I thisen sang damdawi pawh i ei a , mahse a la tlahniam lo em ni? I doctor chuan, "Damdawi chi hrang hrang a pek hnuah pawh , i thisen sang a tlahniam lo ang," a ti mai thei. A châng chuan, eng ang pawhin i nunphung i thlak danglam a, i ei leh in i thunun , leh exercise i tih pawhin, i thisen sang chu a la sang thei tho a ni. Hetiang hunah hian a chhan chu kal (kidney) lama harsatna a ni thei tih kan ngaihtuah tur a ni. Vawiin hian hetiang dinhmun hi kan sawi dawn a ni.
A awlsam zawngin, renovascular hypertension chu eng nge ni?
A hming hi a buaithlak deuh niin a lang a, mahse a thawnthu hi a awlsam hle. Renovascular Hypertension hi i kal a harsatna avanga thisen sang a ni .
Hetiang hian han ngaihtuah teh. Kan taksa peng pawimawh ber pakhat chu kal (kidney) hi a ni. An hna ber chu thisen filter a ni a , bawlhhlawh chu zun angin paih chhuah a ni . He hna hi tha taka thawk tur chuan kal (kidney) hian thisen tha tak a mamawh a ni. Kidney-a thisen phurtu thisen kalna kawng ( arteries ) lian ber berte chu `renal arteries` an ti a.
Tunah chuan eng emaw chhan vangin heng thisen kalna kawngte hi zawi zawiin a zim emaw, a hring emaw tih hi han ngaihtuah teh. Tui pipe a laiah an hrual ang maiin. Chuti a nih chuan eng nge thleng? Thisen kal (kidney) thleng a tlem phah a.
Hetianga thisen kal a tlahniam hian kan kal fing tak takte chuan, “Aw, ka thisen sang hi taksa pum puiah a hniam a, chuvang chuan thisen ka hmu tlem zawk a ni,” tiin an ngaihtuah thin. Chuvangin, an hna tha taka thawh an duh avangin taksaa thisen sang tisang turin hma an la thin. Chutiang ti tur chuan taksaa hormone system pakhat an activate a. Damdawi lam hawi chuan hei hi RAAS (Renin-Angiotensin-Aldosterone System) kan ti a ni. He hormonal system hi a thawh chuan taksa pum puia thisen kalna kawngte chu a inzawm khawm a, thisen sang a sang chho ta a ni.
A awlsam zawngin, kal (kidney)-a thisen kal tlem a nih avangin, kal (kidney) ngei hian taksa pumpuiah pressure a tisang a ni. Hei hi renovascular hypertension an ti a.
Hei hi thisen sang pangngai nen a inang lo. Hei hi secondary hypertension tih category-ah a tla a ni. Chu chu damdawi lam thil dang avanga thisen sang (high blood pressure) tihna a ni.
Hetiang natna lan chhuah dan hi engte nge ni? Engtin nge kan rinhlelh?
Hetah hian harsatna lian ber chu he natna hi a lan chhuah dan chiang tak a awm lo tlangpui. Chu chu thil danglam tak i hmu lo mai thei tihna a ni. Mahse, doctor chuan i medical history leh i damdawi eite a en chuan clues engemaw zat a la chhuak thei a ni. Hengte hi doctor rinhlelhna siamtu a ni.
Chu clues te chu eng nge ni tih i en ang u.
