Ese ibibazo by'impyiko bishobora kugira ingaruka ku magufwa yawe? Reka twige ku bijyanye na Osteodystrophy y'impyiko!

Ese ufite indwara y'impyiko, cyangwa icyo abaganga bita indwara idakira y'impyiko (CKD) ? Cyangwa uzi umuntu urwaye iyi ndwara? Abantu benshi batekereza ko iyo tuvuze indwara y'impyiko, igira ingaruka ku mpyiko gusa. Ariko ukuri ni uko iyo impyiko zacu zidakora neza, zishobora kugira ingaruka zikomeye ku zindi ngingo nyinshi mu mubiri, cyane cyane urusobe rw'amagufwa yacu, ni ukuvuga amagufwa yacu . Uyu munsi rero tugiye kuvuga ku ndwara aho amagufwa yacu acika intege agatera ibibazo bitewe n'indwara y'impyiko. Ibi byitwa mu buvuzi osteodystrophy y'impyiko . Nubwo izina rigoye gato, reka tubisobanukirwe mu buryo bworoshye.

Osteodystrophy y'impyiko ni iki?

Muri make, indwara ya Renal Osteodystrophy ni indwara y’amagufwa ishobora kwibasira abantu bakuru n’abana bafite indwara zidakira z’impyiko (CKD).

Noneho, reba, impyiko zacu zifite uruhare runini cyane. Ni ukugenzura urugero rw'imyunyu ngugu nka kalisiyumu na fosifore mu maraso yacu. Nanone, impyiko zifite inshingano zo gukora vitamine D no gukora imisemburo yitwa calcitriol , ifasha amagufwa yacu gukomera.

Rero, iyo impyiko zinaniwe cyangwa zidakora neza, ntizishobora kugenzura ingano y'iyi myunyungugu n'umusemburo wa calcitriol. Icyo gihe amagufwa yacu atangira gucika intege buhoro buhoro . Ibi byongera ibyago byo kuvunika amagufwa byoroshye, bivuze ko avunika .

Ni imyunyu ngugu n'imisemburo ki bifasha amagufwa yacu kugumana ubuzima bwiza?

Hari imyunyu ngugu myinshi n'imisemburo ifasha amagufwa yacu kuguma afite ubuzima bwiza kandi akomeye. Reka tumenye bike kuri byo.

• Kalisiyumu: Iyi ni yo ngingo nyamukuru y'amagufwa yacu. Amagufwa ameze nk'"inkunga ya kalisiyumu" mu mubiri wacu. Kalisiyumu ntikomeza amagufwa gusa, ahubwo ni ingenzi no mu bindi bintu byinshi, nko gukora kw'imitsi n'imikorere y'imitsi. Impyiko zacu zifasha kuringaniza urugero rwa kalisiyumu mu maraso.
• Fosifore: Kimwe na kalisiyumu, fosifore nayo ni ingenzi cyane mu magufwa. Impyiko zacu zikuraho fosifore nyinshi umubiri udakeneye kandi zigatuma amaraso agira uburinganire bukwiye hagati ya kalisiyumu na fosifore.
• Kalisitriyole: Iyi ni yo vitamine D ikora. Ikorwa n'impyiko zacu. Iyi misemburo ifasha kugenzura ingano ya kalisiyumu umubiri wacu ukura mu biribwa turya ndetse inafasha imikorere y'uturemangingo twa parathyroid.
• Igipimo cy'Ubukure bwa Fibroblast 23 (FGF23):Iyi ni imisemburo ikorwa n'amagufwa yacu. Ifasha mu kugena urugero rwa fosifore na vitamine D. Urugero rwa FGF23 rukunze kwiyongera ku bantu bafite indwara zidakira z'impyiko.
• Hormone Parathyroid (PTH): Iyi hormone ikorwa n'uturemangingo tune duto tuba inyuma y'uturemangingo twa tiroyide mu ijosi ryacu. Izi zitwa parathyroid glands. Akamaro k'iyi hormone ya PTH ni ukurekura kalisiyumu mu magufwa iyo umubiri ukeneye kalisiyumu no gutuma urugero rwa kalisiyumu mu maraso ruguma ruhamye.

Ni ubuhe bwoko bw'ingenzi bwa Osteodystrophy y'impyiko?

