I ke leh i kekawrte a lo hring chhuak mai mai tih i hmu ngai em? A nih loh leh i zun hian foam a ni tih i hre tawh em? Hengte hi ngaihthah mai mai tur symptom a ni lo. I kal (kidney)-ah thil dik lo a awm tih chhinchhiahna an ni thei. Vawiin hian i kal (kidney) tichhe thei thil awm lo mahse pawimawh tak kan sawi dawn a ni. Chu chu Membranous Nephropathy (MN) an ti a.
Membranous Nephropathy (MN) hi eng nge ni?
A awlsam zawngin sawi ila, Membranous Nephropathy (MN) hi natna laka humhimtu i immune system-in nangmah ngeiin i kal (kidney) a beih thinna a ni. Mak a ni lo maw? Kan defense ngeiin min rawn bei mek a ni.
Tunah chuan en teh, kan kal chhungah hian thisen tifai thei filter te tak te maktaduai tam tak a awm a. Hengte hi glomeruli kan ti a ni . Tea strainer ang maiin heng glomeruli te hian thisena bawlhhlawh duh loh te chu an filter a, taksa atangin zun angin an pass chhuak thin. Heng filter-te hnathawh dang chu taksain a mamawh protein ang chi thil pawimawh tak tak thisenah dah a ni.
MN vei chunga thil thleng chu ka sawi tawh ang khan immune system hian heng glomeruli an tih filter te hi a bei a, a tichhia a ni. Hetiang chhiatna a thlen hian filter-a hole te chu a lian zawk thin. Tichuan taksa mamawh protein te chu filter atang hian an filter tan a, zun nen an rawn chhuak ta a ni. Hei hi he natna bulpui ber a ni.
Hetiang dinhmun hi a lo lang nghal thei a, a nih loh leh hun kal zelah zawi zawiin a lo awm thei bawk. A châng chuan, miten kum tam tak chhûng he natna hi an nei tih pawh an hre lo mai thei.
He natna hi chi hnih a awm a.
He Membranous Nephropathy (MN) natna hi chi hnih ah kan then a. He classification hi a chhan a zirin tih a ni.
| Natna chi hrang hrang | Hrilhfiahna |
|---|---|
| A rilru a buai em em a, a rilru a hah em em bawk a. Primary Membranous Nephropathy (Idiopathic) . | Hei hi a tam ber chi a ni (damlo 75% vel). Heta thil thleng chu immune system hian direct-in kidney a bei a, natna dang a awm lo. Hei hi autoimmune condition anga ngaih a ni. |
| Secondary Membranous Nephropathy natna a ni a, a natna hi a hlawhtling hle | Hei hi damdawi lam thil dang, natna hrik emaw, damdawi emaw avanga kal (kidney) tihchhiat a nih chuan a thleng thin. Chumi awmzia chu thil dang side effect angin kidney a chhia tihna a ni. Damlo 25% velin he chi hi an nei a ni. |
Nang pawhin heng symptoms te hi i nei ve em?
MN natna lan chhuah dan ber chu zun atanga protein tam lutuk chhuak vang a ni a, a hmaa ka sawi tawh ang khan. Damdawi lamah chuan he natna avanga natna lan chhuah dan khawlkhawm hi Nephrotic Syndrome kan ti a.
A lan chhuah dan ber chu hengte hi a ni:
- Edema: A hring, a bik takin ke, ke ruh, ke, leh a chang chuan hmai leh kutah a hring. He swelling hi thisenah protein a tlahniam a, chu chuan thisen kalna kawnga tui chu tissue-ah a luang lut a ni.
- Zun foamy lutuk (Proteinuria): Zun chhunga protein tam lutuk avang hian foamy angin a lang thei a, sahbawn tui ang maiin a lang thei.
- Chauhna leh hah lutuk: I taksain a mamawh chakna leh ei tur a hloh avangin i chau reng mai thei.
- Sudden weight gain: Hei hi a takah chuan a lian chho zel lo va, tui tlakchham vanga taksa rihna sang zawk a ni zawk.
