He thinlung leh kal inzawmna hi eng nge ni? Cardiorenal Syndrome chungchang hi i zir dawn teh ang!

Thinlung leh kal (kidney) hi kan taksa peng pahnih, ṭhian ṭha ber ang maia thawk an ni. Pakhatah harsatna a awm chuan a dang pawhin a hre ve a, a nghawng a ni. A châng chuan heng harsatnate hi a lo thleng rang thei hle a, a châng chuan hun kal zelah a pung zêl bawk. Chu chu tunlaia kan sawi tur thinlung leh kal inkar buaina chu a ni , ``Cardiorenal Syndrome`` .

Cardiorenal Syndrome hi eng nge ni? Engvangin nge hetiang hi a lo awm?

A awlsam zawngin, `(Cardiorenal Syndrome)` tih hi i thinlung emaw, i kal emaw a chak lohna chuan taksa peng dangte hnathawh a tichhe thin. Ngaihtuah teh, kan thinlung hi taksa pum puia thisen pump chhuaktu a ni. Kidney hian chu thisen chu a tifai a, bawlhhlawh tul lo chu zun angin a paih chhuak thin. Chu mai pawh ni lovin, taksaa chi leh tui awm zat control hi kal (kidney) hna lian tak a ni bawk. Hei hian kan thisen sang a control a, taksain tui a vawn zat tur a hril a ni.

Tunah chuan, thinlung a chak lo a nih chuan eng nge thleng ang? Taksaah thisen a pump tha tawk lo. Tichuan kal (kidney)-in thisen a dawn zat pawh a tlahniam ve bawk. Kal (kidney) hian hna a thawk tha lo a nih chuan bawlhhlawh chi hrang hrang taksaah a pungkhawm a, tui chi (salt water) chu chhuak lovin taksa chhungah a awm reng thin. Hei hian thinlungah harsatna a siam leh a ni. Hei hi chutiang taka inzawmkhawm, thil kalphung buaithlak tak a ni. A châng chuan ``Kidney-a thisen kal tlem``, thinlunga thisen thlentu vein lian tak takte pressure sang (`vena cava``), leh thinlung pump theihna tlahniam (low ``cardiac output`` emaw ``(heart failure)`` ) te hian hei hi a nghawng thei a ni.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Dik tak chuan, a ruala thinlung leh kal lama harsatna nei hi i ngaihtuah aiin a tam zawk. Khawvelah hian mi maktaduai 64 velin ``Heart failure'' tih natna an vei a ni. Doctor-te chuan heng chronic heart failure nei zinga 45% leh 63% inkar hian kal natna an nei bawk tih an hmuchhuak. A châng chuan buaina chu thinlungah nge kal hmasa ber tih chiang taka hriat a harsa ṭhin.

Cardiorenal Syndrome natna lan chhuah dan chu engte nge ni?

Hetiang dinhmunah hian hetiang symptom hi i nei thei a ni. Mahse, heng symptoms te hi i neih hian he natna hi i nei tihna a ni lo tih hre reng ang che. Mahse, anmahni fimkhur a pawimawh.

• Feeling of constant fatigue (`Fatigue`): Chauhna, engmah tih theihna chakna nei lo ang maia inhriatna.
• Thâwk lak tawi : Tlemte kal emaw, stairs tlemte lawn emaw pawhin thawk harsa tih hriat.
• Zun chhuah tlem : Nitin zun tlem zawka i inhriat chuan.
• Depression : Lungngaih mai mai, i rilru hah ang maia awm.
• Ke leh pum a hring : Ke, ke ruh, leh a chang chuan pum chu a hring niin a lang. Tui an khat ang maiin.
• Feeling confused (`Confusion`): Thil ngaihtuah harsa ang maiin a lang a, thil a buai chho zel ang maiin a lang.
• Heart rhythm inthlak danglamna hriat: I thinlung chu a na nghal zual ang maia hriat, a nih loh leh beat pakhat skip.

