Matambudziko eitsvo ako anogona kukanganisa mapfupa ako here? Ngatidzidzei nezveRenal Osteodystrophy!

Une chirwere cheitsvo here, kana kuti icho isu vanachiremba vanoti chirwere cheitsvo chisingaperi (CKD) ? Kana kuti unoziva mumwe munhu ane chirwere ichi here? Vanhu vazhinji vanofunga kuti patinoti chirwere cheitsvo, chinongokanganisa itsvo chete. Asi chokwadi ndechekuti, kana itsvo dzedu dzikasashanda zvakanaka, zvinogona kukanganisa zvakanyanya mamwe masisitimu emuviri, kunyanya mapfupa edu, kureva mapfupa edu . Saka, nhasi tichataura nezvechirwere umo mapfupa edu anoshaya simba uye zvichikonzera matambudziko nekuda kwechirwere cheitsvo. Izvi zvinonzi renal osteodystrophy . Kunyangwe zita racho rakaoma zvishoma, ngatirinzwisisei zviri nyore.

Chii chinonzi Osteodystrophy yeRenal?

Zvichitaurwa zviri nyore, Renal Osteodystrophy chirwere chemapfupa chinogona kubata vakuru nevana vane chirwere cheitsvo chisingaperi (CKD).

Zvino, tarisai, itsvo dzedu dzine basa rakakosha zvikuru. Ndiko kudzora huwandu hwemaminerari akaita secalcium nephosphorus muropa redu. Zvakare, itsvo dzinoita basa rekuita kuti vhitamini D ishande uye kugadzira hormone inonzi calcitriol , iyo inobatsira kuchengetedza mapfupa edu akasimba.

Saka, kana itsvo dzikatadza kushanda zvakanaka kana kuti dzikasashanda zvakanaka, hadzigoni kudzora huwandu hwemaminerari aya nehomoni inonzi calcitriol. Ndipo panotanga kupera simba mapfupa edu zvishoma nezvishoma . Izvi zvinowedzera njodzi yekuti mapfupa aputsike nyore nyore, zvichireva kuti anotyoka .

Ndezvipi zvicherwa nemahormone zvinobatsira kuchengetedza mapfupa edu akasimba?

Kune zvicherwa zvakakosha nemahormone anobatsira kuchengetedza mapfupa edu akasimba uye ane hutano. Ngatidzidzei zvishoma nezvazvo.

• Calcium: Ichi ndicho chinhu chikuru chinoumba mapfupa edu. Mapfupa akafanana ne "calcium bank" mumuviri wedu. Calcium haingosimbisi mapfupa chete, asiwo inokosha kune zvimwe zvinhu zvakawanda, zvakaita sekushanda kwetsinga uye mashandiro emhasuru. Itsvo dzedu dzinobatsira kuyera huwandu hwecalcium muropa.
• Phosphorus: Kufanana necalcium, phosphorus chinhu chakakoshawo mumapfupa. Itsvo dzedu dzinobvisa phosphorus yakawandisa iyo muviri usingade uye dzinochengetedza chiyero chakakodzera pakati pecalcium nephosphorus muropa.
• Calcitriol: Iyi ndiyo mhando inoshanda yevhitamini D. Inogadzirwa neitsvo dzedu. Hormone iyi inobatsira kudzora huwandu hwecalcium inotorwa nemiviri yedu kubva muzvikafu zvatinodya uye inobatsirawo mashandiro egland redu reparathyroid.
• Chinhu Chinokura Fibroblast 23 (FGF23):Iyi ihormone inogadzirwa nemapfupa edu. Inobatsira kudzora huwandu hwephosphorus nevhitamini D. Huwandu hweFGF23 hunowanzo kukwira muvanhu vane chirwere cheitsvo chisingaperi.
• Hormone yeParathyroid (PTH): Hormone iyi inogadzirwa nematumbu mana madiki ari kuseri kwegomarara rethyroid mumutsipa medu. Aya anonzi matumbu eparathyroid. Basa rehomoni iyi yePTH nderekuburitsa calcium kubva mumapfupa kana muviri uchida calcium uye kuchengetedza huwandu hwecalcium muropa hwakagadzikana.

Ndeapi marudzi makuru eOsteodystrophy yeRenal?

