Yonke into omele uyazi NgeSigaba sesi-3 seZintso

Umxholo

• Isifo sesifo sezintso esinganyangekiyo Inqanaba 3
• Inqanaba 3 iimpawu zesifo sezintso
• Nini ukubona ugqirha ngenqanaba 3 CKD
• Unyango 3 unyango lwesifo sezintso
• Inqanaba 3 ukutya kwesifo sezintso
• Unyango
• Ukuhlala nesigaba 3 sesifo sezintso
• Ngaba inqanaba 3 lesifo sezintso sinokubuyiselwa?
• Isigaba sesi-3 sesifo sesifo sexesha lokuphila
• Ukuthatha

Isifo sezintso esinganyangekiyo (CKD) sithetha ngomonakalo osisigxina kwizintso ezithi zenzeke ngokuthe ngcembe ngokuhamba kwexesha. Ukuqhubela phambili kunokuthintelwa ngokuxhomekeke kwinqanaba layo.

I-CKD yahlulwe yangamanqanaba amahlanu ahlukeneyo, inqanaba loku-1 libonisa owona msebenzi ungcono, kwaye inqanaba lesi-5 libonisa ukusilela kwezintso.

Isigaba sesi-3 sesifo sezintso siwela kanye embindini wesibuko. Kule nqanaba, izintso zinomonakalo omncinci ukuya kumodareyitha.

Isigaba sesi-3 sesifo sezintso sichongwa ngugqirha ngokusekwe kwiimpawu zakho nakwiziphumo zebhabhu. Ngelixa ungenakuguqula umonakalo wezintso, unganceda ukuthintela umonakalo ekuwohlokeni kweli nqanaba.

Funda ukuze ufumanise ukuba ogqirha bacacisa njani inqanaba le-CKD, zeziphi izinto ezichaphazela isiphumo kunye nokunye.

Isifo sesifo sezintso esinganyangekiyo Inqanaba 3

Inqanaba 3 le-CKD lifunyaniswa lisuselwa kuqikelelo lwefreyimu yokuhluza ye-glomerular (eGFR). Olu luvavanyo lwegazi olulinganisa amanqanaba okudala. I-eGFR isetyenziselwa ukumisela ukuba izintso zakho zisebenza njani ekucoceni inkunkuma.

I-eGFR efanelekileyo iphezulu kune-90, ngelixa inqanaba lesi-5 i-CKD lizibonakalisa kwi-eGFR engaphantsi kwe-15.

Inqanaba 3 i-CKD inee-subtypes ezimbini ezisekwe kufundo lwe-eGFR. Unokufumanisa ukuba unesigaba 3a ukuba i-eGFR yakho iphakathi kwama-45 nama-59. Inqanaba 3b lithetha ukuba i-eGFR yakho iphakathi kwama-30 nama-44.

Injongo yenqanaba 3 le-CKD kukuthintela ukuqhubeka kokuphulukana nomsebenzi wezintso. Kwimigaqo yeklinikhi, oku kunokuthetha ukuthintela i-eGFR phakathi kwe-29 kunye ne-15, ebonisa inqanaba le-4 CKD.

Inqanaba 3 iimpawu zesifo sezintso

Awunakuzibona iimpawu zeengxaki zezintso ezingapheliyo kwinqanaba 1 kunye ne-2, kodwa iimpawu ziqala ukubonakala ngakumbi kwinqanaba 3.

Ezinye zeempawu zeCKD yenqanaba 3 zinokubandakanya:

• umchamo omnyama otyheli, orenji, okanye obomvu
• ukuchama ngaphezulu okanye kancinci kunesiqhelo
• i-edema (ukugcinwa kwamanzi)
• Ukudinwa okungachazwanga
• ubuthathaka kunye nezinye iimpawu ezinjenge-anemic
• Ukuphuthelwa kunye neminye imiba yokulala
• iintlungu ezisezantsi
• ukwanda koxinzelelo lwegazi

Nini ukubona ugqirha ngenqanaba 3 CKD

Kubalulekile ukubona ugqirha ngoko nangoko ukuba ufumana naziphi na kwezi mpawu zingasentla. Ngelixa iimpawu ezithile zingabalulekanga kwi-CKD, ukuba nayo nayiphi indibaniselwano yezi mpawu imalunga.

Kuya kufuneka ulandele ugqirha wakho ukuba ukhe wafunyaniswa ukuba unenqanaba 1 okanye inqanaba 2 le-CKD.

Okwangoku, kunokwenzeka ukuba ungabinayo nayiphi na imbali yangaphambili ye-CKD ngaphambi kokuba ufunyaniswe unesigaba 3. Oku kunokuba ngenxa yokuba inqanaba loku-1 kunye nelesi-2 azidli ngokubangela naziphi na iimpawu ezibonakalayo.

Ukuchonga inqanaba 3 le-CKD, ugqirha uya kuqhuba kwezi mvavanyo:

• uxinzelelo lwegazi
• iimvavanyo zomchamo
• Uvavanyo lwe-eGFR (lwenziwa rhoqo kwiintsuku ezingama-90 emva kokuchongwa kokuqala)
• iimvavanyo zokucinga ngokulawula i-CKD engaphezulu

Unyango 3 unyango lwesifo sezintso

Isifo sezintso asinakuphiliswa, kodwa inqanaba 3 lithetha ukuba usenalo ithuba lokuthintela ukuqhubela phambili kokungaphumeleli kwezintso. Unyango kunye notshintsho kwindlela yokuphila kubalulekile kweli nqanaba. Ugqirha wakho uza kuthetha nawe malunga nokusebenzisa la manyathelo alandelayo onyango.