Cardiorenal Syndrome hi engte nge ni?

Hei hi chhan tam tak a awm thei. Ṭhenkhat chu thinlung lam harsatna a ni a, a then chu kal (kidney) nena inzawm a ni a, a then chu taksa pumpui nghawng thei dinhmun a ni bawk.

• Cardiogenic shock : Thinlung tichhe nghal mai.
• `(Heart failure)` : Thinlung hnathawh chak lohna.
• `(Acute coronary syndrome)` : Thinlung supply tu thisen kalna kawng a block avanga emergency condition a ni.
• Lung surgery avanga harsatna awm thei.
• Lung valve natna.
• Vasculitis : Thisen kalna kawnga lo awm thin, inflammatory condition a ni.
• Atherosclerosis : A thisen kalna kawng (arteries) a ti thim a, a khauh bawk.
• Pulmonary embolism (PE) : Lung chhunga thisen kalna kawngkhar tikhawlotu thisen zam.
• Kidney natna emaw, hliam emaw.
• Sepsis : Infection na tak a ni a, taksa pum puiah a darh.
• Lupus : Immune system lama harsatna avanga natna lo awm a ni.
• Sarcoidosis : Taksa hmun hrang hrangah granuloma te te a lo awm thin natna a ni.
• Zunthlum .
• Taksa chhunga electrolyte inthlauhna ( electrolyte disorders) .

Hemi atan hian tute nge hlauhawm ber?

Mi thenkhat chuan he natna hi an vei tam zawk (Cardiorenal Syndrome) . Chumi awmzia chu heng risk factors nei te hian tlem a fimkhur a ngai tihna a ni.

• Zunthlum vei tan chuan .
• Thisen sang nei tan chuan .
• Body mass index (BMI) 30 aia tam nei (i.e. obese) tan .
• Vascular disorder nei tan chuan.
• Kidney natna nei tawh tan chuan .
• Heart failure nei tawh tan chuan .

Cardiorenal Syndrome avanga harsatna awm thei te chu engte nge ni?

Hetiang dinhmun hi uluk taka enkawl a nih loh chuan harsatna tam zawk a thlen thei a ni. Chu chu a dinhmun a chhe zual thei tihna a ni.

• Cardiogenic shock a awm thei bawk.
• Kidney natna a zual thei (`Worsening kidney disease`).
• Atherosclerosis (arteries a zim) a pung thei.
• Inflammation hi taksaah a awm thei.

He natna (Cardiorenal Syndrome) hi engtin nge an hriat theih?

He natna hi hriat chian nan hian "gold standard" pakhat chauh a awm tak zet a ni.Test a awm lo. Doctor chuan a enfiah ang che a, i thinlung, i lung, i pum, i ke leh thisen kalna kawnga tui awm zat a zirchiang ang che. Hei bakah hian test thenkhat order pawh a awm thei bawk.

Chumi atana test tih theihte chu:

• Thisen test : Kal hnathawh leh thinlung a chhiat te enfiah thin.
• Urinalysis : Zun chhunga protein leh thisen awm leh awm loh enfiah thin.
• Echocardiogram (Echo): Heart valve hnathawh dan, a lian leh te, a dinhmun enfiahna scan a ni.
• I kal leh/ emaw i rilru ultrasound scan : Heng taksa peng hrang hrangte dinhmun hi enfiah rawh.
• `(Right heart catheterization)` : Thinlung dinglam a pressure tehna test a ni.
• Chest X -ray: Chuap chhungah tui a awm em tih emaw, thinlung a lian em tih emaw en nan.

Cardiorenal Syndrome chi hrang hrang a awm em?

Ni e, doctor-te chuan he natna hi an classified a. Eng organ-ah nge buaina hi a lo intan hmasak ber a, eng chen nge a liam tawh tih ah a innghat. Hei hi i hriatthiam phawt chuan enkawl a awlsam ta hle mai.

