Liver problem hian kidney direct-a a nghawng dan: Hepatorenal Syndrome chungchang hi chiang takin i zir ang u!

I liver-a harsatna lian tak a awm chuan i kal hrisel ṭha tak pahnih chu vawi khatah hna a thawk tawh lo thei tih i ngaihtuah ngai em? Ngaihtuahna hlauhawm tak a ni lawm ni? Vawiin hian liver failure avanga lo awm thei, nunna atana hlauhawm tak, natna khirh tak kan sawi dawn a ni. Hei hi doctor- te’n Hepatorenal Syndrome (HRS) an tih chu a ni. Eng nge a nih, engvangin nge a lo awm tih leh eng thil dang nge kan tih theih tih hi han thlir ila.

Hepatorenal Syndrome hi eng nge ni?

A awlsam zawngin, hepatorenal syndrome (HRS) hi i thin (liver) a thawk tha lo tihna a ni a, hei hi harsatna lian tak a ni a, liver failure hnuhnung ber a ni. Hetiang a nih chuan i kal (kidney) te hian liver lama harsatna an neih avangin an hnathawh a hloh nghal vek a ni. What’s special chu hei hi prerenal acute kidney failure anga ngaih a ni. Hei hian a hmaa kal natna nei lo leh taksa lama inthlak danglamna emaw, i kal chhiatna emaw a awm loh pawhin he natna hi i nei thei tihna a ni. I kal (kidney) te hi a hrisel tawk viau mai thei a, mahse liver problem avang hian thisen supply a tibuai a, an hna an thawk thei lo.

Tui pump tha taka thawk ang maiin han ngaihtuah teh, mahse tuikhuah panna tui pipe chu a inkhar a nih chuan tui chu a chhuak lovang. Kal a tha a, mahse thin lam harsatna a awm avangin kal a thisen phurtu thisen kalna kawngte chu a inkhar a, a zim a ni. Tichuan, kal (kidney) te hian an mamawh thisen an hmu lo va, an hnathawh chu a tlahniam zauh zauh thin. Hei hi emergency anga ngaih a ni a, a tam zawkah chuan, hei hi enkawlna nghet awmchhun chu liver transplant a ni.

He dinhmun hian tute nge a nghawng ber?

He natna, hepatorenal syndrome (HRS) tia koh hian thin natna khirh tak nei te a nghawng ber a ni . A bik takin, chronic, progressive liver disease , hun kal zelah an liver a chak lo zauh zauh tawhte chu he natna hi an vei theihna chance sang ber a ni. Hetiang hun rei tak chhunga thin natna avang hian thin tissue a hliam a, thin a khauh thin tih i hria em. Hei hi cirrhosis kan ti a ni . Hetiang dinhmun avang hian thin a thisen kal dan a inthlak a, hun kal zelah thin hian hna a thawk tawh lo.

Tin, eng emaw chhan vanga acute liver failure lo awm nghal a nih chuanMahse, HRS hi a lo awm thei a ni. Zirna hrang hrangah chuan HRS hi end-stage liver disease nei zinga 40% thlengin a awm thei tih hmuhchhuah a ni. Kum leh mipa leh hmeichhiaah pawh lo awm thei mah se, an dam chhung kum hnihnaah chuan a tam zawk. Tin, chronic emaw acute liver failure neia damdawi ina awm zinga 10% vel ah pawh a awm bawk. Liver natna avanga kal chak lohna chhan pakhat aia tam awm mah se, HRS hi a danglam bik a, a hmaa kal natna nei lote zingah a awm thin.

Engtin nge cirrhosis hian hepatorenal syndrome a thlen?

Hei hi thil buaithlak deuh a ni. Liver natnain hepatorenal syndrome (HRS) a thlen dan dik tak chungchangah hian zirchiangtute zingah ngaihdan hrang hrang a la awm a, chu chu a pathophysiology .

Engtin nge hei hi a lo thlen tak tak? (Pathophysiology) tih a ni.

