• Isifo seSjögren, isifo esingumzimba apho amadlala avelisa iinyembezi kunye namathe atshatyalaliswa
• Isystemic lupus erythematosus, isifo esizenzekelayo apho amajoni omzimba ahlasela ngempazamo izicwili ezisempilweni
• Isifo sikaWilson, sisifo esizuze ilifa apho kukho ubhedu oluninzi kakhulu kwizicwili zomzimba
• Ukusetyenziswa kwamayeza athile, anje nge-amphotericin B, i-lithium kunye ne-analgesics

Iimpawu ze-distal renal tubular acidosis zibandakanya nayiphi na kwezi zilandelayo:

• Ukudideka okanye ukunciphisa ukulumka
• Ukudinwa
• Ukukhula okungalunganga kubantwana
• Ukonyusa izinga lokuphefumla
• Amatye eentso
• I-Nephrocalcinosis (i-calcium eninzi efakwe kwizintso)
• I-Osteomalacia (ukuthamba kwamathambo)
• Ubuthathaka bemisipha

Ezinye iimpawu zingabandakanya:

• Intlungu yethambo
• Ukuncipha kwemveliso yomchamo
• Ukunyuka kwentliziyo okanye ukubetha kwentliziyo okungaqhelekanga
• Iintlanzi zemisipha
• Intlungu emva, iflank, okanye isisu
• Ukungaqhelekanga kwamathambo

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho.

Uvavanyo olunoku-odolwa lubandakanya:

• Irhasi yegazi ejikelezayo
• Ikhemesti yegazi
• Umchamo pH
• Uvavanyo lomthwalo we-Acid
• Uvavanyo lokufakwa kweBicarbonate
• Uhlalutyo lomchamo

Ukufakwa kweCalcium kwizintso kunye namatye ezintso kunokubonwa kwi:

• X-reyi
• I-Ultrasound
• Ukuskena i-CT

Injongo kukubuyisela umgangatho we-asidi oqhelekileyo kunye nokulinganisela kwe-electrolyte emzimbeni. Oku kuya kunceda ukulungisa ukuphazamiseka kwethambo kunye nokunciphisa ukwakhiwa kwecalcium kwizintso (nephrocalcinosis) kunye namatye ezintso.

Unobangela osisiseko we-distal renal tubular acidosis kufuneka ulungisiwe ukuba unokuchongwa.

Amayeza anokumiselwa afaka i-potassium citrate, isodium bicarbonate, kunye ne-thiazide diuretics. La ngamayeza e-alkaline anceda ukulungisa imeko ye-asidi yomzimba. Isodium bicarbonate inokulungisa ukulahleka kwe potassium kunye ne calcium.

Esi sifo kufuneka sinyangwe ukunciphisa iziphumo kunye nobunzima, obunokuba sisisigxina okanye busongele ubomi. Uninzi lwamatyala alunge ngonyango.

Tsalela umnikezeli wakho ukuba unempawu ze-distal renal tubular acidosis.

Fumana uncedo lwezonyango kwangoko ukuba uvelisa iimpawu zongxamiseko ezinje:

• Ukuhla kwengqondo
• Ukuxhuzula
• Ukwehla okukhulu kokulumkisa okanye ukuziqhelanisa

Akukho sithintelo sesi sifo.

I-acidal tubular acidosis - kude; I-renal tubosis acidosis uhlobo I; Chwetheza i-RTA; RTA - distal; RTA yodidi

• I-anatomy yezintso
• Izintso - ukuhamba kwegazi kunye nomchamo

Bushinsky DA. Amatye eentso. Ku: UMelmed S, uAuchus RJ, uGoldfine AB, uKoenig RJ, uRosen CJ, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahluko 32.

Dixon BP. Ukuqina kwe-tubular acidosis. 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: isahluko 547.

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.