| Rinhlelhna chhinchhiahna | A sawifiahna awlsam tak |
|---|---|
| Kum danglam takah pressure a lo awm tan | Thisen sang hi kum 30 an tlin hma emaw, kum 50 an tlin hnuah emaw a lo awm nghal tlangpui. |
| Pressure sang tak, control tha tak tawh chu | Hun rei tak chhung damdawi hmanga control tha taka lo awm tawh pressure chu thunun theih loh khawpin a pung nghal a. |
| Damdawi ei chhan loh vang | Doctor chuan thisen sang damdawi chi hrang hrang (pathum emaw a aia tam emaw) a pe tawh a, mahse thisen sang erawh a tlahniam lo. Hei hi `resistant hypertension` kan ti a. |
| Hypertensive Crisis a awm thei | Thisen sang chu hlauhawm tak (e.g., 180/120 mmHg aia tam) thlenga tihsan nawn fo thin. |
| Flash Pulmonary Edema a awm thin | A rilru a buai em em a, a rilru a hah em em bawk a, a rilru a buai em em bawk a, a rilru a hah em em bawk a. |
| Thisen kalna kawng danga thau awm | Thinlung, kawr emaw, ke emaw thisen kalna kawngah thau (plaque) awm tawhna history neih. |
| Kidney tha lo a awm | A chhan dang hriat lohvin kal hnathawh a tlahniam zauh zauh. |
| Doctor-in a hriat thawm bik (Bruit) . | Doctor chuan i pum chhungah stethoscope a dah chuan thisen kalna kawngkhar khar chhungah thisen a kal laiin "swooshing" ri i hre thin. |
Engvangin nge hetiang hi a lo awm? A chhan berte chu engte nge ni?
Kidney panna thisen kalna kawng a block chhan ber chu renal artery stenosis an tih hi a ni . Chumi awmzia chu kal chhunga thisen kalna kawng (arteries) te chu a zim tihna a ni. Hei hi chhan lian tak pahnih a awm a.
1. Atherosclerosis: Hei hi a chhan tam ber a ni. A awlsam zawngin sawi ila, thisen kalna kawng bang chhunga thau leh cholesterol (`plaque` an tih) a lo awm zel avanga thisen kalna kawng a zim zauh zauh thin hi a ni. Hei hi kum upat, zunthlum, cholesterol sang, leh meizuk te nen a tam zawk.
2. Fibromuscular Dysplasia (FMD): Hei hi natna awm lo tak a ni. Thisen kalna bang chhunga cell (muscle leh fibrous cells) te chu a pangngai lo taka a lo thang lian a, hmun thenkhatah thisen kalna kawng a ti tawi a, a lo awm thin. Hetiang dinhmun hi hmeichhe naupangte zingah a tam ber.
Heng chhan lian pahnih bakah hian chhan dang hmuh tur awm lo engemaw zat a awm thei bawk.
| A chhan awm lo | A sawifiahna awlsam tak |
|---|---|
| Vasculitis a ni | Thisen kalna kawngte chu inflammation vangin a thim thin. |
| Renal Artery Aneurysm a awm thin | Renal artery wall chak lo tak, balloon ang maia bulh chhuak. |
| Tumor atanga pressure a awm | Kidney emaw artery bula awm tumor, thisen kalna kawng pawn lama pressure awm. |
| Radiation therapy avanga hliam (Fibrosis) awm thin | Cancer ang chi natna avanga radiation therapy an dawn hnuah, chu hmuna thisen kalna kawngte chu a thim a, a hliam a, a inkhar bawk. |
Hei hi ngaihthah a nih chuan eng harsatna nge thleng thei?
Thisen sang chi hrang hrang ang bawkin he natna hian hun rei tak control loha dah a nih chuan harsatna lian tak a thlen thei a ni.
- Lung chhiatna: Hun rei tak chhung thisen sang hian thinlung hna a thawk nasa thei a, chu chuan thinlung ruh a thick, heart attack, leh heart failure ang chi dinhmun a thlen thei a ni.
- Kidney tichhe zual: Kal, thisen kal tlem tawhte chu pressure sang vangin a tichhe zual thei a, chu chuan kal a tichhe thei a ni.
- Mit chhiatna: Mit chhunga thisen kalna kawng nalh tak takte a chhiat chuan mitdelna (retinal disease) a thlen thei a ni.
- Stroke: Thluak lam panna thisen kalna kawng a chhiat chuan stroke vei theihna a tipung a ni.
Engtin chiah nge doctor hian hei hi a hmuh?