A chi hrang hrang 5 a awm a:

• Type 1: Heart failure hi a lo awm thut a. Hei hian kal (kidney) a tichhia a, an hnathawh a tichhe thin. Hei hi `acute` condition a ni.
• Type 2: Lung lama harsatna rei tak awm hian hun kal zelah kal a tichhe zauh zauh a.
• Type 3: Acute kidney injury (AKI) hian acute heart failure a thlen thin.
• Type 4: Chronic kidney disease hian hun kal zelah thinlung lam harsatna a thlen thin. Entîr nân, thinlung thawk ṭha lo, thinlung chak lohna , a nih loh leh coronary artery disease (CAD) .
• Type 5: Taksa pumpui tichhe thei, thinlung leh kal (kidney) pahnih a tichhe thei.

Hei hi engtin nge enkawl a nih?

Cardiorenal Syndrome enkawlna tum ber chu i taksaa thisen leh tui level pangngaia awm reng hi a ni. Hei hi a chhan chu i thinlung a chak lo (heart failure) hian i taksaah tui tam lutuk a lo pungkhawm thei a ni. He tui tam lutuk hi kal (kidney) hian a paih chhuak thin. Chuvângin, i thinlung leh i kal (kidney) te chu a ruala a nghawng chuan, he inthlauhna hi vawng reng chu thil harsa tak a ni thei a ni.

Enkawlna hrang hrang a awm a, damdawi atanga device leh organ transplant thlengin:

• Diuretics : Taksain tui tam lutuk chu zun anga a paih chhuah theihna tura puitu damdawi.
• Beta-blockers : Heart rate control leh heart-a hnathawh tur tihtlem.
• ACE inhibitors : Thisen sang control nan a pui thin.
• ARBs : Hei hi thisen sang control thei damdawi chi khat a ni bawk.
• ARNI (angiotensin receptor/neprilysin inhibitors): Tunlai damdawi chi khat, thinlung hnathawh tichaktu a ni.
• Renin angiotensin system blockers : He system hi block a, thisen sang leh kal chhiatna a tihziaawm.
• Mineralocorticoid receptor antagonists : taksaa chi leh tui balance vawng reng turin a pui thin.
• Inotropes : Lung inzawmna chakna tipungtu damdawi. Hengte hi damdawi ina awm laiin pek thin a ni tlangpui.
• Ultrafiltration or dialysis : Kal (kidney) a thawk tha lo a, machine hmanga thisen tihthianghlim dan a ni.
• Implantable cardioverter defibrillator (ICD ): Thil te tak te, rilru vun hnuaia dah, thinlung rhythm dik lo hlauhawm tak tihtawp nan.
• Left ventricular assist device (LVAD): Mechanical pump a ni a, thinlung pump theihna chak lo tak takte tanpui theitu a ni.
• Cardiac resynchronization therapy (CRT) : Pacemaker ang mai a ni a, chu chuan thinlung pindan te chu a thawk dun thei a ni.
• Lung thlak danglam .
• Kidney thlak danglam a ni .

Enkawlna hian side effect a nei em?

Ni e, enkawlna zawng zawng ang bawkin, heng enkawlna hmang hian ``Cardiorenal Syndrome.`` tan side effect thenkhat a awm thei a ni.Mahse, heng zawng zawng hi mi zawng zawngah a thleng vek lo.

• Lu na.
• Luak chhuak thei.
• Chau.
• Zun tam (a bik takin diuretics ei hian ).
• Heart rate a slow.
• Thisenah potassium level sang tak a awm.
• Kidney hliam (damdawi thenkhat vang).
• Device a thawk tha lo.
• Device dah hnu emaw, taksa peng thlak hnu emawa natna hrik emaw thisen chhuak emaw.
• Kal natna.
• Organ hnawlna a ni.

