I-proximal renal acid tubosis

I-proximal renal tubular acidosis sisifo esenzeka xa izintso zingazisusi ngokufanelekileyo ii-asidi kwigazi 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. Izinto ezinomzimba emzimbeni zithathwa njengezinto zealkaline, ngakumbi i-bicarbonate.

I-proximal renal tubular acidosis (uhlobo II RTA) yenzeka xa i-bicarbonate ingabuyiswanga ngokufanelekileyo yinkqubo yokuhluza yezintso.

Uhlobo II RTA aluqhelekanga kunohlobo I-RTA. Uhlobo I lukwabizwa ngokuba yi-distal renal tubular acidosis. Uhlobo lwe-II luhlala luvela ebusaneni kwaye lunokuhamba lodwa.

Izizathu zohlobo II RTA zibandakanya:

• ICystinosis (umzimba awunakho ukuyichitha icysteine)
• Iziyobisi ezinje nge-ifosfamide (iyeza lonyango lwe-chemotherapy), ii-antibiotics ezithile ezingasasetyenziswanga kakhulu (i-tetracycline), okanye i-acetazolamide
• I-Fanconi syndrome, ukungahambi kakuhle kwimibhobho yezintso apho izinto ezithile zihlala zifakwa egazini zizintso zikhutshwa ziye kumchamo endaweni yoko
• Ukunganyamezelani okuvela kwi-fructose, ukuphazamiseka apho kukho ukunqongophala kweprotein efunekayo yokuphula iziqhamo zeswekile fructose
• Multiple myeloma, uhlobo lomhlaza wegazi
• Isiseko sehyperparathyroidism, ukuphazamiseka apho amadlala afanayo asentanyeni avelisa kakhulu ihomoni yeparathyroid
• Isifo seSjögren, isifo esingumzimba apho amadlala avelisa iinyembezi kunye namathe atshatyalaliswa
• Isifo sikaWilson, sisifo esizuze ilifa apho kukho ubhedu oluninzi kakhulu kwizicwili zomzimba
• Ukusilela kweVitamin D

Iimpawu zesifo se-renal tubular acidosis zibandakanya nayiphi na kwezi zilandelayo:

• Ukudideka okanye ukunciphisa ukulumka
• Ukuphelelwa ngamanzi emzimbeni
• Ukudinwa
• Ukonyusa izinga lokuphefumla
• I-Osteomalacia (ukuthamba kwamathambo)
• Intlungu yezihlunu
• Ubuthathaka

Ezinye iimpawu zingabandakanya:

• Ukuncipha kwemveliso yomchamo
• Ukunyuka kwentliziyo okanye ukubetha kwentliziyo okungaqhelekanga
• Iintlanzi zemisipha
• Ubuhlungu emathanjeni, ngasemva, kwicala, okanye kwisisu
• Ukukhubazeka kwamathambo

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu.

Uvavanyo olunoku-odolwa lubandakanya:

• Irhasi yegazi ejikelezayo
• Ikhemesti yegazi
• Inqanaba le-pH yegazi
• Umchamo we-pH kunye novavanyo lokulayisha i-asidi
• Uhlalutyo lomchamo

Injongo kukubuyisela umgangatho we-asidi oqhelekileyo kunye nokulinganisela kwe-electrolyte emzimbeni. Oku kuya kunceda ukulungisa ukuphazamiseka kwethambo kunye nokunciphisa umngcipheko we-osteomalacia kunye ne-osteopenia kubantu abadala.

Abanye abantu abadala abanakufuna unyango. Bonke abantwana bafuna amayeza ealkaline anje nge potassium citrate kunye nesodium bicarbonate. Eli liyeza elinceda ukulungisa imeko ye-asidi yomzimba. Iyeza linceda ukuthintela isifo samathambo esibangelwa yi-asidi eninzi, enje ngeerickets, kunye nokuvumela ukukhula okuqhelekileyo.

I-Thiazide diuretics ikwasetyenziswa rhoqo ukugcina i-bicarbonate emzimbeni.

Unobangela osisiseko we-proximal renal tubular necrosis kufuneka ulungiswe ukuba unokufumaneka.

I-Vitamin D kunye ne-calcium supplements kunokufuneka ukunceda ukunciphisa ukukhubazeka kwamathambo okubangelwa yi-osteomalacia.

Nangona oyena nobangela we-renal tubular acidosis isenokuhamba yodwa, iziphumo kunye nobunzima bunokuba sisigxina okanye busongele ubomi. Unyango luhlala luphumelela.

Fowunela umnikezeli wakho ukuba uneempawu zesifo se-renal tubular acidosis.

Fumana uncedo lwezonyango kwangoko ukuba kukho kwezi mpawu zikaxakeka zilandelayo:

• Ukwehla kokuphaphama okanye ukudideka
• Ukuhla kwengqondo
• Ukuxhuzula

Uninzi lweengxaki ezibangela ukuba i-acidic tubular acidosis ithintelwe.

I-renal acidosis ye-renal - isondele; Uhlobo lwe-II RTA; RTA - proximal; I-renal tubular acidosis yohlobo II

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

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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.