Ingaba isifo seswekile sichaphazela nezintso? Masiqaphele isifo sezintso seswekile!

Ngaba unesifo seswekile? Okanye kukho umntu kusapho lwakho okanye umhlobo wakho onesifo seswekile? Ngoko mhlawumbi uyazi ngeengxaki ezahlukeneyo ezibangelwa sisifo seswekile. Ngamanye amaxesha sinokoyika kuba singazi ngokupheleleyo ezi zinto. Namhlanje siza kuthetha ngemiphumo ebangelwa sisifo seswekile kwizintso zethu. Oku kubizwa ngokuba yiDiabetic Kidney Disease (DKD).

Yintoni iSifo sezintso seswekile (iSifo sezintso seswekile)?

Ngamafutshane, oku kukonakala kwezintso zakho ngenxa yesifo seswekile. Siyazi ukuba izintso ezimbini emzimbeni wethu zihluza igazi kwaye zisuse inkunkuma . Cinga ngezintso njengee-super filters ezimbini emzimbeni wethu. Zihluza imveliso yenkunkuma ene-nitrogen, efana ne-urea, imveliso yenkunkuma yemisipha (i-creatinine), kunye nezinye iityhefu ezininzi kwaye zikhuphe emchameni. Akupheleli apho, izintso zikwanceda ukugcina ulungelelwaniso lolwelo kunye nee-electrolytes emzimbeni.

Izintso nganye ziqulathe iiyunithi zokucoca ezincinci ezingaphezu kwesigidi ezibizwa ngokuba zii-nephrons. Ngaphakathi kwezi nephrons, imithambo yegazi emincinci iqhagamshelwe ukwenza isakhiwo esifana ne-mesh esibizwa ngokuba yi-glomeruli. Enyanisweni, ezi glomeruli zinyathelo lokuqala lokuhluza igazi. Zivumela amanzi kunye nenkunkuma enyibilikisiweyo ukuba idlule kwiimembrane zazo ezingena ngaphantsi, ezithi emva koko zikhutshwe emzimbeni njengomchamo.

Ngoku khangela, kwenzeka ntoni emzimbeni womntu onesifo seswekile? Umzimba wakhe awukwazi ukuyisebenzisa ngokufanelekileyo iswekile esiyifumana ekutyeni esikutyayo, oko kukuthi, `(iglucose)`. Emva koko inqanaba `(iglucose)` egazini liyakhula. Xa eli nani liphezulu `(iglucose)` likho ixesha elide, ii-membranes ezithambileyo zaloo `(i-glomeruli)` ziqala ukonakala. Kwaye nezinye iindawo ze `(i-nephron)` zinokonakala. `(i-glomeruli)` ezonakele ngale ndlela azikwazi ukucoca igazi ngokufanelekileyo. Emva koko, okwenzekayo kukuba iityhefu ekufuneka zikhutshwe ngomchamo ziqale ukuqokelelana emzimbeni.

Ingaba le meko imbi kakhulu?

Ewe, isifo sezintso esibangelwa sisifo seswekile sisifo esibi kakhulu . Ukuba asilawulwa kakuhle, ekugqibeleni sinokukhokelela ekungasebenzini kwezintso . Ukungasebenzi kakuhle kwezintso kunokuba yingozi ebomini. Kungoko ke, kubaluleke kakhulu ukukwazi oku.

Ngawaphi amanqanaba esifo sezintso esibangelwa sisifo seswekile?

I-eGFR yindlela yokulinganisa ukusebenza kakuhle kwezintso zakho. I-eGFR sisifinyezo sezinga lokuhluza eliqikelelweyo le-glomerular. Ngamafutshane, kukubalwa kwendlela izintso zakho ezihluza ngayo inkunkuma. I-eGFR yomntu ophilileyo imalunga ne-100. Eli xabiso linokwehla liye kwi-0, oko kuthetha ukuba izintso zakho azisebenzi konke konke.

