Umbhali: Robert Simon
Umhla Wokudalwa: 16 Isilimela 2021
Hlaziya Umhla: 1 Eyekhala 2024
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Umxholo

Izintso zinemisebenzi emininzi ebalulekileyo kwimpilo entle. Zisebenza njengezihluzo zegazi lakho, zisusa inkunkuma, ityhefu kunye nolwelo olungaphezulu.

Bayanceda uku:

  • lawula uxinzelelo lwegazi kunye neekhemikhali zegazi
  • gcina amathambo esempilweni kwaye ukhuthaze ukuveliswa kweeseli ezibomvu

Ukuba unesifo sezintso esinganyangekiyo (i-CKD), ube nomonakalo kwizintso zakho ngaphezulu kweenyanga ezimbalwa. Izintso ezonakalisiweyo azicoci gazi njengoko kufuneka, ezinokuthi zikhokelele kwiinkxalabo ezahlukeneyo zempilo.

Kukho amanqanaba amahlanu e-CKD kunye neempawu ezahlukeneyo kunye nonyango olunxulumene nenqanaba ngalinye.

Amaziko oLawulo lweNtsholongwane kunye noThintelo (CDC) aqikelela ukuba abantu abadala base-US bane-CKD, kodwa uninzi alufumaniswanga. Yimeko eqhubela phambili, kodwa unyango lunokucothisa. Asinguye wonke umntu oya kuqhubela phambili ukusilela kwezintso.

Ushwankathelo lwamanqanaba

Ukwabela inqanaba le-CKD, ugqirha wakho kufuneka amisele ukuba zizisebenza njani izintso zakho.

Enye indlela yokwenza oku kukuvavanya umchamo ukuvavanya umlinganiso wealbumin-creatinine ratio (ACR). Ibonisa ukuba iprotein iyavuza na kumchamo (proteinuria), ongumqondiso wokonzakala kwezintso.


Amanqanaba e-ACR ahlelwe ngolu hlobo lulandelayo:

A1ngaphantsi kwe-3mg / mmol, ukunyuka okuqhelekileyo ukuya kancinane
A2I-3-30mg / mmol, ukonyuka okuphakathi
A3ngaphezulu kwe-30mg / mmol, ukunyuka okuqatha

Ugqirha wakho unokuyalela iimvavanyo zokucinga, ezinje nge-ultrasound, ukuvavanya ubume bezintso zakho.

Uvavanyo lwegazi luthatha i-creatinine, i-urea, kunye nezinye iimveliso zenkunkuma egazini ukubona ukuba zisebenza njani izintso. Oku kubizwa ngokuba ngumlinganiso wokucoca nge-glomerular (eGFR). I-GFR ye-100 mL / min iqhelekile.

Le theyibhile ibonisa amanqanaba amahlanu e-CKD. Olunye ulwazi malunga nenqanaba ngalinye lilandela itafile.

InqanabaInkcazoGFRIpesenti yokusebenza kwezintso
1ziqhelekileyo kwizintso ezisebenza kakhulu> 90 mL / min>90%
2ukwehla kancinci ekusebenzeni kwezintso60-89 mL / min60–89%
3Aukwehla kancinci ukuya kumodareyitha ekusebenzeni kwezintso45-59 mL / min45–59%
3Bukwehla kancinci ukuya kumodareyitha ekusebenzeni kwezintso30–44 mL / min30–44%
4ukwehla okukhulu kwintso15–29 mL / min15–29%
5 ukusilela kwezintso<15 mL / min<15%

Ixabiso lokuhluza iGlomerular (GFR)

I-GFR, okanye inqanaba lokucoca glomerular, libonisa ukuba zingakanani igazi lokucoca izintso zakho ngomzuzu omnye.


Ifomula yokubala i-GFR ibandakanya ubungakanani bomzimba, ubudala, isini, kunye nobuhlanga. Ngaphandle kobunye ubungqina beengxaki zezintso, i-GFR esezantsi njengama-60 inokuqwalaselwa njengeqhelekileyo.

Imilinganiselo ye-GFR inokulahlekisa ukuba, umzekelo, ungumakhi womzimba okanye unengxaki yokutya.

Isigaba 1 sesifo sezintso

Kwinqanaba 1, kukho umonakalo omnene kakhulu kwizintso. Ziyakwazi ukuziqhelanisa kwaye zinokuhlengahlengisa oku, zivumela ukuba ziqhubeke nokusebenza kwiipesenti ezingama-90 okanye ngcono.

Kule nqanaba, i-CKD inokuthi ifumaneke ngethuba ngexesha lovavanyo lwegazi kunye nomchamo. Unako ukufumana ezi mvavanyo ukuba unesifo sikashukela okanye uxinzelelo lwegazi, izizathu eziphambili ze-CKD e-United States.

Iimpawu

Ngokwesiqhelo, akukho zimpawu xa izintso zisebenza kwiipesenti ezingama-90 okanye ngcono.

