Isifo sokugqibela sezintso

Isifo sezintso sokuphela (ESKD) sisigaba sokugqibela sesifo sexesha elide (esingapheliyo). Yilapho izintso zakho zingasakwazi ukuxhasa iimfuno zomzimba wakho.

Isifo sezintso zokugqibela sikwabizwa ngokuba sisifo sokugqibela se-renal (ESRD).

Izintso zisusa inkunkuma kunye namanzi amaninzi emzimbeni. I-ESRD yenzeka xa izintso zingasakwazi ukusebenza kwinqanaba elifunekayo kubomi bemihla ngemihla.

Oonobangela abaqhelekileyo be-ESRD eUnited States sisifo seswekile kunye noxinzelelo lwegazi. Ezi meko zinokuchaphazela izintso zakho.

I-ESRD phantse ihlala isiza emva kwesifo sezintso ezingapheliyo. Izintso zinokuyeka kancinci ukusebenza ngexesha leminyaka eli-10 ukuya kwengama-20 ngaphambi kwesiphumo sesifo.

Iimpawu eziqhelekileyo zingabandakanya:

• Ukugula ngokubanzi nokudinwa
• Ukurhawuzelela (pruritus) kunye nolusu olomileyo
• Intloko ebuhlungu
• Ukwehla kobunzima ngaphandle kokuzama
• Ukuphelelwa ngumdla wokutya
• Isicaphucaphu

Ezinye iimpawu zingabandakanya:

• Isikhumba esimnyama ngokungaqhelekanga okanye ukukhanya
• Utshintsho lwesipikili
• Intlungu yethambo
• Ukozela nokudideka
• Iingxaki zokugxila okanye zokucinga
• Ubudenge ezandleni, ezinyaweni, okanye kwezinye iindawo
• Ukudibanisa izihlunu okanye iicramps
• Iphunga lempumlo
• Ukutyumka ngokulula, ukuphuma kwegazi, okanye igazi esitulweni
• Ukunxanwa okugqithisileyo
• Ii-hiccups rhoqo
• Iingxaki ngokusebenza ngokwesondo
• Ukuyeka ukuya exesheni (amenorrhea)
• Iingxaki zokulala
• Ukudumba kweenyawo nezandla (i-edema)
• Ukuphalaza, rhoqo kusasa

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba kunye noku-odola uvavanyo lwegazi. Uninzi lwabantu abanale meko banexinzelelo oluphezulu lwegazi.

Abantu abane-ESRD baya kwenza umchamo omncinci kakhulu, okanye izintso zabo azisenzi umchamo.

I-ESRD itshintsha iziphumo zovavanyo oluninzi. Abantu abafumana i-dialysis baya kufuna ezi kunye nolunye uvavanyo olwenziwa rhoqo:

• Potassium
• Isodium
• Ialbhamu
• Iphosphorus
• Ikhalsiyam
• Icholesterol
• Magnesium
• Gcwalisa ubalo lwegazi (CBC)
• Ii-Electrolyte

Esi sifo sinokutshintsha iziphumo zolu vavanyo lulandelayo:

• Vitamin D
• Ihomoni yeParathyroid
• Uvavanyo lokuxinana kwamathambo

I-ESRD inokufuna ukunyangwa nge-dialysis okanye ukufakelwa kwezintso. Kuya kufuneka uhlale kukutya okukhethekileyo okanye uthathe amayeza ukunceda umzimba wakho usebenze kakuhle.

IZIBHENO

I-Dialysis yenza omnye umsebenzi wezintso xa ziyeke ukusebenza kakuhle.

I-Dialysis inako:

• Susa ityuwa eyongezelelweyo, amanzi kunye nemveliso yenkunkuma ukuze zingakhi emzimbeni wakho
• Gcina amanqanaba akhuselekileyo ezimbiwa kunye neevithamini emzimbeni wakho
• Nceda ukulawula uxinzelelo lwegazi
• Nceda umzimba wenze iiseli ezibomvu zegazi

Umboneleli wakho uya kuxoxa nge-dialysis nawe ngaphambi kokuba uyidinge. I-Dialysis isusa inkunkuma egazini lakho xa izintso zakho zingasakwazi ukwenza umsebenzi wazo.

• Ngokwesiqhelo, uya kuhamba nge-dialysis xa une-10% ukuya kwi-15% kuphela yomsebenzi wakho wezintso oseleyo.
• Nabantu abalinde ukufakelwa izintso banokufuna i-dialysis ngelixa belindile.

Iindlela ezimbini ezahlukeneyo zisetyenziselwa ukwenza i-dialysis:

• Ngexesha le-hemodialysis, igazi lakho lidlula kumbhobho ungene kwizintso ezingezizo, okanye isihluzo. Le ndlela inokwenziwa ekhaya okanye kwiziko le-dialysis.
• Ngexesha le-peritoneal dialysis, isisombululo esikhethekileyo sidlula kwisisu sakho nangona ityhubhu ye-catheter. Isisombululo sihlala esiswini sakho kangangexesha elithile size sisuswe. Le ndlela inokwenziwa ekhaya, emsebenzini, okanye xa useluhambeni.