- Cholesterol sang: Thisen a protein level a tlahniam chuan kan thin hian thau leh cholesterol a siam tam zawk a, chu chu a compensate nan a ni.
- Thisen sang (High Blood Pressure): Kal (kidney) a chhiat chuan thisen sang a sang thei.
- Thâwk harsa: Hetiang dinhmun hi lung chhehvela tui a awm khawm chuan a awm thei.
Engvangin nge hetiang hi a lo awm? A chhan engte nge ni?
A chhan pawh a hmaa kan sawi tawh chi hnih a zirin a inang lo.
A chhan chu primary MN
Primary MN hi autoimmune condition a ni tih ka sawi a. Heta thil thleng hi kan immune system hian kidney filter (glomeruli)-a protein bik phospholipase A2 receptor (PLA2R) tih chu "hmêlma" tiin a hriat sual vang a ni. Tichuan, he PLA2R protein tichhe turin antibody a siam a, a bei ta a ni. He insualna hian chu filter te chu a tichhia a, protein chu a leak chhuak ta a ni.
Secondary MN thlen thei thil
Secondary MN hi thil dang atanga lo chhuak a ni. A nghawng thei thil thenkhat chu hetiang hi a ni:
- Autoimmune natna dang: Lupus leh Rheumatoid Arthritis ang chi natna.
- Hri kai: Hepatitis B, Hepatitis C, Malaria, leh Syphilis te ang chi natna.
- Cancer: A bik takin lung leh ril cancer.
- Damdawi: 1.1.Hun rei tak chhunga damdawi hman thin, natna tidamtu thenkhat (NSAID) leh penicillamine te.
- Toxins: Mercury ang chi metal rit tak tak nena inzawmna.
Heng symptoms te hi i neih chuan a pawimawh ber chu a rang thei ang bera doctor pan a, thurawn lak a ni tih hre reng la, a chhan hi chhut chhuah ai chuan.
Hei hian eng harsatna nge a thlen theih?
MN hi uluk taka enkawl a nih loh chuan hun kal zelah harsatna lian tak tak a awm thei a ni.
- Cholesterol sang leh thinlung natna hlauhawmna: Thisen a thau tam chuan thinlung natna leh stroke ang chi natna a tipung a ni.
- Thisen zam: Protein zun atanga a chhuah chuan thisen zam vengtu protein te pawh taksa a\angin a chhuak \hin. Hei hian ke ruh (veins)-ah thisen zam (blood clots) a siam thei a ni. Hei hi Deep Vein Thrombosis (DVT) kan ti a ni. He thisen zam hi a lo chhuak a, lung chhunga vein pakhatah a tlakbuak chuan natna khirh tak leh nunna atana hlauhawm tak , Pulmonary Embolism (PE) tih a ni.
- Kidney Failure: Natna hi thunun a nih loh chuan kal (kidney) tihchhiatna a pung zauh zauh a, a tawpah chuan kal (kidney) te chu a thawk tha lo vek thei a ni.
Engtin nge doctor hian hei hi a hmuh theih?
A chunga symptoms te hi i neih chuan i chhungkaw doctor chuan kidney specialist (Nephrologist) hnenah a refer ang che. He natna hi dik taka a hriat theih nan test eng emaw zat a ti dawn a ni.
| Fiahna | Eng nge i check? |
|---|---|
| Zun Test a ni | Zun chhunga protein leh thisen engzat nge awm tih an enfiah thin. |
| Thisen Test a ni | Thil chi hrang hrang , creatinine, thisen urea nitrogen (BUN) , kal hnathawh tehna, leh thisen protein level (albumin) te enfiah thin a ni. |
| Glomerular Filtration Rate (GFR) a ni a, a chhuahna tur hmun leh a hmanna tur hmun chu a inthlau hle. | Hei hi thisen test hmanga tih a ni bawk. I kal (kidney)-in bawlhhlawh a filter chak zia a teh a ni. |
| Kidney Biopsy tih a ni | Hei hi 100% a natna finfiah nan a tha ber a ni. Needle te tak te hmangin kidney atanga tissue te tak te tak te chu lakchhuah a ni a, microscope hmangin an enfiah thin. Hei hian MN natna nena inzawm inthlak danglamna leh antibodies te chu a awm leh awm loh dik takin a hre thei a ni. |
Hei hi eng enkawlna nge ni?
