Chirwere cheshuga chinokanganisawo itsvo here? Ngatizivei nezvechirwere chetsvo chechirwere cheshuga!

Une chirwere cheshuga here? Kana kuti mumwe munhu mumhuri mako kana shamwari yako ane chirwere cheshuga here? Saka pamwe unoziva nezvematambudziko akasiyana-siyana anouya nechirwere cheshuga. Dzimwe nguva tinogona kutya nekuti hatizivi zvizere nezvazvo. Nhasi tichataura nezvemigumisiro iyo chirwere cheshuga chinogona kuita paitsvo dzedu. Izvi zvinonzi Chirwere cheKidney cheDiabetic (DKD).

Chii chinonzi Diabetic Kidney Disease (Diabetic Kidney Disease)?

Zvichitaurwa zviri nyore, izvi zvinokanganisa itsvo dzako nekuda kwechirwere cheshuga. Tinoziva kuti itsvo mbiri dziri mumuviri wedu dzinosefa ropa dzobvisa tsvina . Funga nezveitsvo semafirita maviri makuru mumuviri wedu. Izvi zvinosefa tsvina ine nitrogen, semuenzaniso urea, tsvina inobva mutsandanyama (creatinine), nezvimwe zvinhu zvakawanda zvine chepfu uye zvinozviburitsa muweti. Kwete izvozvo chete, itsvo dzinobatsirawo kuchengetedza kuenzana kwemvura nema electrolytes mumuviri.

Itsvo imwe neimwe ine mayuniti madiki ekusefa anopfuura miriyoni anonzi manephrons. Mukati memanephrons aya, mitsipa midiki yeropa yakabatana kuti igadzire chimiro chakaita semesh chinonzi glomeruli. Kutaura zvazviri, maglomeruli aya ndiwo danho rekutanga mukusefa ropa. Anobvumira mvura netsvina yakanyungudutswa kuti zvipfuure nepakati pemamembrane avo anopindika zvishoma, ayo anozoburitswa mumuviri seweti.

Zvino tarisai, chii chinoitika kumuviri wemunhu ane chirwere cheshuga? Muviri wavo haugone kushandisa shuga yatinowana kubva muchikafu chatinodya nemazvo, kureva kuti, `(glucose)`. Ipapo huwandu hwe`(glucose)` muropa hunowedzera. Kana huwandu uhwu hwakawanda hwe`(glucose)` huchiripo kwenguva yakareba, ma membrane akapfava e`(glomeruli)` iwayo anotanga kukuvara. Uye zvimwe zvikamu zve`(nephron)` zvinogonawo kukuvara. `(glomeruli)` zvinokuvadzwa nenzira iyi hazvigone kusefa ropa nemazvo. Zvadaro, chinoitika ndechekuti chepfu dzinofanira kuburitswa nemuto dzinotanga kuungana mumuviri.

Mamiriro ezvinhu aya akakomba here?

Ehe, chirwere cheitsvo chinokonzerwa nechirwere cheshuga chirwere chakakomba . Kana chikasatarisirwa zvakanaka, chinogona kupedzisira chakonzera kutadza kushanda kweitsvo . Kukundikana kushanda kweitsvo kunogona kuisa hupenyu panjodzi. Saka, zvakakosha kuziva izvi.

Matanho api echirwere cheitsvo chinokonzerwa nechirwere cheshuga?

EGFR inzira yekuyera mashandiro ari kuita itsvo dzako. EGFR ipfupiso yehuwandu hwe glomerular filtration. Muchidimbu, inhamba yekuti itsvo dzako dzinosefa tsvina zvakadii. EGFR yemunhu ane hutano inenge 100. Kukosha uku kunogona kuderera kusvika pa0, zvinoreva kuti itsvo dzako hadzisi kushanda zvachose.