Mapfupa anokura patinenge tiri vadiki. Asi kunyangwe patinenge tava vakuru, mapfupa edu haangogari ipapo chete. Anogara achivandudzwa uye achigadziriswa. Kufanana nekubvisa zvidhinha zvekare nekuisa zvitsva kuti uvake rusvingo, mapfupa ekare anoputsika uye mapfupa matsva anoumbwa. Tinodana maitiro aya kuti "kutendeuka kwemapfupa."

Osteodystrophy yeRenal inogona kuitika kana kushanduka kwemapfupa uku kuchikurumidza kana kuti kuchinonoka. Kune mhando ina huru:

• Osteitis Fibrosa: Ichi chirwere apo mapfupa anoputsika nekukurumidza. Izvi zvinokonzerwa nekuwedzera kwemazinga eparathyroid hormone (PTH). Izvi zvinonzi hyperparathyroidism .
• Osteomalacia: Ichi chirwere apo mapfupa anoputsika, asi mapfupa matsva anoumbwa zvishoma nezvishoma. Mapfupa anova seasina simba uye asina simba. Izvi zvinogona kukonzerwa nekushaikwa kwevhitamini D, chepfu yesimbi, uye kugadzirwa kwakawandisa kwehomoni yeFGF23 nekuda kwemamwe marudzi ekenza.
• Chirwere cheMapfupa Chinochinja-chinja: Ichi chirwere chinoita kuti kuumbwa kwemapfupa kuwedzere uye kugadziriswa kwawo kushoma. Chikonzero chikuru cheizvi ihuwandu hwakaderera hwehomoni yeparathyroid (PTH).
• Osteodystrophy yeRenal Mixed: Chirwere ichi chinosanganisira zviratidzo zveOsteitis Fibrosa neOsteomalacia.

Zvino ngatitaurei nezvemhando idzi zvakadzama.

Osteitis Fibrosa

Tinowanzonzwa kuti vanhu vane chirwere cheitsvo chisingaperi vane huwandu hwakakwira hwe parathyroid hormone (PTH). PTH ndiyo inoburitsa calcium kubva mumapfupa ichipinda muropa kuti ienzanise huwandu hwecalcium muropa. Zvisinei, kana huwandu hwePTH hwakanyanya, hunodhonza calcium yakawandisa kubva mumapfupa. Izvi zvinogona kukonzera kuumbwa kwefibrous cysts mukati memapfupa, zvichiita kuti mapfupa asave nesimba.

Kune zvikonzero zvakawanda nei huwandu hwePTH hunogona kuwedzera:

• Kushaikwa kweCalcitriol: Kana itsvo dzikakuvara, hadzigone kugadzira calcitriol nemazvo, izvo zvinowedzera kugadzirwa kwePTH.
• Kuwedzera kwemazinga eFGF23:Ichi chinogona kuva chiratidzo chekutanga chechirwere cheitsvo. Chinogonawo kuva mhinduro inobva kumapfupa yekumisa huwandu hwephosphorus muropa kuti husawedzere.
• Kuwedzera kwephosphorus: Muchirwere cheitsvo chisingaperi, phosphorus inoungana muropa nekuti itsvo hadzikwanise kuibvisa nemazvo. Izvi zvinokurudzirawo kugadzirwa kwePTH.

Osteomalacia

Chikonzero chikuru chechirwere ichi kushomeka kwevhitamini D. Izvi zvinowanzoitika kuvanhu vane chirwere cheitsvo kwenguva refu.

Uyewo, dzimwe simbi dzinogona kukonzera osteomalacia nekuda kwechepfu yesimbi . Semuenzaniso, simbi dzakadai searuminiyamu dzinokanganisa kuumbwa nekuchengetedzwa kwemapfupa. Kare, mimwe mishonga yaishandiswa kudzora huwandu hwephosphorus (phosphate binders) yaive nearuminiyamu. Zvisinei, mishonga iyi haichakurudzirwi kuvanhu vane chirwere cheitsvo, kunyanya avo vari padialysis . Mishonga inosunga phosphorus isiri yearuminiyamu ikozvino yavepo. Kana ikatorwa nechikafu, inodzivirira phosphorus iri muchikafu kuti isanyudzwe muropa.

Mamwe marudzi egomarara anogonawo kukonzera kugadzirwa kwakanyanya kwehomoni yeFGF23, izvo zvinogona kukonzera osteomalacia uye kutyoka kwemapfupa.