Kan hriat angin kal (kidney failure) hi kal chhunga thisen kalna kawngte a zim a, a inkhar a, chuta thisen kalna a tlahniam chuan a awm thin. Zirchiangtute chuan he thisen kalna kawng a zim hi thin natna leh thin chak lohna nena inzawm thil hrang hrang inzawmkhawm vang niin an ngai. Hei hi a chhan ber chu portal hypertension a ni .

Portal hypertension hi i liver kal tlanga vein lian ber portal vein-a thisen sang leh a nena inzawm leh i chaw ei dan zawng zawnga inzar pharh vein-a thisen sang a sanna a ni. Hei hi a thlen tam ber chu cirrhosis a ni . Cirrhosis hian cirrhotic cardiomyopathy tih natna a thlen thei bawk a, chu chuan i taksaa thisen kalna kawng thenkhat chu a pangngai lo takin a tizau thei a ni. Hetianga thisen kal dan inthlak danglamna buaithlak tak hian thisen kalna kawng thenkhat a tizau a, thenkhat (a bik takin i kal chhunga awmte) chu a ti tawi bawk. Kawngpui sir khata traffic jam ang maiin ngaihtuah la, chu chuan a sir dangte pawh a nghawng a ni.

He dinhmun tizualtu precipitating factors te chu engte nge ni?

HRS natna atana "trigger" emaw precipitating factor emaw ni thei, liver natna nena inzawm thil dang pawh a awm bawk. Chung zinga a tam ber chu Spontaneous Bacterial Peritonitis (SBP) a ni . Hei hi i pum chhunga lining (peritoneum) a bacteria infection a ni. SBP hi ascites , a complication a ni a, chu chu pum chhunga tui awmkhawm a ni. Ascites hi portal hypertension vangin pum chhunga veins atanga fluid leak vang a ni.

Ngaihtuah teh, i pum chu tui (ascites)-in a khat a nih chuan, chutah chuan natna hrik awlsam takin a lut thei a, natna hrik a thlen thei a ni. Chu chu he spontaneous bacterial peritonitis (SBP) tih hi a ni.

Tin, portal hypertension hian i thisen zam a ti puak thei a, i pum chhungah thisen a chhuak thei bawk. Hetiang hian:Gastrointestinal bleeding avanga thisen tlakchhamna (acute blood loss) hi a chhan dang a ni. Chu mai pawh ni lovin, diuretics , a nih loh leh "tui pills" hman tam lutuk pawh hi a chhan a ni thei bawk. Diuretics hian taksa atanga tui tam lutuk paih chhuakin hna a thawk a. Liver natna zual tak nei te chuan heng tui pill te hi ascites emaw edema , taksa hring hring emaw atan an ei thei a ni.

Eng nge a lan chhuah dan?

Hepatorenal syndrome (HRS) vei te hian a hmasa berah chuan hriselna tha lo, a tlangpuiin an rilru a na hle. A lan chhuah dan chu:

• Chau
• Luhai
• Pum a na
• Ka chhungah a thlum tha lo

Hei bakah hian thin natna zual emaw, thin chak lohna emaw chhinchhiahna an nei thei bawk. Chung zingah chuan:

• Jaundice (mit dum hring hring) .
• Bruising leh thisen chhuah awlsam
• Thluak rawng hring leh zun rawng dum
• Pum natna (ascites vang, thin emaw spleen emaw a lian vang) .
• Vun a na
• Buaina, hriatrengna hloh, emaw mut theih lohna (Hepatic Encephalopathy) .

Kidney failure a nasat chuan i zun chhuah zat chu nasa takin a tlahniam tih i hmu mai thei .

Engtin nge hei hi i hriat chian?

Hepatorenal syndrome (HRS) hi kal natna chi khat a ni a, thin natna nasa tak awmnaah a awm a, kal chak lohna chhan dang a awm lo. Chuvangin, doctor-te chuan hei hi liver natna leh kal (kidney failure) an nemnghet hmasa a, chutah chuan kal (kidney failure) awm thei dangte chu an paih chhuak a ni. Chutianga tih nân chuan, i liver leh kidney-te hnathawh dân enfiah nân imaging test hrang hrang , scan, thisen test, leh zun test te an hmang a ni.