Kune matanho akati wandei echirwere cheitsvo, kusanganisira chirwere cheitsvo chinokonzerwa nechirwere cheshuga:

• Danho rekutanga:GFR yako iri pa90 kana kupfuura. Panguva ino, itsvo dzako dzingave dzakakuvara, asi dzichiri kushanda zvakanaka.
• Danho rechipiri: GFR inogona kuva pakati pe60 ne89. Itsvo dzakakuvara zvakanyanya kupfuura mudanho rekutanga, asi dzichiri kushanda zvakanaka.
• Danho rechitatu: GFR inogona kuva pakati pe30 ne59. Panguva ino, mashandiro eitsvo anogona kuderera zvishoma kana zvakanyanya.
• Danho rechina: GFR inogona kuva pakati pe15 ne29. Izvi zvinoreva kuti mashandiro eitsvo aderera zvakanyanya.
• Danho rechitatu: GFR iri pasi pe15. Izvi zvinoreva kuti itsvo dzava pedyo nekukundikana zvachose, kana kuti dzakundikana.

Ndiani ane mukana mukuru wekuwana chirwere ichi? Ndezvipi zvinhu zvinokonzera njodzi?

Munhu wese ane chirwere cheshuga cherudzi rwekutanga kana rwechipiri anogona kurwara neitsvo. Zvisinei, vamwe vanhu vari panjodzi huru. Semuenzaniso:

• Vanhu vatema
• Vanhu vekuAmerica, vekuAlaska, kana kuti veMarudzi Ekutanga
• Vanhu vekuPolynesia
• Vanhu vechiMaori

Kune zvimwe zvinhu zvinokonzera njodzi:

• Kuva nechirwere cheitsvo mumhuri.
• Kuva neBP yakakwira.
• Kushandisa zvigadzirwa zvefodya (zvakaita sefodya).
• Hyperglycemia chirwere apo huwandu hweshuga muropa hunogara hwakakwira.
• Mafuta akawanda muropa (hyperlipidemia).

Chirwere ichi chakajairika zvakadii?

Chirwere cheitsvo chinokonzerwa nechirwere cheshuga chirwere chinowanzoitika . Ndicho chinokonzera chirwere cheitsvo chinosvika padanho rekupedzisira pasi rose. Zvinofungidzirwa kuti vanhu vanosvika 40% vane chirwere cheshuga vanowana chirwere ichi cheitsvo.

Ndezvipi zviratidzo zvechirwere cheitsvo chinokonzerwa nechirwere cheshuga?

Kazhinji, zviratidzo zviri pachena hazvionekwi kusvika 80% kusvika 90% yeitsvo dzakuvara. Kana zviratidzo zvikaonekwa, unogona kuona zvinhu zvakaita se:

• Kuzvimba kwechiso, maoko, nemakumbo (edema).
• Kusvotwa nekurutsa.
• Kunzwa kuneta kana kuneta nguva dzose.
• Kutadza kufema zvakanaka (dyspnea).
• Chikafu hachina kunaka.
• Weti ine furo kana kuti inobuda matumbu.
• Kuomerwa nekuisa pfungwa pachinhu chimwe chete kana kunzwa kuvhiringidzika.
• Ganda rakaoma uye rinokwenya.
• Kurwadziwa kwetsandanyama.
• Kuda kuderedza huwandu hweinsulin inotorwa (kune avo vanotora mishonga yechirwere cheshuga).

Ndezvipi zviratidzo pakutanga?

Chirwere cheitsvo chinokonzerwa nechirwere cheshuga kazhinji hachiratidzi zviratidzo pakutanga.Ungave uine mapuroteni muweti yako (proteinuria). Asi izvi zvinongoonekwa chete nachiremba anoita weti yacho.

Chii chinokonzera izvi? Zvinotapukira here?

Chikonzero chikuru cheizvi ndechekuva nechirwere cheshuga cherudzi rwekutanga kana rwechipiri.

Kwete, ichi hachisi chirwere chinotapuriranwa. Haugone kuparadzira chirwere ichi kune mumwe munhu.

Ungaziva sei kana uine chirwere cheitsvo nekuda kwechirwere cheshuga?

Kana uine chirwere cheshuga, zvakakosha kuti uone chiremba wako mwedzi mitatu kusvika mitanhatu yega yega kuti aongororwe, sezvakakurudzirwa nachiremba wako. Kana chiremba wako achifungidzira kuti une chirwere cheitsvo chinokonzerwa nechirwere cheshuga, achakuraira kuti uongororwe zvimwe zvirwere.