Chirwere cheMapfupa Adynamic

Apa ndipo padzikira kuumbwa nekugadziriswa kwemapfupa. Dambudziko iri rinonyanya kuitika kuvanhu vane chirwere cheitsvo chakakomba uye avo vari pa dialysis. Chikonzero chikuru cheizvi ndechekuti huwandu hwecalcium nevhitamini D mumuviri hwakanyanya . Pakurapa chirwere cheitsvo, dzimwe nguva calcium nevhitamini D zvinofanirwa kupihwa. Kunyangwe izvi zvichibatsira kudzivirira osteodystrophy yeitsvo, iyo inokonzerwa nekuchinja kwemapfupa zvakanyanya, dzimwe nguva zvinogona kukonzera kuti huwandu hweparathyroid hormone (PTH) hudzikire zvakanyanya.

Kune zvimwe zvikonzero zvakawanda:

• Kuongororwa kweropa mudumbu kunoenderera mberi: Iyi imhando yekuongorora ropa. Pano, ropa rinocheneswa mukati medumbu. Izvi zvakasiyana nekuongorora ropa mudumbu , uko kunoitwa kuburikidza netsinga iri muruoko rwako. Mamwe ma fluid ekuongorora ropa mudumbu ane calcium yakawanda. Izvi zvinogona kukonzera mazinga ePTH akaderera.
• Chirwere cheshuga: Muchirwere cheshuga, kuwedzera kweshuga muropa uye kudzikira kwemazinga e insulin kunogonawo kuderedza kugadzirwa kwePTH.

Chii chinonzi CKD-MBD (Chronic Kidney Disease-associated Mineral and Bone Disorder)?

Kana kuenzana kwemaminerari nemahormone muropa redu kukakanganiswa, zvinogona kukanganisa mwoyo yedu netsinga dzeropa. CKD-MBD (Chronic Kidney Disease Mineral and Bone Disorder) izwi guru rinosanganisira zvirwere zvakaita seRenal Osteodystrophy nezvimwe zvirwere zvemwoyo.

Zvichitaurwa zviri nyore, kana calcium ne phosphorus muropa zvakawandisa, zvinogona kukonzera chirwere chemwoyo. Chikonzero cheizvi inzira inonzi calcification . Kureva kuti, calcium inoungana uye inoisa mukati metsinga dzeropa. Izvi zvinogona kukonzera kuti madziro etsinga dzeropa akobvu uye aome. Izvi zvinonzi atherosclerosis . Izvi zvinogona kutungamira kuzvirwere zvakakomba zvakaita seBP, chirwere chemwoyo, uye sitiroko. Fungidzira kuti dambudziko reitsvo rinogona kusvika papi!

Osteodystrophy yeRenal inowanikwa zvakadii?

Zvinofungidzirwa kuti vanhu vakuru vanosvika 15% muUnited States vane chirwere cheitsvo chisingaperi. Vazhinji vavo vanogona kunge vaine chirwere cheitsvo chinonzi osteodystrophy. Kukuvara kwemapfupa uku kunogona kuwedzera kana itsvo dzatadza kushanda zvakanaka, uye mushure mekushandisa dialysis kwenguva refu. Dambudziko iri rinowanzoitikawo muSri Lanka.

Ndezvipi zvikonzero zveOsteodystrophy yeRenal?

Chikonzero chikuru chirwere cheitsvo chisingaperi (CKD) . Chirwere cheitsvo chinokanganisa huwandu hwemaminerari nemahormone, uye chinokanganisawo maitiro akajairika ekugadzirisa mapfupa (kuchinja kwemapfupa). Kana kuchinja uku kwemapfupa kuchikurumidza kana kuti kuchinonoka, zvese zvinogona kukonzera mapfupa asina simba.

Ndezvipi zviratidzo zveOsteodystrophy yeRenal?

Zviratidzo zvikuru kurwadziwa kwemapfupa nekutyoka . Vamwe vanhu vanogona kunge vasina zviratidzo zvachose pakutanga kwechirwere. Ndiyo nzvimbo inotyisa zvikuru.

Vana vadiki vane chirwere cheitsvo vanogona kunonoka kukura nekuda kwechirwere cheitsvo chinonzi osteodystrophy. Vanogonawo kuva nemapfupa akaremara anonzi ma rickets . Ma rickets chirwere chinoitika pahudiki chinonzi osteomalacia. Izvi zvinoreva kuti mapfupa anova akapfava uye anogona kukotama.

