Izinto ekufuneka uzazi malunga nokusilela kwezintso!

Ngaba wakha wazibuza ukuba ezi zintso zimbini zincinci zisebenza kangakanani emzimbeni wethu? Ngamanye amaxesha, ezi zintso zinokungasebenzi. Xa oko kusenzeka, sikubiza ngokuba yi-Kidney Failure. Nangona oku kunokuba yingongoma eyoyikisayo kwabanye, kubalulekile ukuyiqonda.

Yintoni Ukusilela Kwezintso?

Ngamafutshane, ukusilela kwezintso yimeko apho enye okanye zombini izintso zakho zingasebenzi kakuhle. Oku kuthetha ukuba azikwazi ukwenza umsebenzi wazo zodwa. Oku kunokwenzeka ngeendlela ezimbini. Enye kukusilela kwezintso okukhawulezileyo . Le yimeko efika ngequbuliso. Kodwa ngamanye amaxesha iba yeyokwexeshana kwaye inokunyangeka. Olunye uhlobo kukusilela kwezintso okungapheliyo . Oku kukonakala kancinci kancinci kwezintso ngokuhamba kwexesha. Le yeyona meko ixhaphakileyo kubantu abaninzi.

Le meko yokusilela kwezintso ingaqhubeka kancinci kancinci iye kwinqanaba lokugqibela, eliyi -End-Stage Kidney Disease (ESKD) . Enyanisweni, ukuba ayinyangwa, i-ESKD inokuba yingozi ebomini. Umntu onesi sifo unokuphila iintsuku okanye iiveki ezimbalwa kuphela ngaphandle konyango. Kodwa ungakhathazeki, ngonyango olufanelekileyo, ukusilela kwezintso kunokulawulwa kwaye kuphile ubomi obusemgangathweni.

Kwenzeka ntoni kwizintso zethu?

Ngoku makhe sibone ukuba la malungu abizwa ngokuba zizintso enza ntoni emizimbeni yethu. Izintso zakho zifana neembotyi ezimbini. Zilingana nenqindi lakho. Uyazi ukuba ziphi? Zifumaneka ngaphantsi kwembambo yakho, ngasemva. Uninzi lwabantu lunezintso ezimbini ezisebenza kakuhle. Kodwa ukuba izintso enye isebenza kakuhle, ungaphila kamnandi.

Umsebenzi ophambili wezintso kukususa ubuthi emizimbeni yethu . Zicinge njengesihluzo. Zihluza igazi lakho kwaye zisuse inkunkuma engafunekiyo kulo njengomchamo (esikwabiza ngokuba ngumchamo ).

Khawucinge nje, kwenzeka ntoni ukuba ezi zintso azisebenzi kakuhle? Ezo zinto zingcolileyo ziyaqokelelana emzimbeni. Xa oko kusenzeka, uqala ukuziva ugula, kwaye ukuba awunyangwa, ungafa ekugqibeleni. Kodwa, njengoko benditshilo ngaphambili, uninzi lwabantu lunokuyilawula le meko ngonyango olufanelekileyo.

Kuqheleke kangakanani ukungasebenzi kakuhle kwezintso?

Makhe sibone ukuba esi sifo sixhaphake kangakanani na ekuthiwa yi-kidney failure. Kwilizwe elifana neMelika, esi sifo sichaphazela abantu abamalunga ne-7.5 lakh ngonyaka. Ukuba ujonga kwihlabathi liphela, malunga nezigidi ezi-2 zabantu banesifo esi. Kukho abantu abaninzi abanale meko kwilizwe lethu, ingakumbi kuba izifo ezifana nesifo seswekile kunye noxinzelelo lwegazi oluphezulu zixhaphakile.

Zithini izigaba ezintlanu zesifo sezintso?

Xa sithetha ngamanqanaba esifo sezintso, sijonga i-eGFR yakho (Izinga lokuHlanganisa iGlomerular eliQikelelweyo).Ixabiso libizwa ngokuba. Olu luvavanyo lwegazi.

Ngamafutshane, i-eGFR yindlela yokulinganisa indlela izintso zakho ezihluza ngayo izinto. I-eGFR yomntu ophilileyo idla ngokuba ngaphezulu kwama-90. I-eGFR ye-0 ithetha ukuba izintso azisebenzi konke konke.

Kukho amanqanaba amahlanu aphambili esifo sezintso:

• Inqanaba lokuQala: I-GFR yakho ingaphezulu kwama-90. Okwangoku, izintso zakho zisebenza ngokuqhelekileyo, nangona kukho umonakalo othile.
• Inqanaba lesiBini: I-GFR yakho inokuba phakathi kwama-60 nama-89. Izintso zonakele kakhulu kunakwinqanaba lokuQala, kodwa zisasebenza kakuhle.
• Inqanaba lesiThathu: I-GFR yakho inokuba phakathi kwama-30 nama-59. Kweli nqanaba, ukusebenza kwezintso kunokuba buthathaka okanye kube nzima.
• Inqanaba lesi-4: I-GFR yakho inokuba phakathi kwe-15 kunye ne-29. Kulapho ukusebenza kwezintso kuncipha kakhulu.
• Inqanaba lesi-5: I-GFR yakho ingaphantsi kwe-15. Oku kuthetha ukuba izintso zakho zisondele okanye aziphumelelanga ngokupheleleyo. Kulapho ke iimpawu zihlala ziqala ukubonakala khona.