Unyango

Unokucothisa ukuqhubela phambili kwesifo ngokuthatha la manyathelo:


  • Sebenza ekulawuleni amanqanaba eswekile yegazi ukuba unesifo seswekile.
  • Landela ingcebiso kagqirha wakho wokwehlisa uxinzelelo lwegazi ukuba unexinzelelo lwegazi.
  • Gcina ukutya okusempilweni, okunesondlo.
  • Sukusebenzisa icuba.
  • Zibandakanye kwimisebenzi yomzimba imizuzu engama-30 ngosuku, ubuncinci iintsuku ezintlanu ngeveki.
  • Zama ukugcina ubunzima obufanelekileyo bomzimba wakho.

Ukuba awukayiboni ingcali yezintso (nephrologist), cela ugqirha wakho jikelele ukuba akuthumele kwenye.

Isigaba 2 sesifo sezintso

Kwinqanaba 2, izintso zisebenza phakathi kwe-60 kunye ne-89 yepesenti.

Iimpawu

Kule nqanaba, usenokungabi nampawu. Okanye iimpawu azicacanga, ezinje:

  • ukudinwa
  • ukurhawuzelela
  • Ukuphelelwa ngumdla wokutya
  • iingxaki zokulala
  • ubuthathaka

Unyango

Lixesha lokuphuhlisa ubudlelwane nengcali yezintso. Akukho lunyango lwe-CKD, kodwa unyango lwakwangoko lunokucothisa okanye luyeke ukuqhubela phambili.

Kubalulekile ukulungisa unobangela. Ukuba unesifo seswekile, uxinzelelo lwegazi, okanye isifo sentliziyo, landela imiyalelo kagqirha yokulawula le miba.

Kukwabalulekile ukugcina ukutya okufanelekileyo, ukufumana imithambo rhoqo, kunye nokulawula ubunzima bakho. Ukuba uyatshaya, buza ugqirha wakho malunga neenkqubo zokuyeka ukutshaya.

Isigaba 3 sesifo sezintso

Isigaba 3A sithetha ukuba izintso zakho zisebenza phakathi kweepesenti ezingama-45 no-59. Inqanaba 3B lithetha ukusebenza kwezintso kuphakathi kwama-30 ukuya kuma-44 eepesenti.

Izintso azihluzi inkunkuma, ityhefu, kunye nolwelo kakuhle kwaye ezi ziqala ukwakha.

Iimpawu

Asinguye wonke umntu oneempawu kwinqanaba lesi-3.

  • umqolo obuhlungu
  • ukudinwa
  • Ukuphelelwa ngumdla wokutya
  • ukurhawuzelela ezingapheliyo
  • iingxaki zokulala
  • ukudumba kwezandla neenyawo
  • ukuchama ngaphezulu okanye ngaphantsi kunesiqhelo
  • ubuthathaka

Iingxaki zinokubandakanya:

  • ianemia
  • isifo samathambo
  • igazi elonyukayo

Unyango

Kubalulekile ukulawula iimeko ezisisiseko ukunceda ukugcina ukusebenza kwezintso. Oku kunokubandakanya:

  • uxinzelelo lwegazi oluphezulu njenge-angiotensin-converting enzyme (ACE) inhibitors okanye i-angiotensin II receptor blockers
  • i-diuretics kunye nokutya okunetyuwa encinci ukukhulula ukugcinwa kolwelo
  • iyeza zokunciphisa i-cholesterol
  • I-erythropoietin yongeza i-anemia
  • ivithamin D isongezo sokujongana namathambo abuthathaka
  • Izibophelelo ze-phosphate zokuthintela ukubalwa kwimithambo yegazi
  • ukulandela ukutya okusezantsi kweprotein ukuze izintso zakho zingasebenzi nzima

Uya kudinga ukutyelelwa rhoqo kunye nokuvavanywa rhoqo ukuze kwenziwe uhlengahlengiso xa kukho imfuneko.

Ugqirha wakho angakudlulisela kwingcali yokutya ukuze uqiniseke ukuba ufumana zonke izondlo ozifunayo.

Isigaba 4 sesifo sezintso

Inqanaba lesi-4 lithetha ukuba unobungozi obumodareyitha. Zisebenza phakathi kwe-15 kunye ne-29 yepesenti, ngenxa yoko unokuba usakha inkunkuma eninzi, ityhefu, kunye nolwelo emzimbeni wakho.

Kubalulekile ukuba wenze konke onako ukukhusela ukuqhubela phambili ukusilela kwezintso.

Ngokwe-CDC, yabantu abanesifo esincitshiswe kakhulu sezintso abazi nokuba banaso.