Heng side effects te hi i ngaihtuah hmain doctor nen inbiakna neih hmasak a tha ber. Chutiang chuan thil theih leh tih tur dik tak chu i hrethiam thei ang.

Cardiorenal Syndrome vei chuan eng nge a beisei theih ang?

Hetiang dinhmun hi hriat hmasak a pawimawh hle. Tichuan, a hun takah enkawlna dik tak i dawn chuan i nunphung chu eng emaw chen chu i vawng reng thei a ni. Mahse, dik tak chuan `(Cardiorenal Syndrome)`Hetiang dinhmunah hian damlo `prognosis` emaw `outlook` emaw hi a tha vak lo tlangpui. Chumi awmzia chu natna hi a na hle mai thei tihna a ni. Chutiang hunah chuan enkawl dan `palliative care` tih hi a \angkai hle thei a ni. Hei hi symptoms control-na hmanga tih a ni a, damlo chu a hahdam tir a, damdawi ina luh tam lutuk tihtlem a ni.

Engtin nge he risk hi ka tihziaawm theih ang?

Thil engemaw control-na hmang hian Cardiorenal Syndrome vei theihna i tihziaawm thei a ni.

• Zunthlum i neih chuan , control tha rawh.
• Coronary artery disease i neih chuan enkawl tha rawh.
• Thisen sang i neih chuan , control rawh.
• I body mass index (BMI) 30 aia tam a nih chuan i taksa rihna tihtlem tum ang che.

Heng natna hrang hrangte tan hian damdawi dik tak, a dose dik takah ei a pawimawh hle. A chhan chu damdawi thenkhat ei dik loh chuan kal hnathawh a nghawng thei bawk.

Cardiorenal Syndrome ka nei a, engtin nge ka in enkawl ang?

Hetiang dinhmun hi i neih chuan hengte hi enkawl a pawimawh hle:

• I doctor enkawl dan tur dik takin zawm rawh. I damdawi ei tur chu a hun takah leh a tih angin ei thin ang che.
• Symptom thar i neih chuan, emaw, symptom awm tawh chu a na zual a nih chuan doctor hnenah hrilh nghal rawh.
• Appointment ruat saah doctor hnenah kal ngei ngei tur a ni.

Engtikah nge damdawi in (ETU) ah ka kal nghal ang?

Heng symptoms te hi i neih chuan doctor lam pan vat a pawimawh hle. Damdawi inah a rang thei ang bera kal rawh.

• Zun i siam chhuah loh chuan .
• I thawk i la thei lo a nih chuan .

Doctor hnenah eng zawhna nge ka zawh ang?

Doctor i hmuh hunah zawhna i neihte zawh hreh suh. Hetiang thil hi i zawt thei ang:

• Eng enkawl dan nge ka tan a tha ber?
• Damdawi chauh hmangin ka enkawl thei ang em?
• Cardiorenal Syndrome vei te tan support group a awm em ?
• Ka dinhmun hi engtiang chiahin nge a nasat?

A tawp berah chuan hriat reng tur (Take-Home Message) .

`(Thinlung natna)`A nihna takah chuan thil awmdan buaithlak deuh a ni. A chhan chu, hetah hian thil thleng hi kan taksa peng pawimawh ber pathum – thinlung leh kal pahnih – hian hna a thawk tha lo a ni. Chuvangin, he natna hi i neih chuan doctor thupek dik tak zawm hi a tha ber tur a ni. I duhzawngte i hmangaihte hriattirna chuan rilru thlamuanna nasa tak a pe ang che. I dinhmun a chhe nghal a nih chuan i dam laiin `living will` ziah a nih chuan i chhungte chu eng ang enkawlna nge i mamawh tih thutlukna siam turin a pui ang.

` Cardiorenal Syndrome, Cardiorenal Syndrome, Lung natna, Kal natna, Thlawhna tawi, Edema, Damdawi lam thurawn