Kukho izigaba ezahlukeneyo zesifo sezintso, kuquka nesifo sezintso esibangelwa sisifo seswekile:

• Inqanaba lokuQala:I-GFR yakho ingama-90 nangaphezulu. Okwangoku, izintso zakho zisenokuba zonakele, kodwa zisasebenza ngendlela eqhelekileyo.
• Inqanaba lesiBini: Ixabiso le-GFR linokuba phakathi kwama-60 nama-89. Izintso zonakele kakhulu kunakwinqanaba loku-1, kodwa zisasebenza kakuhle.
• Inqanaba lesi-3: Ixabiso le-GFR linokuba phakathi kwama-30 nama-59. Ngeli xesha, ukusebenza kwezintso kunokuncipha kancinci okanye kakhulu.
• Inqanaba lesi-4: Ixabiso le-GFR lingaba phakathi kwe-15 kunye ne-29. Oku kuthetha ukuba ukusebenza kwezintso kuye kwehla kakhulu.
• Inqanaba V: I-GFR ingaphantsi kwe-15. Oku kuthetha ukuba izintso ziphantse zangasebenzi ngokupheleleyo, okanye ziye zangasebenzi.

Ngubani onokuthi abe nesi sifo? Zithini izinto ezinokubangela esi sifo?

Nabani na onesifo seswekile sohlobo 1 okanye uhlobo 2 unokuba nesifo sezintso. Nangona kunjalo, abanye abantu basengozini enkulu. Umzekelo:

• Abantu abamnyama
• Abantu baseMelika abangamaNdiya, ama-Alaskan Native, okanye abantu beZizwe zokuqala
• Abantu basePolynesia
• Abantu baseMaori

Kukho nezinye izinto ezinobungozi:

• Ukuba nesifo sezintso kusapho.
• Ukuba noxinzelelo lwegazi oluphezulu.
• Ukusetyenziswa kweemveliso zecuba (ezifana neecuba).
• I-Hyperglycemia yimeko apho amanqanaba eswekile egazini ehlala ephezulu.
• Amanqanaba aphezulu e-cholesterol egazini (i-Hyperlipidemia).

Ixhaphake kangakanani le sifo?

Isifo sezintso esibangelwa sisifo seswekile sisifo esixhaphakileyo . Sisona sibangela siphambili sesifo sezintso esikwinqanaba lokugqibela kwihlabathi liphela. Kuqikelelwa ukuba malunga nama -40% abantu abanesifo seswekile banesifo sezintso.

Zithini iimpawu zesifo sezintso esibangelwa sisifo seswekile?

Kwiimeko ezininzi, iimpawu ezicacileyo azibonakali de kube yi-80% ukuya kwi-90% yezintso ezonakeleyo. Xa iimpawu zibonakala, unokubona izinto ezifana nezi:

• Ukudumba kobuso, izandla, nemilenze (i-edema).
• Isicaphucaphu nokuhlanza.
• Ukuhlala uziva udiniwe okanye udiniwe.
• Ubunzima bokuphefumla (ukuphelelwa ngamandla).
• Ukutya akunancasa.
• Umchamo onegwebu okanye onamaqamza.
• Ubunzima bokugxila okanye ukuziva udidekile.
• Ulusu olomileyo nolurhawuzelayo.
• Ukuqaqamba kwemisipha.
• Ukufuna ukunciphisa ubungakanani be-insulin ethathwayo (kwabo bathatha amayeza esifo seswekile).

Ziziphi iimpawu kwizigaba zokuqala?

Isifo sezintso esibangelwa sisifo seswekile asisoloko sibonisa zimpawu kwasekuqaleni.Usenokuba uneproteni kumchamo wakho (proteinuria). Kodwa oku kunokubonwa kuphela ngugqirha owenza uvavanyo lomchamo.

Yintoni ebangela oku? Ingaba kuyasulela?

Isizathu esiphambili soku kukuba nesifo seswekile sohlobo 1 okanye uhlobo 2.

Hayi, esi ayisosifo sisulelayo. Awunakusasaza esi sifo komnye umntu.

Ufumanisa njani ukuba unesifo sezintso esibangelwa sisifo seswekile?

Ukuba unesifo seswekile, kubalulekile ukubona ugqirha wakho rhoqo emva kweenyanga ezintathu ukuya kwezintandathu ukuze ahlolwe, njengoko ugqirha wakho ecebise. Ukuba ugqirha wakho ukrokrela ukuba unesifo sezintso esinxulumene nesifo seswekile, uya kuyalela uvavanyo oluthile.

Zeziphi iimvavanyo ezenziwayo ukuze kubonwe oku?