Osteodystrophy yeRenal inoonekwa sei?

Chiremba wako achanyatsoteerera zviratidzo zvako, nhoroondo yako yehutano, uye kana paine mumwe munhu mumhuri mako akamborwara zvakafanana. Zvadaro, vachaongorora muviri wako.

Kune nzira dzakasiyana-siyana dzekuongorora chirwere ichi:

• Kuongororwa kweropa: Izvi zvinoongorora huwandu hwecalcium, phosphorus, vhitamini D, uye parathyroid hormone (PTH) muropa. Zvinoyerawo zvimwe zviratidzo zvekuchinja kwemapfupa, zvakaita sealkaline phosphatase . Kana uine chirwere cheitsvo kwenguva refu, chiremba wako anowanzoita bvunzo idzi dzeropa kuti aone kana paine shanduko muhuwandu uhwu.
• Kuongororwa kweBone Biopsy: Izvi zvinosanganisira kutora chidimbu chidiki chenyama kubva pabhonzo wochiyedza murabhoritari. Izvi zvinogona kupa pfungwa yakanaka yehuremu uye chimiro chebhonzo. Zvisinei, iyi haisi bvunzo yakajairika.
• Kuyedzwa kwehuwandu hwemapfupa: Inonziwo DEXA scan , iyi inoyera kusimba kwemapfupa ako uye njodzi yekutyoka kwawo.
• Miedzo yekufungidzira: Miedzo yakaita seX-rays , CT scans , uye MRIs inogona kutsvaga shanduko mumapfupa. CT scans uye echocardiograms ( kuongororwa kwemoyo) zvinoshandiswawo kutsvaga calcium deposits (calcification) mutsinga dzeropa.

Yeuka kuti havasi vese vanofanira kuongororwa zvese izvi. Chiremba wako ndiye achasarudza kuti ndeapi mabvunzo anonyanya kukosha zvichienderana nemamiriro ako ezvinhu.

Ndeipi mishonga yekurapa renal osteodystrophy?

Kurapwa kwauchaitwa kunoenderana nekuti mapfupa ako akakuvara zvakadii, danho rechirwere cheitsvo, uye kuti mapfupa ako anoshanduka nekukurumidza here kana kuti zvishoma nezvishoma. Kune nzira dzakawanda dzekurapa:

• Kuchinja kwekudya: Chiremba wako anogona kukurudzira kudya kusina phosphorus yakawanda . Izvi zvinoreva kuderedza kudya kune phosphorus yakawanda (zvikafu zvakagadzirwa uye zvakaputirwa) - zvakaita sezvikafu zvemumagaba, manoodles ekukurumidza, uye masoseji. Kana chirwere chako cheitsvo chakakomba, ungangodawo kuderedza kudya kune phosphorus yakawanda (semuenzaniso, zvimwe zvigadzirwa zvemukaka, nzungu, uye nyama nehove dzakaomeswa).
• Mishonga nezvinowedzera: Izvi zvinogona kubatsira kudzikamisa huwandu hwemaminerari nemahormone. Semuenzaniso, mishonga inowedzera calcium nevhitamini D, mishonga inoderedza huwandu hweparathyroid hormone (PTH), uye zvinosunga phosphorus zvinogona kunyorerwa. Vanachiremba vanowanzo kurudzira mishonga isingasanganisi calcium phosphorus nekuti calcium yakawandisa inogona kukonzera chirwere chemapfupa chisingashande zvakanaka.
• Kuvhiyiwa kweParathyroid: Kana mamwe marapirwo asina kushanda, kuvhiyiwa kunogona kuitwa. Izvi zvinosanganisira kubvisa rimwe kana akawanda parathyroid gland. Izvi zvinonzi parathyroidectomy . Kazhinji, kanenge kamwe chete parathyroid gland kanosara. Izvi zvinogona kubatsira kudzivirira PTH kuti isadzike zvakanyanya uye kukonzera chirwere chemapfupa chisina simba.

Pamusoro pezvose izvi, chiremba wako achakubatsirawo kugadzirisa chirwere chako cheitsvo. Nekutevera hurongwa hwekurapa nemazvo, unogona kudzivirira kukuvara kwemapfupa ako.

Osteodystrophy yeRenal inogona kudzivirirwa here?