Engtin nge enkawl a nih?

HRS hi kal (kidney failure) avanga natna khirh tak ni mahse, a harsatna bulpui ber chu liver-ah a awm a ni . Hepatorenal syndrome (HRS) hi "prerenal" form of acute kidney failure tiin an dah a, a chhan chu i kal hi a dangin a hrisel a ni. Dik tak chuan i kal (kidney) te hi lak a, midang taksaah dah a nih chuan a thawk tha khawp mai. Chutiang bawkin i liver function a normal leh chuan i kidney te pawh a thawk tan leh theihna chance tha tak a awm.

Acute liver failure nei thenkhat chuan an liver leh kidney function te pawh an lo tha leh thei bawk. Mahse midang zawng zawng chuan liver transplant an mamawh dawn a ni . Engtin pawhin engtik lai pawhin liver transplant an mamawh mai thei a, mahse HRS hian a mamawhna chu a tizual hle. Mahse, mi zawng zawng hian liver transplant an tlin vek lo va, an tlin pawh nise, an dawn hma chu an nghah a ngai a ni.

Hetiang hunah hian enkawl vat leh enkawl dan dik hi a pawimawh ber a ni.

Chutih lai chuan i doctor emaw nurse emaw chuan i kal hnathawh chu a theih ang anga humhim a tum ang a, he natna lan chhuah dan leh a side effects te pawh a tihziaawm ang. Heng step te hian i hriselna zawng zawng a ti tha thei a, liver transplant atana inbuatsaih nan a pui thei bawk. Liver transplant i neih chuan i result tihchangtlunna kawngah pawh an pui thei bawk. Mahse, hengte hi damdawi a ni lo . Heng enkawlnate hi a hnuaia mi ang hian a ni thei:

• IV fluids , saline ang chi thilte hi taksaa electrolyte inthlauhna siam\hat nan leh thisen kal (kidney)-a kal theihna tura pui turin pek a ni.
• Damdawi thenkhat, diuretics (tui pill) te tihtawp.
• Infection inzawm te tan antibiotics pek.
• Paracentesis hi ascites vanga tui tam lutuk awmkhawm chu paih chhuah nan an ti thin.
• Vasoconstrictors tih damdawi pek . Chûngte chuan i thisen kalna kawng zau tak takte chu a tizau a, kal (kidney)-a thisen kalna a tipung a ni.
• Hemodialysis , chu chu thisen dialysis a ni a, chu chu i stressed kidney te tanpui nan a ni.

A veng thei ang em?

Hepatorenal syndrome (HRS) laka invenna tha ber chu liver natna chu cirrhosis a lo thlen hmaa enkawl hi a ni . Chronic liver disease hi kum tam tak chhunga zawi zawiin a lo awm thin a ni. Mite chuan he natna hi an vei tih an hriat chuan zu in tihtlem te, taksa rihna tihtlem te, leh ei leh in tihchangtlun te ang chi thil tih hmangin natna kal zel dan chu an thunun thei a, a chang chuan an tidanglam thei bawk. Mahse, mi tam takin symptoms an lan loh avangin damdawi lam enfiahna pangngai tel lo chuan hriatchhuah a ni lo mai thei.

Cirrhosis i neih tawh chuan HRS lo awm tur hi sawi lawk theih leh ven theih a ni lo. Mahse, Spontaneous Bacterial Peritonitis (SBP) natna hi a awm thei a ni.Chutiang a nih lai chuan, hei hi "trigger" hman tlanglawn ber chu i pumpelh thei a ni. Cirrhosis vei zingah HRS vei zinga 25% vel chu SBP hian a thlen a ni. Chuvangin, i doctor chuan SBP vei theihna chance sang tak neia a ngaih chuan, invenna atana antibiotics ei hian he trigger hi a tihziaawm thei a, HRS vei theihna a ti tlem thei bawk.