Ndedzipi bvunzo dzinoitwa kuti zvionekwe izvi?

Miedzo inotevera inobatsira pakuongorora chirwere ichi:

• Kuongororwa kweweti:

Izvi zvinosanganisira kutora sampuro yeweti yako woiongorora kuti ionekwe sei, kuti yakagadzirwa sei, uye kuti ine makemikari api, uye kuti ionekwe nemicroscope. Chiremba wako anogona kushandisa dipstick kuita bvunzo iyi. Anogonawo kukurudzira mhando dzakasiyana dzebvunzo dzeweti. Mubvunzo we dipstick, unowetisa mumudziyo wakakosha. Wobva waisa bepa (dipstick) rine makemikari akaiswa pairi. Kana paine protein (albumin) muweti, chidimbu chacho chinochinja ruvara.

Kana chiremba wako achida kuyerwa kwakanyatsojeka, anogona kuraira kuti uongorore mapuroteni emuweti . Izvi zvinosanganisira kutumira sampuro yeweti yako kurabhoritari kuti ione huwandu hweprotein necreatinine muweti yako (protein-to-creatinine ratio). Kana huwandu uhwu hwakanyanya, hunogona kuva chiratidzo chechirwere cheitsvo chinokonzerwa nechirwere cheshuga.

• Kuongororwa kweropa:

Kuongororwa kwe eGFR kunoyera kugona kweitsvo dzako kusefa ropa. Chiremba wako achatora ropa shoma kubva mutsinga iri muruoko rwako uye achashandisa huwandu hwe creatinine muropa pamwe neruzivo rwehutano kuti averenge eGFR yako.

• Miedzo yemifananidzo:

Miedzo iyi inogona kubatsira chiremba wako kuti azive hutano hweitsvo dzako.

• Kuongororwa kweUltrasound: Izvi zvinogona kutarisa chimiro nehukuru hweitsvo.
• MRI neCT scans: Izvi zvinonyatsoona mitsipa yeropa uye ropa rinoenda kuitsvo.

• Kuongororwa kweitsvo:

Mukuita uku, chiremba anotora kanyama kadiki kubva muitsvo yako okaongorora nemaikorosikopu murabhoritari. Usati waita izvi, nzvimbo yacho inenge yaoma zvekuti haunzwi kurwadziwa. Achakupawo mushonga wekurerutsira kuti unzwe kugadzikana. Zvadaro, tsono inopinzwa nepaganda ichipinda muitsvo uye sampuli yenyama inotorwa.

Ndezvipi zvinorapwa izvi?

Kurapwa kunoenderana nedanho rechirwere chako, zera rako, uye hutano hwako hwese. Kudzora chirwere chako cheshuga ndiyo nhanho yekutanga mukurapa chirwere ichi cheitsvo. Zvinhu zvinotevera zvinogona kukubatsira kudzora chirwere chako cheshuga:

• Isa zvekudya zvakawanda zvine fiber yakawanda, mafuta mashoma uye macalorie mashoma mukudya kwako.
• Kurovedza muviri nguva dzose.
• Kudzora huremu hwemuviri.
• Rega kusvuta kana kushandisa zvimwe zvigadzirwa zvefodya.

Kana uine BP yakakwira, zvakakoshawo kuirapa. Chiremba wako anogona kukupa mishonga yeBP yakakwira.

Kukuvara kweitsvo kunogona kugadziriswa here?

Kwete, kukuvara kweitsvo kunokonzerwa nechirwere cheshuga hakugone kugadziriswa zvachose. Zvisinei, unogona kudzora, kuderedza kumhanya, uye pamwe kutomisa kukuvara kweitsvo nekutora mishonga yako sezvakarairwa nachiremba wako, kutevedzera kudya kwakanaka, uye kuramba uchiita maekisesaizi.

Mishonga ipi inopihwa nekuda kweizvi?