Amagufwa akura tukiri bato. Ariko nubwo tuba bakuru, amagufwa yacu ntabwo aba aho gusa. Ahora avugururwa kandi agasanwa. Kimwe no gukuraho amatafari ashaje no gushyiramo andi mashya kugira ngo twubake urukuta, igufwa rishaje rirasenyuka maze igufwa rigahinduka. Ubu buryo twita "guhinduranya amagufwa."

Osteodystrophy y'impyiko ishobora kubaho iyo uku guhinduka kw'amagufwa kwihuta cyane cyangwa gutinda cyane. Hari ubwoko bune bw'ingenzi:

• Osteitis Fibrosa: Iyi ni indwara aho ingingo z'amagufwa zicika vuba cyane. Ibi biterwa no kwiyongera k'umusemburo wa parathyroid (PTH). Ibi byitwa hyperparathyroidism .
• Osteomalacia: Iyi ni indwara aho igufwa ricika intege, ariko amagufwa mashya agatangira gukora buhoro buhoro. Amagufwa ahinduka nk'ikibuno kandi agacika intege. Ibi bishobora guterwa no kubura vitamine D, uburozi bw'icyuma, no gukora cyane kwa hormone FGF23 bitewe n'ubwoko bumwe na bumwe bwa kanseri.
• Indwara y'amagufwa idakora neza: Iyi ni indwara ituma ingirabuzimafatizo z'amagufwa zigabanuka cyane. Impamvu nyamukuru ibitera ni urugero ruto rw'imisemburo ya parathyroid (PTH).
• Indwara ya Mixed Renal Osteodystrophy: Iyi ndwara ihuza ibimenyetso bya Osteitis Fibrosa na Osteomalacia.

Noneho reka tuvuge kuri ubwo bwoko mu buryo burambuye.

Osteitis Fibrosa

Dukunze kumva ko abantu barwaye impyiko zidakira bafite urugero rwinshi rwa hormone ya parathyroid (PTH). PTH niyo ishinzwe kurekura calcium mu magufwa ikayishyira mu maraso kugira ngo igere ku rugero rwa calcium mu maraso. Ariko, iyo urugero rwa PTH ruri hejuru cyane, rukura calcium nyinshi mu magufwa. Ibi bishobora gutuma habaho fibrous cysts mu magufwa, bigatuma amagufwa acika intege.

Hari impamvu nyinshi zishobora gutuma urugero rwa PTH rushobora kwiyongera:

• Kubura kwa Kalisitiriyo: Iyo impyiko zangiritse, ntizishobora gukora Kalisitiriyo neza, ibyo bikaba byongera umusaruro wa PTH.
• Inyongera y'urugero rwa FGF23:Iki gishobora kuba ikimenyetso cy’indwara y’impyiko. Bishobora kandi kuba igisubizo cy’amagufwa kugira ngo urugero rwa fosifore mu maraso ruhagarike kwiyongera.
• Fosifore yiyongera: Mu ndwara y'impyiko idakira, fosifore yirundanya mu maraso kuko impyiko zidashobora kuyikuramo neza. Ibi kandi bitera imbaraga ikorwa rya PTH.

Osteomalacia

Impamvu nyamukuru itera iyi ndwara ni ukubura vitamine D. Ibi bikunze kugaragara ku bantu bafite indwara z'impyiko z'igihe kirekire.

Nanone, ibyuma bimwe na bimwe bishobora gutera osteomalacia bitewe n'uburozi bw'icyuma . Urugero, ibyuma nka aluminiyumu bibangamira ishingwa ry'amagufwa no kuyabungabunga. Mu bihe byashize, imiti imwe n'imwe yakoreshwaga mu kugenzura urugero rwa fosifore (fosifore binders) yari irimo aluminiyumu. Ariko, iyi miti ntabwo ikigirwa inama ku bantu bafite indwara z'impyiko, cyane cyane abari kuri dialyse . Ubu haraboneka imiti idakoresha fosifore ya aluminiyumu. Iyo ifashwe n'ibiryo, ibuza fosifore mu biribwa kwinjira mu maraso.

Hari ubwoko bumwe na bumwe bwa kanseri bushobora gutera ikorwa ryinshi ry’umusemburo wa FGF23, ibyo bikaba byatera osteomalacia no kuvunika amagufwa.