UKUTSHINTSHELA IZINTSHO

Ukufakelwa kwezintso kuqhaqho lokubeka izintso ezisempilweni emntwini onesifo sezintso. Ugqirha wakho uya kukuthumela kwiziko lokufakelwa. Kulapho, uya kubonakala kwaye uvavanywe liqela lokufakelwa. Baza kufuna ukuqinisekisa ukuba ungumgqatswa ofanelekileyo wokufakelwa kwezintso.

UKUTYA OKUKHETHEKILEYO

Kuya kufuneka uqhubeke nokulandela ukutya okukhethekileyo kwesifo sezintso ezingapheliyo. Ukutya kunokubandakanya:

• Ukutya ukutya okuphantsi kwiprotheni
• Ukufumana iikhalori ezaneleyo ukuba ulahlekelwa ngumzimba
• Ukunciphisa ulwelo
• Ukunciphisa ityuwa, i-potassium, i-phosphorus kunye nezinye i-electrolyte

OLUNYE UNYANGO

Olunye unyango luxhomekeke kwiimpawu zakho, kodwa lunokubandakanya:

• I-calcium eyongezelelweyo kunye nevithamini D. (Soloko uthetha nomboneleli wakho ngaphambi kokuba uthathe izongezelelo.)
• Amayeza abizwa ngokuba yi-phosphate binders, ukunceda ukuthintela amanqanaba e-phosphorus ekubeni aphezulu kakhulu.
• Unyango lwe-anemia, enjenge-iron eyongezelelweyo ekutyeni, iipilisi zentsimbi okanye ukudubula, ukudubula kweyeza elibizwa ngokuba yi-erythropoietin, kunye notofelo-gazi.
• Amayeza okulawula uxinzelelo lwegazi.

Thetha nomboneleli wakho malunga nokugonywa onokukufuna, kubandakanya:

• Isitofu sokugonya se-Hepatitis A
• Ugonyo lwe-Hepatitis B
• Ugonyo lomkhuhlane
• Ugonyo lwepneumonia (PPV)

Abanye abantu banokuxhamla ngokuthatha inxaxheba kwiqela lenkxaso yesifo sezintso.

Isifo sezintso esiphelayo sikhokelela ekufeni ukuba awunayo i-dialysis okanye ukufakelwa kwezintso. Zombini ezi ndlela zonyango zinomngcipheko. Iziphumo zahlukile kumntu ngamnye.

Iingxaki zempilo ezinokubangelwa yi-ESRD zibandakanya:

• Ukunqongophala kwegazi
• Ukopha esuswini okanye emathunjini
• Intlungu yethambo, edibeneyo, kunye nezihlunu
• Utshintsho kwiswekile yegazi (iswekile)
• Ukonakaliswa kwemithambo yemilenze kunye neengalo
• Ulwakhiwo lwamanzi olujikeleze imiphunga
• Uxinzelelo lwegazi, isifo sentliziyo, kunye nokusilela kwentliziyo
• Inqanaba eliphezulu le potassium
• Ukwanda komngcipheko wosulelo
• Ukonakala kwesibindi okanye ukusilela
• Ukungondleki
• Ukungabikho komtshato okanye ukungachumi
• Imilenze yesifo esinganyangekiyo
• Ukubetha, ukuxhuzula, kunye nesifo sengqondo esixhalabisayo
• Ukudumba kunye nokudumba
• Ukwenza buthathaka kwamathambo kunye nokwaphuka okunxulumene nenqanaba eliphezulu le-phosphorus kunye ne-calcium esezantsi

Ukusilela kwezintso - isigaba sokuphela; Ukungaphumeleli kwezintso - inqanaba lokuphela; I-ESRD; I-ESKD

• I-anatomy yezintso
• IGlomerulus kunye nephron

IGaitonde DY, Cook DL, iRivera IM. Isifo sezintso esinganyangekiyo: ukufumanisa kunye nokuvavanya. NdinguGqirha weNdawo. Ngo-2017; 96 (12): 776-783. IINKCUKACHA: 29431364 www.ncbi.nlm.nih.gov/pubmed/29431364/.

Inker LA, Levey AS. Ukubeka kunye nokulawulwa kwesifo sezintso ezingapheliyo. Ku: Gilbert SJ, Weiner DE, ii-eds. Isiseko seSizwe seZintso kwiZifo zeZintso. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 52.

I-Taal MW. Ukwahlula-hlula kunye nolawulo lwezifo zezintso ezingapheliyo. 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: isahluko 59.

Yeun JY, Young B, Depner TA, Chin AA. Uhlalutyo lweHemodialysis. 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. 63.