Isifo se-nephritic

I-acute nephritic syndrome liqela leempawu ezithi zenzeke xa kukho iingxaki ezithile ezibangela ukudumba kunye nokudumba kwe-glomeruli kwizintso, okanye i-glomerulonephritis.

I-acute nephritic syndrome ihlala ibangelwa yimpendulo yomzimba yokuzikhusela ebangelwa sisifo okanye esinye isifo.

Izizathu eziqhelekileyo kubantwana nakwishumi elivisayo zibandakanya:

• I-hemolytic uremic syndrome (ingxaki eyenzeka xa usulelo kwinkqubo yokwetyisa luvelisa izinto ezinetyhefu ezitshabalalisa iiseli ezibomvu zegazi kwaye zibangele ukulimala kwezintso)
• I-Henoch-Schönlein purpura (isifo esibandakanya amabala amfusa kulusu, iintlungu ezidibeneyo, iingxaki zesisu kunye ne-glomerulonephritis)
• I-nephropathy ye-IgA (ukuphazamiseka apho ii-antibodies ezibizwa ngokuba yi-IgA zakha kwizicubu zezintso)
• I-post-streptococcal glomerulonephritis (isifo sezintso esenzeka emva kokosulelwa zizifo ezithile ze-streptococcus bacteria)

Izizathu eziqhelekileyo kubantu abadala zibandakanya:

• Amathumba esiswini
• I-Goodpasture syndrome (ingxaki apho amajoni omzimba ahlasela i-glomeruli)
• IHepatitis B okanye uC
• I-Endocarditis (ukudumba komphakathi ngaphakathi kwamagumbi entliziyo kunye neevalvu zentliziyo ezibangelwa yintsholongwane okanye isifo sokungunda)
• I-Membranoproliferative glomerulonephritis (ingxaki ebandakanya ukudumba kunye notshintsho kwiiseli zezintso)
• Ukuqhubela phambili ngokukhawuleza (i-crescentic) i-glomerulonephritis (ifom ye-glomerulonephritis ekhokelela ekulahlekelweni ngokukhawuleza kwezintso)
• I-Lupus nephritis (ingxaki yezintso zenkqubo ye-lupus erythematosus)
• I-Vasculitis (ukudumba kwemithambo yegazi)
• Izifo zentsholongwane ezinjenge-mononucleosis, imasisi, uqwilikana

Ukudumba kuchaphazela ukusebenza kweglomerulus. Le yinxalenye yezintso ezihluza igazi lokwenza umchamo nokususa inkunkuma. Ngenxa yoko, igazi kunye neeprotein ziyavela kumchamo, kwaye ulwelo olugqithisileyo luyanda emzimbeni.

Ukudumba komzimba kwenzeka xa igazi liphulukana neprotein ekuthiwa yialbumin. Ialbumin igcina ulwelo kwimithambo yegazi. Xa ilahlekile, ulwelo luqokelela kwizicwili zomzimba.

Ukuphulukana kwegazi kwizakhiwo zezintso ezonakeleyo kukhokelela egazini kumchamo.

Iimpawu eziqhelekileyo zesifo se-nephritic:

• Igazi kumchamo (umchamo ubonakala umnyama, umbala weti, okanye unamafu)
• Ukunciphisa ukuphuma komchamo (umchamo omncinci okanye awunako ukuveliswa)
• Ukudumba kobuso, isokethi yamehlo, imilenze, iingalo, izandla, iinyawo, isisu, okanye ezinye iindawo
• Igazi elonyukayo

Ezinye iimpawu ezinokuthi zenzeke zibandakanya:

• Ukubona okungacacanga, kuhlala kuphuma imithambo yegazi kwi-retina yamehlo
• Isikhohlela esine-mucus okanye ipinki, izinto ezinomqolo ezivela kulwakhiwo lolwelo emiphungeni
• Ukuphefumla okufutshane, ukusuka kulwakhiwo lwamanzi emiphungeni
• Ukugula gwenxa (ukukhubazeka), ukozela, ukudideka, iintlungu kunye neentlungu, intloko ebuhlungu

Iimpawu zokungasebenzi kakuhle kwezintso okanye isifo sexesha elide (esinganyangekiyo) sinokukhula.

Ngexesha loviwo, umboneleli wakho wezempilo unokufumana le miqondiso ilandelayo:

• Igazi elonyukayo
• Intliziyo engaqhelekanga nemiphunga iyavakala
• Iimpawu zolwelo olungaphezulu (i-edema) ezinje ngokudumba emilenzeni, ezingalweni, ebusweni nasesiswini
• Ukwandiswa kwesibindi
• Imithambo eyandisiweyo entanyeni

Uvavanyo olunokwenziwa lunokubandakanya:

• Ii-electrolyte zegazi
• Igazi urea nitrogen (BUN)
• Uyilo
• Ukucoca creatinine
• Uvavanyo lwe potassium
• Iiprotheni kumchamo
• Uhlalutyo lomchamo

I-biopsy yezintso iya kubonisa ukuvuvukala kwe-glomeruli, enokubonisa unobangela wale meko.

Uvavanyo lokufumana unobangela we-acute nephritic syndrome lunokubandakanya:

• Isihloko se-ANA yelupus
• I-antibodyerular basement membrane antibody
• Antineutrophil cytoplasmic antibody ye vasculitis (ANCA)
• Inkcubeko yegazi
• Inkcubeko yomqala okanye yolusu
• Iserum complement (C3 kunye neC4)

Injongo yonyango ukunciphisa ukudumba kwizintso kunye nokulawula uxinzelelo lwegazi. Kuya kufuneka uhlale esibhedlele ukuze ufumane kwaye unyangwe.

Umboneleli wakho unokucebisa:

• Bedrest de uzive ungcono ngonyango
• Ukutya okuthintela ityuwa, ulwelo kunye ne potassium
• Amayeza okulawula uxinzelelo lwegazi oluphezulu, ukunciphisa ukudumba, okanye ukususa ulwelo emzimbeni wakho
• I-dialysis yezintso, ukuba iyafuneka

Imbonakalo ixhomekeke kwisifo esibangela i-nephritis. Xa imeko iphucula, iimpawu zokugcinwa kwamanzi (njengokuvuvukala kunye nokukhwehlela) kunye noxinzelelo lwegazi oluphezulu lunokuphela kwiiveki ezi-1 okanye ezi-2. Uvavanyo lomchamo lungathatha iinyanga ukubuyela esiqhelweni.

Abantwana bathambekele ekwenzeni ngcono kunabantu abadala kwaye bahlala bechacha ngokupheleleyo. Kunqabile kuphela ukuba bakhulise iingxaki okanye inkqubela phambili kwi-glomerulonephritis engapheliyo kunye nesifo esinganyangekiyo sezintso.

Abantu abadala abaphili kakuhle okanye ngokukhawuleza njengabantwana. Nangona kungaqhelekanga ukubuya kwesi sifo, kwabanye abantu abadala, esi sifo siyabuya kwaye baya kuba nesifo sokugqibela sezintso kwaye banokufuna i-dialysis okanye ukufakelwa kwezintso.

Tsalela umnikezeli wakho ukuba unempawu zesifo esibi se-nephritic.

Rhoqo, ukuphazamiseka akunakuthintelwa, nangona unyango lokugula kunye nosulelo lunokunceda ukunciphisa umngcipheko.

I-Glomerulonephritis - ngokukhawuleza; Glomerulonephritis ebukhali; Nephritis syndrome - etsolo

• I-anatomy yezintso
• IGlomerulus kunye nephron

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 M, 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.