Enkawlna chu MN chi i neih leh i natna lan chhuah dan a nasat danah a innghat a ni. Enkawlna tum ber chu natna lan chhuah dan tihtlem leh natna a zual zel tur ven hi a ni.
A hnuaia mi pakhat emaw, a aia tam emaw hi enkawlna atan hman theih a ni:
- Thisen sang damdawi: ACE inhibitor leh ARB ang damdawi te hian thisen sang a control a, zun atanga protein chhuak pawh a ti tlem bawk.
- Diuretics: Hengte hi "tui pills" an ti bawk. Taksa atanga tui tam lutuk chu zun angin an paih chhuak a, swelling tihziaawmna atan an pui thin.
- Cholesterol tihhniamna damdawi (Statins): Hengte hi thisen a cholesterol level sang lutuk control nan pek thin a ni.
- Blood thinners: Hengte hi DVT ang chi harsatna awm thei tihziaawmna atan hman a ni.
- Immunosuppressants: Damdawi corticosteroids te hi immune system hnathawh tihtawp nan leh kal (kidney) a beih loh nan tihtawp tumna atan pek thin a ni.
- Dietary changes: Chi leh thau tamna ei tur i ei tlem a pawimawh hle . I doctor chuan ei leh in tur dik tak a hrilh ang che.
Heng standard treatment te hi natna control nan a tawk lo a nih chuan doctor chuan immunotherapy tih damdawi chak zawkah a kal thei a ni. Rituximab leh Cyclophosphamide ang damdawi te hi kal (kidney) beitu antibodies siamtu cell te tihchhiat nan hman a ni.
Secondary MN vei tan chuan a chhan bulpui (e.g., hepatitis infection, lupus) enkawl hian kal chhiatna a titawp thei a, a ti tlem thei bawk.
Natna hi a nasat ber thlengin a kal a, kal a tichhe a nih chuan dialysis emaw kal thlak emaw a ngai mai thei.
He natna nen hian nun hi engtin nge a awm?
He natna kal dan hi mi hrang hrangah a inang lo. Mi thenkhat tan chuan natna hi enkawl tlem emaw, enkawl loh emaw chuan a reh vek thin. Mi dangte tan chuan he natna hi kum tam tak chhung a awm reng a ni.
A tha ber chu MN vei zinga 15% aia tlem lo chuan kal (kidney failure) an nei chho zel a, chu chu a tam zawk chu enkawlna nen nun pangngai an hmang thei tihna a ni.
Mahse hriat reng tur pawimawh tak chu he natna hi enkawl hnuah pawh a lo lang leh thei tih hi a ni. Chuvangin, clinic-te tlawh a, i nephrologist-in a tih angin hun ruat saah test neih a pawimawh hle. Tichuan, natna lo lang leh tur chhinchhiahna a awm chuan enkawl tan nghal theih a ni.
Take-Home Thuchah a ni
- I ke, ke emaw, i hmai emaw-ah sawifiah theih loha hliam i neih emaw, i zun-ah foam tam lutuk i hmuh chuan ngaihthah suh. Doctor hmu nghal rawh.
- Membranous Nephropathy (MN) hi autoimmune condition a ni a, nangmah ngeiin i immune system hian i kal (kidney) a bei thin.
- He natna hi dik taka hriat theih nan kidney biopsy hi a pawimawh hle.
- He natna hi tihdam kim theih ni lo mah se, a natna lan chhuah dan control nan te, kal (kidney) tihchhiat tlem nan te, harsatna awm thei tur venna atan te enkawlna tha tak tak a awm a ni.
- I doctor thupek dik taka zawm leh a hun taka clinic kal hi i kal hriselna vawng reng turin a pawimawh hle.
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