Ezi mvavanyo zilandelayo zinceda ekuxilongeni esi sifo:

• Uhlalutyo lomchamo:

Oku kuquka ukuthatha isampuli yomchamo wakho uze uwuhlole ukuze ubone ukuba ubonakala njani, ukwakheka kwawo kwiikhemikhali, kunye novavanyo oluncinci. Ugqirha wakho angasebenzisa i-dipstick ukwenza olu vavanyo. Angacebisa neentlobo ezahlukeneyo zovavanyo lomchamo. Kuvavanyo lwe-dipstick, uchamela kwisitya esikhethekileyo. Emva koko kufakwa umcu wephepha (i-dipstick) oneekhemikhali ezifakwe kuwo. Ukuba kukho iproteni (i-albumin) kumchamo, umcu uya kutshintsha umbala.

Ukuba ugqirha wakho ufuna umlinganiselo ochanekileyo, angayalela uvavanyo lweproteni yomchamo . Oku kuquka ukuthumela isampuli yomchamo wakho kwilebhu ukuze kujongwe umlinganiselo weproteni kwi-creatinine kumchamo wakho (umlinganiselo weproteni kwi-creatinine). Ukuba lo mlinganiselo uphezulu kakhulu, unokuba luphawu lwesifo sezintso esinxulumene nesifo seswekile.

• Uvavanyo lwegazi:

Uvavanyo lwe-eGFR lulinganisa amandla ezintso zakho okucoca igazi. Ugqirha wakho uza kuthatha igazi elincinci kumthambo osengalweni yakho aze asebenzise inqanaba le-creatinine egazini kunye nolwazi olusisiseko lwempilo ukuze abale i-eGFR yakho.

• Uvavanyo lomfanekiso:

Olu vavanyo lunokunceda ugqirha wakho ukuba afumane umbono ngempilo yezintso zakho.

• Uvavanyo lwe-ultrasound: Olu vavanyo lunokujonga ulwakhiwo kunye nobukhulu bezintso.
• Ii-MRI kunye ne-CT scans: Ezi zinokubona ngokucacileyo imithambo yegazi kunye nokuhanjiswa kwegazi kwizintso.

• I-biopsy yezintso:

Kule nkqubo, ugqirha uthatha iqhekeza elincinci lesicwili sezintso zakho aze alihlole phantsi kwe-microscope kwilebhu. Ngaphambi kokuba enze oku, indawo leyo iyavaleka ukuze ungabi nantlungu. Uza kukunika neyeza lokuthomalalisa elilula ukukunceda uphumle. Emva koko, kufakwa inaliti eluswini iye kwizintso kwaye kuthathwe isampuli yesicwili.

Zithini iindlela zonyango zoku?

Unyango luxhomekeke kwinqanaba lesifo sakho, ubudala bakho, kunye nempilo yakho iyonke. Ukulawula isifo sakho seswekile linyathelo lokuqala ekunyangeni esi sifo sezintso. Ezi zinto zilandelayo zinokukunceda ukulawula isifo sakho seswekile:

• Faka ukutya okuninzi okunefayibha eninzi, amafutha aphantsi kunye neekhalori ekutyeni kwakho.
• Ukuzilolonga rhoqo.
• Ukulawula ubunzima bomzimba.
• Yeka ukutshaya okanye ukusebenzisa ezinye iimveliso zecuba.

Ukuba une-high blood pressure, kubalulekile ukuyinyanga nayo. Ugqirha wakho angakunika amayeza onyango lwe-high blood pressure.

Ngaba umonakalo wezintso ungabuyiselwa?

Hayi, umonakalo wezintso obangelwa sisifo seswekile awunakuguqulwa ngokupheleleyo. Nangona kunjalo, ungayilawula, uyinciphise isantya, mhlawumbi ungayiyeki nomonakalo ongakumbi wezintso ngokuthatha amayeza akho njengoko ugqirha wakho ekuyalele, ulandele ukutya okunempilo, kwaye uhlale usebenza.

Ngawaphi amayeza anikwa oku?