Inqanaba 3 ukutya kwesifo sezintso

Ukutya okuqhubekileyo kunzima kakhulu emzimbeni. Kuba izintso zakho zinoxanduva lokususa inkunkuma kunye nokulinganisa ii-electrolyte, ukutya okuninzi kakhulu kokutya okungalunganga kunokuzalisa izintso zakho.

Kubalulekile ukutya ukutya okuninzi okupheleleyo njengemveliso kunye neenkozo, kunye nokutya ukutya okucutshungulwayo okuncinci kunye nokuncinci kwamafutha agcweleyo afumaneka kwiimveliso zezilwanyana.

Ugqirha unokucebisa ukunciphisa iprotheni oyityayo. Ukuba amanqanaba akho e-potassium aphezulu kakhulu kwi-CKD, banokucebisa ukuba uphephe ukutya okune-potassium eninzi njengebhanana, iitapile kunye neetumato.

Umgaqo ofanayo ubhekisele kwisodiyam. Kuya kufuneka unciphise ukutya okunetyiwa ukuba amanqanaba esodium aphezulu kakhulu.

Ukwehla kobunzima kuqhelekile kumanqanaba aphezulu eCKD ngenxa yokutya. Oku kunokukubeka emngciphekweni wokungondleki.

Ukuba ufumana ukulahleka kwesidlo, qwa lasela ukutya okuncinci, ukutya rhoqo rhoqo imini yonke ukuze uqiniseke ukuba ufumana iikhalori ezaneleyo kunye nezondlo.

Unyango

Inqanaba lesi-3 i-CKD ayifuni i-dialysis okanye ukufakelwa kwezintso. Endaweni yoko, uya kumiselwa amayeza athile ukunyanga iimeko zonyango ezinokuba negalelo kumonakalo wezintso.

Oku kubandakanya i-angiotensin yokuguqula i-enzyme (ACE) inhibitors kunye ne-angiotensin II receptor blockers (ARBs) yoxinzelelo lwegazi oluphezulu, kunye nolawulo lweglucose kwisifo seswekile.

Ugqirha wakho unokuyalela amayeza ukunceda ukunciphisa iziphumo ebezingalindelekanga zeCKD, ezinje:

• izongezo zentsimbi ze-anemia
• i-calcium / i-vitamin D yongeza ukukhusela ukuphuka kwethambo
• iziyobisi ezinciphisa i-cholesterol
• womchamo ukunyanga nokudumba

Ukuhlala nesigaba 3 sesifo sezintso

Ngaphandle kokuthatha amayeza amiselweyo kunye nokutya ukutya okusempilweni, ukusebenzisa ezinye iinguqulelo kwindlela yokuphila kunokukunceda ukulawula inqanaba le-CKD 3. Thetha nogqirha wakho malunga noku kulandelayo:

• Zilolonge. Cwangcisa ubuncinci bemizuzu engama-30 yomsebenzi ophakathi ngemini kwiintsuku ezininzi zeveki. Ugqirha unokukunceda ukuba uqale inkqubo yokuzilolonga ngokukhuselekileyo.
• Ulawulo lwexinzelelo lwegazi. Uxinzelelo lwegazi oluphezulu lunokuba ngumanduleli weCKD, kwaye inokwenza imeko yakho ibe mandundu. Cwangcisa uxinzelelo lwegazi lwe-140/90 nangaphantsi.

• Ngaba inqanaba 3 lesifo sezintso sinokubuyiselwa?

  Injongo yeCKD yenqanaba 3 unyango kukuthintela ukuqhubela phambili. Akukho lunyango lalo naliphi na inqanaba le-CKD, kwaye awunakuguqula umonakalo wezintso.

  Nangona kunjalo, omnye umonakalo usengancitshiswa ukuba ukwinqanaba lesi-3. Kunzima ngakumbi ukuthintela ukuqhubela phambili kwinqanaba le-4 nelesi-5.

  Isigaba sesi-3 sesifo sesifo sexesha lokuphila

  Xa ufunyaniswe kwaye ulawulwa kwangethuba, inqanaba lesi-3 le-CKD linobude obude bexesha lokuphila kunamanqanaba aphezulu esifo sezintso. Uqikelelo lungahluka ngokuxhomekeke kubudala nakwindlela yokuphila.

  Olunye uqikelelo luthi umyinge wobude bexesha lokuphila yiminyaka engama-24 kumadoda angama-40, nama-28 kwabasetyhini abakwiminyaka efanayo.

  Ngaphandle kobude bexesha lokuphila, kubalulekile ukuba uqwalasele umngcipheko wokuqhubela phambili kwesifo. Kwinqanaba lesi-3 abaguli be-CKD bafumanise ukuba malunga nesiqingatha sinyukele kumanqanaba aphezulu esifo sezintso.

  Kwakhona kunokwenzeka ukufumana iingxaki ezivela kwi-CKD, ezifana nesifo senhliziyo, esinokuchaphazela ubomi bakho bonke.

  Ukuthatha

  Inqanaba lesi-3 i-CKD ihlala ifunyanwa okokuqala xa umntu eqala ukufumana iimpawu zale meko.

  Ngelixa inqanaba 3 i-CKD inganyangeki, ukuxilongwa kwangoko kunokuthetha ukumisa ukuqhubela phambili. Isenokuthetha ukwehla komngcipheko weengxaki, ezinjengesifo sentliziyo, i-anemia, kunye nethambo lokophuka.

  Ukuba nenqanaba lesi-3 i-CKD akuthethi ukuba imeko yakho iya kuthi ngokuzenzekelayo iqhubele phambili ukusilela kwezintso. Ngokusebenza nogqirha kunye nokuhlala ngaphezulu kotshintsho kwindlela yokuphila, kunokwenzeka ukuthintela isifo sezintso ekubeni sibi.