Indwara y'amagufwa idakora neza

Iki ni cyo gihe ingirabuzimafatizo z'amagufwa zigabanuka cyane. Iyi ndwara ikunze kugaragara cyane ku bantu bafite indwara zikomeye z'impyiko ndetse n'abari kuri dialyse. Impamvu nyamukuru ibitera ni uko ingano ya kalisiyumu na vitamine D mu mubiri iba nyinshi cyane . Mu kuvura indwara z'impyiko, rimwe na rimwe kalisiyumu na vitamine D biba ngombwa ko bitangwa. Nubwo ibi bifasha mu gukumira osteodystrophy y'impyiko, iterwa no guhinduka cyane kw'amagufwa, rimwe na rimwe bishobora gutuma urugero rwa hormone ya parathyroid (PTH) rugabanuka cyane.

Hari izindi mpamvu nyinshi:

• Dialysis ihoraho yo mu nda: Ubu ni ubwoko bwa dialysis. Aha, amaraso asukurwa mu nda. Ibi bitandukanye na hemodialysis , ikorwa binyuze mu mutsi uri mu kuboko kwawe. Amwe mu mazi ya dialysis yo mu nda aba arimo kalisiyumu nyinshi. Ibi bishobora gutuma urugero rwa PTH rugabanuka.
• Diyabete: Muri diyabete, kwiyongera kw'isukari mu maraso no kugabanuka k'urugero rwa insuline nabyo bishobora kugabanya umusaruro wa PTH.

Indwara ya Mineral and Bone Disease (CKD-MBD) ni iki?

Iyo uburinganire bw'imyunyu ngugu n'imisemburo mu maraso yacu buhungabanye, bishobora kugira ingaruka ku mutima no ku mitsi y'amaraso. CKD-MBD (Indwara y'impyiko idakira Mineral and Bone Disorder) ni ijambo rigari rikubiyemo indwara nka Osteodystrophy y'impyiko n'izindi ndwara zijyanye n'umutima n'amaraso.

Mu magambo make, iyo kalisiyumu na fosifore mu maraso bikabije, bishobora gutera indwara z'umutima n'imitsi. Impamvu yabyo ni inzira yitwa calcium . Ni ukuvuga ko kalisiyumu yiyongera ikayishyira imbere mu miyoboro y'amaraso. Ibi bishobora gutuma inkuta z'imiyoboro y'amaraso zikomera kandi zigakomera. Ibi byitwa atherosclerosis . Ibi bishobora gutera indwara zikomeye nko kuzamuka k'umuvuduko w'amaraso, indwara z'umutima, na stroke. Tekereza aho ikibazo cy'impyiko gishobora kugera!

Indwara ya Osteodystrophy y'impyiko ikunze kugaragara gute?

Bivugwa ko abantu bakuru bagera kuri 15% muri Leta Zunze Ubumwe za Amerika bafite indwara y’impyiko idakira. Benshi muri bo bashobora kuba bafite ikibazo cy’impyiko mu buryo runaka. Uku kwangirika kw’amagufwa gushobora kwiyongera nyuma y’uko impyiko zinaniwe burundu, ndetse no nyuma yo kuvurwa igihe kirekire. Iki kibazo gikunze kugaragara muri Sri Lanka.

Ni izihe mpamvu zitera indwara ya Osteodystrophy y'impyiko?

Impamvu nyamukuru ni indwara y'impyiko idakira (CKD) . Indwara z'impyiko zibangamira urugero rw'imyunyu ngugu n'imisemburo, ndetse zikanabangamira inzira isanzwe yo gusana amagufwa (guhindura amagufwa). Iyo uku guhinduka kw'amagufwa kwihuta cyane cyangwa gutinda cyane, byombi bishobora gutuma amagufwa adakora neza.

Ni ibihe bimenyetso bya Osteodystrophy y'impyiko?

Ibimenyetso by'ingenzi ni ububabare bw'amagufwa no kuvunika . Hari abantu bashobora kutagira ibimenyetso na gato mu ntangiriro z'indwara. Icyo ni cyo gice giteye ubwoba kurusha ibindi.

Abana bato barwaye impyiko bashobora kugira ikibazo cyo kudakura neza bitewe na osteodystrophy y'impyiko. Bashobora kandi kugira ubumuga bw'amagufwa bwitwa rickets . Rickets ni indwara iterwa n'ubwana bw'umuntu witwa osteomalacia. Ibi bivuze ko amagufwa aba yoroshye kandi agashobora kunama.