Ukuze ulawule isifo sezintso seswekile, kubalulekile ukulawula isifo sakho seswekile, ukunciphisa uxinzelelo lwegazi, kunye nokunciphisa amanqanaba e-cholesterol yakho. Ugqirha wakho angakunika amayeza alandelayo ukunyanga ezi meko:

• Kwisifo seswekile:
• IiBiguanides (umz. i-metformin): Ezi zinciphisa ubungakanani beglucose eveliswa sisibindi sakho. Zikwaphucula indlela esebenza ngayo i-insulin emzimbeni, zinciphisa isantya sokuguqulwa kweecarbohydrate zibe yiswekile.
• Izithinteli ze-Sodium-glucose cotransporter 2 (SGLT2): Ezi zinceda izintso ukuba zikhuphe i-glucose emzimbeni ngezintso nakumchamo.
• Ii-agonists ezifana ne-Glucagon-like peptide 1 (GLP-1): Ezi zinyusa ukukhululwa kwe-insulin, zinciphisa ukukhululwa kwe-glucose esibindini emva kokutya, kwaye zilibazise ukuphelelwa yisisu. Oku kunokunceda ekunciphiseni ubunzima.

• Xa unexinzelelo lwegazi oluphezulu:
• Izithinteli ze-enzyme eguqula i-angiotensin (ACE): Ezi zithintela ukuveliswa kwehomoni ebizwa ngokuba yi-angiotensin II. Umzimba usebenzisa le homoni ngokwendalo ukulawula uxinzelelo lwegazi. Emva konyango olunezithinteli ze-ACE, uxinzelelo lwegazi kufuneka lwehle.
• Ii-Angiotensin II receptor blockers (ARBs): Ezi zithintela i-hormone angiotensin II ekubeni ibophe kwii-receptors kwimithambo yegazi. Ii-ARB zisebenza ngendlela efanayo nee-ACE inhibitors, zinciphisa uxinzelelo lwegazi.

Kubalulekile: Ukongeza ekunciphiseni uxinzelelo lwegazi, ii-ACE inhibitors kunye nee-ARB zikwanceda ekunciphiseni ukuqhubela phambili kwesifo sezintso esinxulumene nesifo seswekile.

• Kwi-cholesterol ephezulu:
• Iistatin: Ezi zinciphisa i-cholesterol embi kwaye ziphakamisa i-cholesterol elungileyo. Zinokuba luncedo kwabanye abantu abanesifo sezintso esinxulumene nesifo seswekile.

Luluphi unyango ukuba isifo siqhubeka sisanda?

Ukuba isifo sezintso seswekile siba sibi kakhulu, iindlela zonyango ziquka:

• I-Dialysis: Ukuba izintso zakho azisebenzi kakuhle, i-dialysis ingenza umsebenzi wezintso zakho. Kule meko, umatshini uthatha igazi lakho, uhluze inkunkuma kunye nolwelo olongezelelweyo, uze ubuyisele igazi elicociweyo emzimbeni wakho.
• Ukufakelwa kwezintso: Kule nto, ufumana izintso eziphilileyo komnye umntu (umxhasi wezintso).

Ungasiphepha njani esi sifo?

Eyona ndlela ilungileyo yokuthintela isifo sezintso seswekile kukulawula isifo sakho seswekile kunye noxinzelelo lwegazi kakuhle. Kubalulekile ukulandela isicwangciso sonyango esichazwe ngugqirha wakho ngokuchanekileyo.

Yintoni enokulindelwa ngumntu onesi sifo?

Isifo sezintso seswekile sisifo esiqhubeka kancinci kancinci . Ukuba unesi sifo, umonakalo kwizintso zakho awunakuguqulwa. Nangona kunjalo, ukuba uyifumana kwangethuba kwaye ulandela isicwangciso sonyango esifanelekileyo, ungayicothisa okanye uyimise inkqubela yesi sifo.

Ukuba esi sifo siba sibi kakhulu, sinokukhokelela ekungasebenzini kwezintso, nto leyo ebeka ubomi esichengeni. Iindlela zonyango lokungasebenzi kwezintso kukusebenzisa i-dialysis okanye ukufakelwa izintso.

Ndingazinyamekela njani?