Kuti urarame nechirwere cheshuga, zvakakosha kudzora chirwere chako cheshuga, kuderedza BP, uye kuderedza cholesterol. Chiremba wako anogona kukupa mishonga inotevera yekurapa zvirwere izvi:

• Kune chirwere cheshuga:
• MaBiguanides (semuenzaniso metformin): Aya anoderedza huwandu hweshuga inogadzirwa muchiropa chako. Anovandudzawo mashandiro anoita insulin mumuviri, zvichideredza mwero wekushandurwa kwemakabhohaidhiretsi kuita shuga.
• Mishonga inodzivirira shuga yeSodium-glucose cotransporter 2 (SGLT2): Inobatsira itsvo kubvisa shuga mumuviri kuburikidza neitsvo nemuweti.
• Maagonist eGlucagon-like peptide 1 (GLP-1): Aya anowedzera kuburitswa kweinsulin, anoderedza kuburitswa kweglucose kubva muchiropa mushure mekudya, uye anonotsa kubuda kwemafuta mudumbu. Izvi zvinogonawo kubatsira nekudzikisa uremu.

• Kune BP yakakwira:
• Angiotensin-converting enzyme (ACE) inhibitors: Izvi zvinodzivisa kugadzirwa kwehomoni inonzi angiotensin II. Muviri unoshandisa homoni iyi nenzira yechisikigo kudzora BP. Mushure mekurapwa nemishonga inodzivirira ACE, BP inofanira kuderera.
• Angiotensin II receptor blockers (ARBs): Izvi zvinomisa hormone angiotensin II kuti isasungane nemareceptors ari patsinga dzeropa. MaARB anoshanda nenzira yakafanana neACE inhibitors, zvichideredza BP.

Zvakakosha: Pamusoro pekuderedza BP, mishonga inodzivirira ACE neARBs inobatsirawo kuderedza kufambira mberi kwechirwere cheitsvo chinokonzerwa nechirwere cheshuga.

• Kune cholesterol yakakwira:
• MaStatins: Aya anoderedza cholesterol yakaipa uye anowedzera cholesterol yakanaka. Anogona kubatsira kune vamwe vanhu vane chirwere cheitsvo chinokonzerwa nechirwere cheshuga.

Chii chinorapwa kana chirwere chikawedzera?

Kana chirwere cheshuga cheitsvo chikanyanya, nzira dzekurapa dzinosanganisira:

• Dialysis: Kana itsvo dzako dzisiri kushanda zvakanaka, dialysis inogona kushanda paitsvo dzako. Mukuita izvi, muchina unotora ropa rako, wobvisa tsvina nemvura yakawandisa, wodzosera ropa rakacheneswa mumuviri wako.
• Kuisirwa itsvo: Muizvi, unowana itsvo ine hutano kubva kune mumwe munhu (anopa itsvo).

Ungadzivirira sei chirwere ichi?

Nzira yakanakisisa yekudzivirira chirwere cheitsvo chine chirwere cheshuga ndeyekutarisira chirwere chako cheshuga neBP zvakanaka. Zvakakosha kutevedzera hurongwa hwekurapa hwaunorayirwa nachiremba wako nemazvo.

Chii chingatarisirwa nemunhu ane chirwere ichi?

Chirwere cheitsvo cheshuga chirwere chinokura zvishoma nezvishoma . Kana uine chirwere ichi, kukuvara kweitsvo dzako hakugone kugadziriswa. Zvisinei, kana ukabatwa nechirwere ichi nekukurumidza uye ukatevera hurongwa hwakakodzera hwekurapa, unogona kuderedza kana kutomisa kufambira mberi kwechirwere.

Kana chirwere ichi chikanyanya kuipa, chinogona kukonzera kutadza kushanda kweitsvo, izvo zvinogona kuisa hupenyu panjodzi. Nzira dzekurapa kutadza kushanda kweitsvo dzinosanganisira dialysis kana kuisirwa itsvo.

Ndinofanira kuzvitarisira sei?