Ni gute indwara ya Osteodystrophy y'impyiko ipimwa?

Muganga wawe azagutega amatwi witonze ibimenyetso byawe, amateka y'ubuzima bwawe, ndetse niba hari umuntu wo mu muryango wawe wigeze kugira indwara nk'izo. Hanyuma, azagukorera isuzuma ry'umubiri.

Hari ibizamini byinshi bikoreshwa mu gusuzuma neza iyi ndwara:

• Ibipimo by'amaraso: Ibi bipima urugero rwa kalisiyumu, fosifore, vitamine D, na hormone ya parathyroid (PTH) mu maraso. Bipima kandi ibindi bimenyetso byerekana ko amagufwa agenda neza, nka alkaline phosphatase . Niba ufite indwara y'impyiko igihe kirekire, muganga wawe akunze gukora ibi bipimo by'amaraso kugira ngo arebe niba hari impinduka muri ibi bipimo.
• Gupima amagufwa: Ibi bikubiyemo gufata agace gato k'umubiri mu igufwa ukagapima muri laboratwari. Ibi bishobora gutanga igitekerezo cyiza ku bucucike n'imiterere y'igufwa. Ariko, iki si ikizamini gikunze kugaragara cyane.
• Ikizamini cy’ubucucike bw’amagufwa: Nanone cyitwa DEXA scan , iki gipima imbaraga z’amagufwa yawe n’ibyago byo kuvunika.
• Ibizamini byo gupima: Ibizamini nka X-rays , CT scans , na MRIs bishobora kureba impinduka mu magufwa. CT scans na echocardiograms ( gupima umutima) nabyo bikoreshwa mu gushakisha calcium deposits (calcification) mu mitsi y'amaraso.

Wibuke ko atari buri wese ugomba gukora ibi bizamini byose. Muganga wawe ni we uzaguhitiramo ibizamini bikenewe cyane bitewe n'uko urwaye.

Ni ubuhe buryo bwo kuvura indwara ya renal osteodystrophy?

Uburyo uzavurwa buzaterwa n'ingano y'ibyangiritse ku magufwa yawe, uko indwara y'impyiko yawe iteye, ndetse niba ihindagurika ry'amagufwa yawe ryihuse cyangwa rigenda buhoro. Hari uburyo bwinshi bw'ingenzi bwo kuvura:

• Guhindura imirire: Muganga wawe ashobora kukugira inama yo kurya indyo irimo fosifore nkeya . Ibi bivuze kugabanya ibiryo birimo fosifore nyinshi (ibiryo byatunganyijwe kandi bipakiye) - nk'ibiryo byo mu macupa, noodles zikonje, na sosiso. Niba indwara y'impyiko yawe ikomeye, ushobora kandi gukenera kugabanya ibiryo bifite fosifore nyinshi mu buryo busanzwe (urugero: bimwe mu bikomoka ku mata, imbuto, n'inyama n'amafi zumye).
• Imiti n'inyongeramusaruro: Ibi bishobora gufasha kuringaniza urugero rw'imyunyu ngugu n'imisemburo. Urugero, inyongeramusaruro za kalisiyumu na vitamine D, imiti igabanya urugero rw'imisemburo ya parathyroid (PTH), hamwe n'inyongeramusaruro za fosifore bishobora kwandikirwa. Ubu abaganga bakunze gutanga inama ku miti idafite kalisiyumu ya fosifore kuko kalisiyumu nyinshi ishobora gutera indwara y'amagufwa idakora neza.
• Kubaga Parathyroid: Niba ubundi buryo bwo kuvura butagenze neza, kubagwa bishobora gukorwa. Ibi bikubiyemo gukuraho ingirabuzimafatizo imwe cyangwa nyinshi za parathyroid. Ibi byitwa parathyroidectomy . Ubusanzwe, nibura ingirabuzimafatizo imwe ya parathyroid irasigara. Ibi bishobora gufasha gukumira ko urugero rwa PTH rugabanuka cyane bigatuma amagufwa arwara indwara idakora neza.

Uretse ibi byose, muganga wawe azagufasha no kuvura indwara z'impyiko zawe. Ukurikije gahunda yo kuvura neza, ushobora kwirinda kwangirika kw'amagufwa yawe.