Iimpawu

Iimpawu zingabandakanya:

  • umqolo obuhlungu
  • iintlungu zesifuba
  • kunciphise ubukhali bengqondo
  • ukudinwa
  • Ukuphelelwa ngumdla wokutya
  • izihlunu okanye iinyanda
  • isicaphucaphu nokugabha
  • ukurhawuzelela ezingapheliyo
  • ukuqhawukelwa ngumphefumlo
  • iingxaki zokulala
  • ukudumba kwezandla neenyawo
  • ukuchama ngaphezulu okanye ngaphantsi kunesiqhelo
  • ubuthathaka

Iingxaki zinokubandakanya:

  • ianemia
  • isifo samathambo
  • igazi elonyukayo

Ukwanomngcipheko owandileyo wesifo sentliziyo kunye nokufa icala.

Unyango

Kwinqanaba le-4, kuya kufuneka usebenze ngokusondeleyo kunye noogqirha bakho. Ukongeza kunyango olufanayo njengakwizigaba zangaphambili, kuya kufuneka uqale ngengxoxo malunga ne-dialysis kunye nokufakelwa kwezintso ukuba izintso zakho zisilele.

Ezi nkqubo zithatha umbutho ngononophelo kunye nexesha elininzi, ke kububulumko ukuba nesicwangciso endaweni ngoku.

Isigaba 5 sesifo sezintso

Inqanaba lesi-5 lithetha ukuba izintso zakho zisebenza ngaphantsi kweepesenti ezili-15 okanye usilela kwizintso.

Xa oko kusenzeka, inqwaba yenkunkuma kunye neetyhefu zisongela ubomi. Esi sifo sesifo se-renal.

Iimpawu

Iimpawu zokusilela kwezintso zingabandakanya:

  • umqolo nesifuba iintlungu
  • iingxaki zokuphefumla
  • kunciphise ubukhali bengqondo
  • ukudinwa
  • kancinci ukungabinamdla wokutya
  • izihlunu okanye iinyanda
  • isicaphucaphu okanye ukugabha
  • ukurhawuzelela ezingapheliyo
  • ingxaki yokulala
  • ubuthathaka obukhulu
  • ukudumba kwezandla neenyawo
  • ukuchama ngaphezulu okanye ngaphantsi kunesiqhelo

Umngcipheko wesifo sentliziyo kunye ne-stroke uyakhula.

Unyango

Nje ukuba usilele ngokupheleleyo kwizintso, ixesha lokuphila liinyanga nje ezimbalwa ngaphandle kokuchithwa kwedialysis okanye ukufakelwa kwezintso.

I-Dialysis ayilulo unyango lwezifo zezintso, kodwa yinkqubo yokususa inkunkuma kunye nolwelo egazini lakho. Zimbini iintlobo zedialysis, ihemodialysis kunye neparitoneal dialysis.

Uhlalutyo lweHemodialysis

I-Hemodialysis yenziwa kwiziko le-dialysis kwishedyuli ebekiweyo, ihlala iphindwe kathathu ngeveki.

Ngaphambi konyango ngalunye, iinaliti ezimbini zibekwa engalweni yakho. Zincamathele kwi-dialyzer, ngamanye amaxesha ekubhekiswa kuyo njengezintso ezingezizo. Igazi lakho lifunxwe kwisihluzi kwaye labuyela emzimbeni wakho.

Ungaqeqeshelwa ukwenza oku ekhaya, kodwa kufuna inkqubo yotyando yokwenza ukufikelela kwemithambo. I-dialysis yasekhaya yenziwa rhoqo kunedalysis kwiziko lonyango.

I-Peritoneal dialysis

Kwi-peritoneal dialysis, uya kuba necatheter ngotyando ebekwe esiswini sakho.

Ngexesha lonyango, isisombululo se-dialysis sihamba nge-catheter ukuya esiswini, emva koko unokuhamba malunga nosuku lwakho oluqhelekileyo. Emva kweeyure ezimbalwa, unokuyikhupha itafile uze uyilahle. Oku kufuneka kuphindwe amaxesha ama-4 ukuya kuma-6 ngosuku.

Ukufakelwa kwezintso kubandakanya ukubuyisela izintso zakho endaweni esempilweni. Izintso zinokuza kubaxhasi abaphilayo okanye abangasekhoyo. Awuyi kuyidinga i-dialysis, kodwa kuya kufuneka uthathe iziyobisi ezichasayo ubomi bakho bonke.

Iindlela zokuthatha eziphambili

Kukho amanqanaba ama-5 esi sifo sezintso esinganyangekiyo. Amanqanaba amiselwe ngokuvavanywa kwegazi nomchamo kunye nenqanaba lokonzakala kwezintso.

Ngelixa sisifo esiqhubela phambili, ayinguye wonke umntu oya kuqhubeka nokuphuhlisa ukusilela kwezintso.

Iimpawu zesifo sokuqala sezintso zincinci kwaye zinokujongwa ngokulula. Yiyo loo nto kubalulekile ukuba uhlolwe rhoqo ukuba unesifo seswekile okanye uxinzelelo lwegazi, izizathu ezibangela isifo sezintso.

Ukuchongwa kwangoko kunye nolawulo lweemeko ezikhoyo kunokunceda ukucothisa okanye ukuthintela ukuqhubela phambili.

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