Ugqirha wakho uza kukunceda uphuhlise isicwangciso sonyango esifanelekileyo kuwe. Sisenokubandakanya amayeza kunye notshintsho kwindlela ophila ngayo. Isicwangciso sakho sonyango singabandakanya:

• Ukusela amayeza esifo seswekile kunye noxinzelelo lwegazi achazwe ngugqirha ngqo.
• Jonga amanqanaba eswekile egazini lakho kunye noxinzelelo lwegazi rhoqo.
• Ukulandela ukutya okunempilo (njengokutya kwaseMedithera okanye ukutya kweDASH).
• Zilolonge ubuncinane imizuzu engama-30 ngosuku uninzi lweentsuku zeveki. Zama ukwenza umthambo ubuncinane imizuzu eli-150 ngeveki. Ungahamba, ubaleke, ubhayisekile, uqubhe, okanye wenze nawuphi na omnye umsebenzi wentliziyo owuthandayo.
• Ukuphepha amayeza anokonakalisa izintso. Oku kungabandakanya amayeza okudambisa iintlungu (amayeza angengowe-steroidal alwa nokuvuvukala - ii-NSAIDs).
• Ukugcina idinga likagqirha kunye nokwenza zonke iimvavanyo zelebhu.
• Yeka ukutshaya okanye ukusebenzisa ezinye iimveliso zecuba.
• Ukunciphisa utywala obuselayo.
• Lala phakathi kweeyure ezisixhenxe nezisithoba ubusuku ngabunye.

Ndifanele ndimbone nini ugqirha?

Ukuba unesifo seswekile, kufuneka ubonane nogqirha wakho rhoqo rhoqo kwiinyanga ezintathu ukuya kwezintandathu, njengoko ugqirha wakho ekucebisa.

Ukuba unesifo seswekile, ugqirha wakho uya kucebisa ukuba uhlolwe isifo sezintso seswekile minyaka le , uqale kwiminyaka emihlanu emva kokuba uxilongiwe. Umonakalo kwizintso awubonakali kwiminyaka eli-10 yokuqala emva kokuba uxilongiwe. Ukuba ubunesifo seswekile iminyaka engaphezu kwama-25 kwaye izintso zakho azikabonakali, amathuba okuba ube nesifo sezintso seswekile aphantsi.

Ndingayibuza yiphi imibuzo ugqirha?

Kubaluleke kakhulu ukubuza imibuzo efana nale xa ubona ugqirha wakho:

• Uyazi njani ukuba ndinesifo sezintso ngenxa yesifo seswekile?
• Ngaba kufuneka ndidibane nogqirha wezifo zengqondo okanye omnye umntu ochwephesha?
• Zeziphi iimvavanyo ozenzayo ukuze ufumanise isifo sezintso esinxulumene nesifo seswekile?
• Isifo sam sezintso esinesifo seswekile sibi kangakanani?
• Zeziphi iinguqu endinokuzitshintsha kwindlela endiphila ngayo ukuze ndinciphise okanye ndiyeke ukuqhubeka kwesifo sam sezintso esibangelwa sisifo seswekile?
• Ngawaphi amayeza owacebisayo?
• Loluphi unyango olucebisayo?
• Kufuneka ndize kangaphi ngexesha lee-aphoyintimenti?
• Ungacebisa amaqela enkxaso kubantu abanesifo sezintso esinxulumene nesifo seswekile?

Lo ngumyalezo obalulekileyo endifanele ndikunike wona...

Ukonakala kwezintso ngenxa yesifo seswekile yimeko embi kakhulu. Ingaqhubekela phambili iye ekungasebenzini kwezintso, nto leyo ebeka ubomi esichengeni. Ukuba ugqirha wakho ufumanisa ukuba unesifo sezintso esinxulumene nesifo seswekile, kuyinto eqhelekileyo ukuziva usoyika kwaye ulusizi. Nangona kunjalo, ukuba usifumana esi sifo kwangethuba kwaye ulandele isicwangciso sakho sonyango ngononophelo, unganciphisa okanye umise ukuqhubeka kwesifo sezintso esinxulumene nesifo seswekile.

Ukufumana unyango lwemeko efana nale kunokuba luxinzelelo ngokweemvakalelo. Kodwa khumbula, ugqirha wakho ukho ukukunceda. Uzimisele ukuphendula yonke imibuzo yakho kwaye akuncede ugcine umgangatho wobomi bakho. Ngoko ke ungoyiki ukuthetha nogqirha wakho ngayo yonke into ekucingayo.

Isifo Seswekile , Isifo Sezintso, Isifo Sezintso Seswekile, I-DKD, I-Nephropathy, i-eGFR, Uvavanyo Lomchamo, I-Dialysis