Hei hi tihdam theih a ni em? Nunna atana hlauhawm a ni em?

Liver transplant tel lo chuan mi tam tak chu an dinhmun a na hle. HRS a nasat thut a, transplant a awm loh chuan dam rei zawng chu kar hnih chauh a ni . Chronic HRS-ah chuan transplant tel lova dam rei zawng chu thla thum atanga thla ruk chhung a ni . Liver failure nasat dan azirin a natna hi a na zual thuai thei. Tin, i dinhmun a na zual thuai chuan i na lutuk a, transplant pawh i nei thei lo a, chu chu a buaithlak thei hle bawk.

Mahse, liver transplant i neih chuan i dinhmun chu nasa takin a ṭha chho ang . HRS vei te hian liver transplant an neih hnuah kum thum hnuah damchhuah theihna chance 60% an nei a ni. Hei hi liver transplant nei tlangpui (75%) te kum thum chhunga dam rei zat aiin a hniam deuh hlek a ni. Mi tam zawkte kal (kidney function) chu kar tlemte chhungin a pangngaiin a lo let leh ang. Mi tlemte tak tak (5% vel) chuan dialysis chhunzawm a ngai mai thei .

End-stage liver failure zawi zawiin a chhe zel emaw, i hun tikhawtlai thei hepatorenal syndrome (HRS) lo awm nghal mai emaw pawh ni ila, liver donor waiting list-a tel hi thil tha tak a ni lo. A chhan chu chu list-a awmte tan chuan donor liver a awm tawk lo a ni. Mahse, living liver donor i hmuh theih chuan , list-ah hian i tel a ngai lo mai thei a, i hriselna zawng zawng pawh a ṭha chho thei bawk.

Donor nung hi volunteer hrisel tak tak an ni a, a tlangpuiin i hmangaih tak takte an ni a, i thisen chi leh taksa lian leh te nena inmil an ni. Mi nung dang atanga lak chhuah liver tlemte pawh nangmah leh a petuah pawh liver tling takah a lo thang lian leh thei a ni. Tin, donor thi tawhte hnen atanga liver lak aiin liver nung hi a dinhmun a tha zawk a rinawm bawk. Surgeon-te chuan heng heroic living donors te surgery hi a theih ang anga invasive tlem thei ang bera siam turin theihtawp an chhuah thin.

A tawp berah chuan thil hriat reng tur

Chuvangin, tunah chuan hepatorenal syndrome hi natna khirh tak, ngaihven ngai tak a ni tih i hrethiam tawh mai thei, a chhan chu liver problem avanga kal (kidney) a nghawng vang a ni.

• Liver hriselna hi a pawimawh hle:Liver natna i neih chuan uluk taka enkawl a pawimawh hle a, a bik takin cirrhosis ang chi condition-a a kal loh nan.
• Symptoms ngaihven rawh: Liver natna nena inzawm symptoms i neih emaw, a tlangpuiin i rilru a hahdam loh emaw i neih chuan doctor pan nghal rawh.
• I kal (kidney) chungchang ngaihtuah teh: Liver lama harsatna i neih hian i kal (kidney) pawh i enkawl a ngai bawk. Zun tlem ang chi symptom i neih chuan doctor hnenah hrilh rawh.
• Enkawlna a awm: HRS hi natna khirh tak ni mah se, liver transplant ang chi enkawlna hian nunna a chhanhim thei a ni. Chuvangin beiseina bansan suh.
• Nunphung a pawimawh: Nun hrisel, ei leh in inthlau tak, leh zu in loh ang chi thilte hian thin hrisel a vawng reng thei a ni.

He thu hi in tan a tangkai ngei ka beisei. Nangmah emaw, i hriat miin emaw hetiang harsatna hi i tawk a nih chuan a tha ber chu damdawi lam thurawn lak nghal hi a ni.

` Hepatorenal syndrome, thin natna, kal tha lo, cirrhosis, thin thlak, portal hypertension, ascites