I doctor chuan he natna hi a rinhlelh chuan detective angin hna a thawk ang a, thutlukna siam turin clues a piece together ang. Hetiang kalphung hian thil pawimawh engemaw zat a huam a ni.
1. Taksa enfiahna: Doctor in a enfiah ang che, a bik takin i pum chungah stethoscope dahin a hmaa kan sawi tawh ‘bruit’ ri chu a enfiah ang.
2. I damdawi lam chanchin zawh: Zawhna tam tak i zawt ang a, chu chu i thisen sang i neih kum, i chhungte zingah tu pawhin an nei em, eng damdawi nge i ei tih leh natna dang i neih leh neih loh te hi a ni.
3. Special test: Rinhlelhna finfiah nan test eng emaw zat tih a ngai dawn a ni.
- Thisen test: RAAS system-a kal hnathawh (creatinine, eGFR) leh hormone level te enfiah thin.
- Zun test: Zun chhunga protein ang chi thil awm leh awm loh enfiah thin ang che.
- Kidney Ultrasound Doppler: Hei hi test pawimawh ber a ni. Kidney-a thisen phurtu artery-a thisen kal chak dan a teh a , blockage eng pawh dik takin a hmu thei bawk.
- Scan dang: A then phei chuan scan complex zawk CT angiogram emaw MR angiogram emaw tih a tha thei.
Awle, tunah chuan enkawl dan tur kan sawi dawn nia.
Hetiang dinhmun hi hriat chhuah a nih hnuah chuan hlauh tur a awm tawh lo. Hemi atan hian enkawlna tha tak tak a awm. Enkawlna tum ber chu thisen sang control leh kal leh taksa peng dangte venhim a ni.
Damdawi (damdawi) .
A tam zawkah chuan damdawi hmangin he natna hi a control tha thei hle. Thisen sang pangngai atana damdawi pek bakah hian doctor chuan he natna atana hman tur bik damdawi a pe bawk ang.
- Angiotensin-Converting Enzyme (ACE) Inhibitors: Entirnan, damdawi Enalapril leh Lisinopril ang chi te.
- Angiotensin Receptor Blockers (ARBs): Entirnan, damdawi Losartan leh Telmisartan ang chi te.
Heng damdawi pahnihte hian a hmaa kan sawi tawh RAAS hormone system hnathawh dan a control a, thisen sang sang pawh a titawp bawk.
Pawimawh: Heng damdawi ei tan hian kal hnathawhnaah nghawng tlem a nei thei. Chuvangin, i doctor chuan heng damdawi i ei tan atanga kar khat emaw kar hnih vel hnuah i kal hnathawh dan a enfiah leh ang. Ngaihtuah buai suh, thil kalphung pangngai a ni.
Tin, damdawi dang cholesterol tihhniamna statin, calcium channel blocker, leh diuretics te pawh i dinhmun a zirin i pe thei bawk.
A tul chuan tih dan tur (procedures) te
A chang chuan damdawi ringawt pawha i thisen sang control a harsa thin. A nih loh leh thisen kalna kawng nasa taka a inkhar chuan i doctor chuan tih dan bik a rawt thei bawk.
- Renal Artery Angioplasty leh Senting: Hei hi thinlung chhunga thisen kalna kawng hrang hrangte tan angioplasty tih nen a inang a ni. Tube te tak te chu ke emaw kut emaw a vein kaltlangin dahin, renal artery blocked thlengin hmasawn a ni. Chumi hnuah chuan tube chu balloon te tak te hmangin inflated a ni a, chu chuan blocked area chu a tizau ta a ni. A block leh loh nan mesh ang chi tube te tak te (stent) chu a hmunah dah a ni.
- Renal Denervation: Hei hi enkawlna thar tak a ni. Heat emaw ultrasound energy hmangin renal artery chhehvela nerve awmte hnathawh a tihtlem phah a ni. Heng nerve te hi thluak ah signal thawn chhuakin pressure tisangtu an ni. Chuvangin an hnathawh tihtlem hian thisen sang a tihniam thei a ni.