Zvakaoma kudzivirira zvachose Osteodystrophy yeRenal. Zvisinei, nekurapa chirwere cheitsvo chisingaperi (CKD) zvakanaka, chirwere ichi chinogona kudzorwa uye kufambira mberi kwacho kunoderera.Izvi zvinoreva kuti kutora mushonga wakanyorerwa nachiremba nenguva, kutevedzera kudya kwakanyorwa, uye kuita kurapwa ne dialysis nemazvo zvakakosha zvikuru. Zvakare, kurovedza muviri, kurega kusvuta, uye kuderedza kunwa doro zvinobatsirawo.

Chii chingatarisirwa nemunhu ane Renal Osteodystrophy?

Hapana mushonga wechigarire wechirwere ichi kunze kwekuisirwa itsvo . Vanhu vane chirwere cheitsvo kwenguva refu vanorasikirwa nekushanda kweitsvo zvishoma nezvishoma. Vanhu vazhinji vanopedzisira vatadza kushanda zvakanaka kweitsvo uye vanoda dialysis. Renal Osteodystrophy idambudziko rinowanzoitika nekuda kweizvi.

Uyewo, vanhu vazhinji vane chirwere cheitsvo chisingaperi vanorwarawo nemoyo. Chirwere chemwoyo ndicho chinokonzera kufa kwakawanda nekuda kwekutadza kushanda zvakanaka kweitsvo.

Asi musazvidya mwoyo. Chiremba wenyu anogara achiongorora huwandu hwemaminerari nemahormone enyu uye anokupai mazano ekurapa kuchengetedza mapfupa nemwoyo wenyu.

Unofanira kutaura nachiremba rini?

Kana uine chirwere cheitsvo chisingaperi (CKD), iva nechokwadi chekuudza chiremba wako kana uchinzwa kurwadziwa kwemapfupa kana kuomarara . Izvi zvinogona kuva chiratidzo che osteodystrophy yeitsvo.

Vanhu vazhinji vanongoona kuti vane chirwere cheitsvo chisingaperi kana chatokura. Saka, kuongororwa nachiremba nguva dzose kunogona kubatsira kuona chirwere cheitsvo nekukurumidza. Kana zvikaitika, unogona kutora matanho ekudzivirira kuti chisanyanya kuipa. Izvi zvinonyanya kukosha kana uine chinhu chinogona kukonzera chirwere cheitsvo (semuenzaniso, kufuta, kuva nechirwere cheshuga, kuva nenhoroondo yemhuri yechirwere cheitsvo, chirwere chemwoyo, kana BP yakakwira).

Mharidzo Yekuenda Nayo Kumba

Zvakanaka, ngatitaurei zvimwe zvezvinhu zvamunofanira kurangarira kubva pane zvatataura nezvazvo:

• Osteodystrophy yeRenal chirwere chemapfupa chinokonzerwa nechirwere cheitsvo chisingaperi (CKD).
• Kana itsvo dzikasashanda zvakanaka, huwandu hwecalcium , phosphorus, uye vhitamini D muropa hunova husina kuenzana, uye mapfupa anogona kushaya simba.
• Kurwadziwa kwemapfupa nekutyoka ndizvo zviratidzo zvikuru, asi pakutanga panogona kunge pasina zviratidzo.
• Vanachiremba vanoongorora chirwere ichi kuburikidza nekuongororwa kweropa uye kuskena.
• Kurapa kunosanganisira kudzora kudya, mishonga, uye dzimwe nguva kuvhiyiwa.
• Nzira yakanakisisa yekudzora chirwere ichi ndeyekutarisira chirwere cheitsvo zvakanaka.
• Kana uine chirwere cheitsvo uye uchinzwa kurwadziwa mumapfupa ako, enda kuna chiremba nekukasika.
• Kuongororwa nachiremba nguva dzose kunogona kubatsira kuona chirwere cheitsvo nekukurumidza.

Kunyangwe chirwere ichi chisingarapike zvachose, nekurapwa kwakakodzera uye kutevedzera mazano echiremba, unogona kuramba uine hupenyu hwakanaka. Saka usavhunduka, taura nachiremba wako, uye ita zvinhu zvinodiwa.

Osteodystrophy yeitsvo , chirwere cheitsvo, chirwere chemapfupa, calcium, phosphorus, vhitamini D, parathyroid hormone, CKD-MBD