Ese indwara ya Osteodystrophy y'impyiko ishobora kwirindwa?

Biragoye kwirinda burundu indwara y’impyiko (Renal Osteodystrophy). Ariko, iyo ufashe neza indwara zidakira z’impyiko (CKD), iyi ndwara ishobora kugenzurwa kandi igakomeza kwiyongera..Ibyo bivuze ko gufata imiti yandikiwe na muganga ku gihe, gukurikiza indyo yandikiwe, no gukora ubuvuzi bwa dialyse neza ni ingenzi cyane. Nanone, gukora imyitozo ngororamubiri, kureka kunywa itabi, no kugabanya inzoga nabyo birafasha.

Ni iki umuntu urwaye impyiko (Renal Osteodystrophy) ashobora kwitega?

Nta muti urambye w'iyi ndwara uretse guterwa impyiko . Abantu bafite indwara y'impyiko igihe kirekire batakaza imikorere y'impyiko buhoro buhoro. Abantu benshi amaherezo bagira impyiko zinanirwa burundu kandi bagakenera dialyse. Indwara yo mu impyiko ni ikibazo gikunze kugaragara muri iki gikorwa.

Nanone, abantu benshi barwaye indwara z'impyiko zidakira nabo barwara indwara z'umutima. Indwara z'umutima ni zo zitera impfu nyinshi ziturutse ku kunanirwa kw'impyiko.

Ariko ntugire ikibazo. Muganga wawe azahora asuzuma urugero rw'imyunyu ngugu n'imisemburo yawe, kandi azaguhe inama zo kuvura amagufwa n'umutima wawe.

Ni ryari ugomba kuvugana na muganga?

Niba ufite indwara y'impyiko idakira (CKD), menya neza ko wabibwiye muganga wawe niba ubabara amagufwa cyangwa ugakomera . Bishobora kuba ikimenyetso cy'indwara y'impyiko.

Abantu benshi bamenya gusa ko bafite indwara y'impyiko idakira iyo imaze gukomera. Kubwibyo, kwisuzumisha kwa muganga buri gihe bishobora gufasha kumenya indwara y'impyiko hakiri kare. Iyo bibaye, ushobora gufata ingamba zo kuyirinda ko ikomeza kwiyongera. Ibi ni ingenzi cyane cyane niba ufite ibyago byo kurwara impyiko (urugero: kuba ufite umubyibuho ukabije, kurwara diyabete, kuba ufite amateka y'indwara y'impyiko mu muryango wawe, indwara y'umutima, cyangwa umuvuduko ukabije w'amaraso).

Ubutumwa bwo kujyana mu rugo

Sawa, reka dusubiremo bimwe mu bintu ugomba kwibuka mu byo twavuze:

• Osteodystrophy y'impyiko ni indwara y'amagufwa iterwa n'indwara y'impyiko idakira (CKD).
• Iyo impyiko zidakora neza, urugero rwa kalisiyumu, fosifore, na vitamine D mu maraso ruba rudakora neza, kandi amagufwa ashobora gucika intege.
• Kubabara amagufwa no kuvunika ni byo bimenyetso by'ingenzi, ariko bishobora kugaragara ko nta bimenyetso byabyo bya mbere.
• Abaganga bapima iyi ndwara binyuze mu gupima amaraso no gupima.
• Ubuvuzi burimo kugenzura indyo, imiti, ndetse rimwe na rimwe no kubagwa.
• Uburyo bwiza bwo kugenzura iyi ndwara ni ugufata neza indwara z'impyiko.
• Niba ufite indwara y'impyiko kandi ukumva ububabare mu magufwa yawe, hita ubonana na muganga.
• Gusuzumwa kwa muganga buri gihe bishobora gufasha kumenya indwara y'impyiko hakiri kare.

Nubwo iyi ndwara idashobora gukira burundu, iyo uyivuje neza kandi ugakurikiza inama za muganga, ushobora gukomeza ubuzima bwiza. Ntugatinye rero, vugana na muganga wawe, kandi ukore ibikenewe byose.

` Osteodystrophy y'impyiko, indwara y'impyiko, indwara y'amagufwa, kalisiyumu, fosifore, vitamine D, imisemburo ya parathyroid, CKD-MBD