Inzai
Surgery hi hman a ni tlem hle. Surgery hi thisen kalna kawng insiam dan a buaithlak lutuk a, angioplasty ang chi tih theih loh emaw, chutiang hmanrua te chu a hlawhchham chuan emaw chauh tih a ni.
- Surgical Renal Revascularization: Hei hi renal bypass surgery an ti bawk.Hetah hian surgeon chuan i taksa peng dang atanga thisen kalna kawng khat emaw, artificial tube emaw atanga lak chhuah hmangin thisen kalna kawng thar (bypass) a siam a, a blocked part chu a bypass a ni.
Enkawl hnuah eng nge thleng?
Vawikhat enkawlna i tan tawh chuan engkim a tawp tawh tih ngaihtuah suh. Doctor-in a tih angin follow-up appointment-a tel a pawimawh hle.
Heng clinic-ah hian Dr.
- I thisen sang an teh a, enkawlna a hlawhtlin zia an hmu thin.
- Kidney hnathawh dan enfiah nan thisen test an nei thin.
- A tul chuan i damdawi hman dan tur chu thlak danglam emaw, damdawi thar dah belh emaw a ni ang.
Heng appointment te hi nangmah tan pawh a pawimawh hle. Hei hi doctor hnenah zawhna emaw, ngaihtuahna emaw i neih chuan zawh theihna hun tha tak a ni.
He natna hi a dam kim thei ang em?
Renovascular hypertension hi enkawl theih a ni. Chumi awmzia chu damdawi dik tak leh a tul chuan inrawlhna \ha tak tak hmangin i thisen sang chu hrisel takah a tlahniam thei tihna a ni. Mahse, "dam vek" ai chuan "well-controlled" theih a ni tih hi a dik zawk.
He zinkawngah hian i thawhhlawkzia hi a pawimawh hle tih hre reng ang che. Doctor inenkawlna chu eng ang pawhin tha mah se, i lam atanga thil dik i tih loh chuan a rah a tha lo ang.
- I damdawi ei tur chu a hun takah ei rawh: I damdawi ei tur chu i doctor-in a tih ang chiah chiah la la, ni khat pawh skip lovin.
- I ei leh in enkawl tha rawh: Chaw chi, hriak leh sugar tamna ei tur chu tihtlem la. I doctor chuan DASH diet ang chi special diet a rawt a nih chuan zawm rawh.
- Exercise: I taksa tan eng exercise nge tha tih leh eng chen nge i tih tur tih doctor zawt la, chutiang chuan che rawh.
Hei hi i thisen sang thunun theih loh chhan a ni tih i hriat hnuah chuan hahdamna nasa tak i nei ang. A chhan chu tunah chuan a chhan i hriat tawh avangin a enkawlna dik tak i hmu thei tawh a ni. Chuvangin, hemi chungchangah hian zawhna i neih chuan i doctor nen inbiakna neih hlau suh.
Take-Home Thuchah a ni
- Damdawi engemaw zat hmang pawha thunun theih loh thisen sang hi kal lama harsatna vang a ni thei.
- Hei hi a chhan ber chu kal (kidney)-a thisen phurtu thisen kalna kawng (arteries) a zim vang a ni.
- Hetiang dinhmun hian thinlung, thluak leh kal (kidney) te a tichhia thei a ni.
- He natna hi scanning test hmangin dik takin a hriat theih a ni.
- Damdawi leh angioplasty ang chi enkawlna tha tak tak a awm avangin hlauh a ngai lo.
- Doctor thupek dik tak zawm a, a hun taka clinic kal hi a pawimawh hle.
Renovascular Hypertension, hypertension, pressure, kidney, renal artery stenosis, thisen sang, thisen sang Sinhala, kal natna Sinhala, kal natna, pressure awm chhan
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