Chiremba wako achakubatsira kugadzira hurongwa hwekurapa hwakakunakira. Hunogona kusanganisira mishonga uye shanduko dzemararamiro. Hurongwa hwako hwekurapa hunogona kusanganisira:

• Kutora mishonga yechirwere cheshuga neBP yakanyorwa nachiremba nemazvo.
• Tarisa huwandu hweshuga muropa rako uye BP yako nguva nenguva.
• Kutevera kudya kune hutano (senge kudya kweMediterranean kana kudya kweDASH).
• Edza kurovedza muviri kwemaminitsi makumi matatu pazuva mazuva mazhinji evhiki. Edza kurovedza muviri kwemaminitsi zana nemakumi mashanu pavhiki. Unogona kufamba, kumhanya, kuchovha bhasikoro, kushambira, kana kuita chero chimwe chiitiko chemwoyo chaunoda.
• Kudzivisa mishonga inogona kukuvadza itsvo. Izvi zvinogona kusanganisira mishonga inoderedza marwadzo (mishonga isingashandisi steroidal inorwisa kuzvimba - NSAIDs).
• Kuchengeta nguva yekuonana nachiremba uye kuita bvunzo dzese dzemurabhoritari.
• Rega kusvuta kana kushandisa zvimwe zvigadzirwa zvefodya.
• Kuderedza huwandu hwedoro raunonwa.
• Rara pakati pemaawa manomwe nemapfumbamwe husiku hwega hwega.

Ndinofanira kuona chiremba rini?

Kana uine chirwere cheshuga, unofanira kuona chiremba wako nguva dzose mwedzi mitatu kusvika mitanhatu yega yega, sezvakakurudzirwa nachiremba wako.

Kana uine chirwere cheshuga, chiremba wako anokurudzira kuongororwa gore rega rega kwechirwere cheshuga , kutanga makore mashanu mushure mekuonekwa kwako. Kukuvara kweitsvo kazhinji hakuonekwi mukati memakore gumi ekutanga mushure mekuonekwa kwako uine chirwere cheshuga. Kana wave nemakore anopfuura makumi maviri nemashanu uine chirwere cheshuga uye itsvo dzako dzisina kukuvara, mikana yako yekubatwa nechirwere cheshuga ishoma.

Mibvunzo ipi yandinofanira kubvunza chiremba?

Zvakakosha kubvunza mibvunzo yakaita seiyi kana ukaenda kuna chiremba wako:

• Unoziva sei kana ndine chirwere cheitsvo nekuda kwechirwere cheshuga?
• Ndinofanira kuona chiremba wepfungwa kana mumwe nyanzvi here?
• Ndedzipi bvunzo dzamunoita kuti muone kana chirwere cheitsvo chine chekuita nechirwere cheshuga?
• Chirwere changu chetsvo cheshuga chakakomba zvakadini?
• Ndezvipi zvandingashandura mararamiro angu kuti ndideredze kana kumisa kufambira mberi kwechirwere changu cheitsvo chinokonzerwa nechirwere cheshuga?
• Mishonga ipi yaunokurudzira?
• Ndeapi marapirwo amunokurudzira?
• Ndinofanira kuuya kakawanda sei kuzosangana nevamwe?
• Unogona here kukurudzira mapoka ekutsigira vanhu vane chirwere cheitsvo chinokonzerwa nechirwere cheshuga?

Iri ndiro shoko rakakosha randinofanira kukupai...

Kukuvara kweitsvo kunokonzerwa nechirwere cheshuga chirwere chakakomba. Chinogona kufambira mberi kusvika pakutadza kushanda kweitsvo, izvo zvinoisa hupenyu panjodzi. Kana chiremba wako akakuongorora kuti une chirwere cheitsvo chine chekuita nechirwere cheshuga, zvakajairika kuti unzwe kutya uye kusuruvara. Zvisinei, kana ukabatwa nechirwere ichi nekukurumidza uye ukatevera hurongwa hwako hwekurapwa nokungwarira, unogona kuderedza kana kutomisa kufambira mberi kwechirwere cheitsvo chine chekuita nechirwere cheshuga.

Kurapwa chirwere chakadai kunogona kushungurudza mupfungwa. Asi yeuka kuti chiremba wako aripo kuti akubatsire. Akazvipira kupindura mibvunzo yako yese uye kukubatsira kuchengetedza hupenyu hwako hwakanaka. Saka usatya kutaura nachiremba wako nezve zvese zviri mupfungwa dzako.

Chirwere cheshuga , Chirwere cheItsvo, Chirwere cheItsvo cheShuga, DKD, Nephropathy, eGFR, Kuongororwa kweWeti, Dialysis