Ziziphi iimpawu zokuqala zokungasebenzi kakuhle kwezintso?

Amaxesha amaninzi, isifo sezintso sasekuqaleni asinazo iimpawu , okanye iimpawu ezingephi. Kodwa nokuba awuboni nto, isifo sezintso esinganyangekiyo (CKD) sinokubangela umonakalo ngaphakathi.

Iimpawu zokungasebenzi kakuhle kwezintso zingahluka kumntu nomntu. Ukuba izintso zakho azisebenzi kakuhle, khangela enye okanye ezingaphezulu kwezi mpawu zilandelayo:

• Ukuziva udiniwe kakhulu (ukudinwa). Akupheleli nje ekudinweni, kodwa kukudinwa okungapheliyo nokuba ulala kangakanani na.
• Isicaphucaphu nokuhlanza. Oku kusenokuhamba nokuphelelwa ngumdla wokutya.
• Ukuziva udidekile okanye unengxaki yokugxila. Khawuthelekelele uziva unesizungu, ungakwazi ukugxila kwinto ethile.
• Ukudumba (i-edema). Ukudumba, ingakumbi ezandleni, emaqatheni, okanye ebusweni. Abanye abantu baxela ukudumba okujikeleze amehlo abo xa bevuka kusasa.
• Utshintsho kwindlela ochama ngayo kangaphi. Kusenokufuneka uchame rhoqo okanye ubungakanani bomchamo ophumayo bunokuncipha. Usenokuba nomchamo onamagwebu.
• Ukuqaqamba kwemisipha okanye ukuqhwalela.
• Ulusu olomileyo okanye olurhawuzelelayo.
• Ukuphelelwa ngumdla wokutya, okanye incasa yesinyithi emlonyeni.

Ungakhathazeki ukuba unenye okanye ezimbini kwezi mpawu, kodwa ukuba ziyaqhubeka, ngokuqinisekileyo kuya kufuneka ubone ugqirha .

Zithini izizathu eziphambili zokungasebenzi kakuhle kwezintso?

Ezibini zezona zinto ziphambili ezibangela isifo sezintso esingapheliyo kunye nokungasebenzi kakuhle kwezintso sisifo seswekile kunye noxinzelelo lwegazi oluphezulu . Zombini ezi zizifo ezixhaphakileyo kwilizwe lethu.

Ukuba unesifo seswekile, ukuba asilawulwa kakuhle, amanqanaba eswekile egazini lakho aya kuhlala ephezulu (i-hyperglycemia). Ukuba amanqanaba eswekile egazini lakho ahlala ephezulu, anokonakalisa izintso zakho kunye nezinye izitho zomzimba.

Uxinzelelo lwegazi oluphezulu luthetha ukuba igazi lihamba ngemithambo yegazi ngamandla kakhulu. Ukuba alinyangwa ixesha elide, la mandla ongezelelweyo anokonakalisa izicubu zezintso.

Ukungasebenzi kakuhle kwezintso asinto eyenzeka ngequbuliso. Kukho nezinye izinto ezinokukuchaphazela oku:

• Isifo sezintso esinePolycystic (PKD): Esi sisifo esidluliselwa kwimfuza ngomnye wabazali. Kule meko, ii-cysts ezizaliswe lulwelo (ii-cysts) zenzeka ngaphakathi kwezintso.
• Izifo zeGlomerular: Ezi zifo zichaphazela amandla ezintso okucoca imveliso engcolileyo.
• Izifo zezintso ezizikhusela ngokwazo emzimbeni: Umzekelo, isifo esibizwa ngokuba yi-lupus . Esi sisifo esizikhusela ngokwazo emzimbeni, oko kuthetha ukuba inkqubo yomzimba yokuzikhusela ihlasela iiseli zayo. Oku kunokubangela umonakalo kwizitho zomzimba, iintlungu zamalungu, umkhuhlane, kunye nezilonda zesikhumba.

Ngamanye amaxesha, ukungasebenzi kakuhle kwezintso kunokwenzeka ngequbuliso ngesizathu esingalindelekanga. Oku kubizwa ngokuba yi -Acute Kidney Injury . Kwimeko enjalo, izintso ziphelelwa ngamandla azo okusebenza ngequbuliso. Le meko inokwenzeka kwiintsuku ezimbalwa. Kodwa uninzi lwexesha, iba yeyokwexeshana.

Izizathu eziqhelekileyo zokungasebenzi kakuhle kwezintso ngesiquphe zezi:

• Amayeza athile, ingakumbi amayeza athile okudambisa iintlungu, anokubangela oku.
• Ukuphelelwa ngamanzi emzimbeni kakhulu. Xa umzimba ungenamanzi aneleyo.
• Ukuvaleka kwendlela yomchamo. Oku kunokubangelwa yinto efana nelitye lomchamo.
• Izifo ezinganyangwanga emzimbeni. Umzekelo, isifo sentliziyo okanye isifo sesibindi.

Zithini izinto ezibangela ukungasebenzi kakuhle kwezintso?

Ukungasebenzi kakuhle kwezintso kunokwenzeka nakubani na. Nangona kunjalo, usenokuba sengozini enkulu ukuba unenye yezi zinto zilandelayo:

• Ukuba unesifo seswekile .
• Ukuba unesifo soxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) .
• Ukuba unesifo sentliziyo .
• Ukuba kukho umntu kusapho lwakho oye waba nesifo sezintso (isifo esidluliselwa kwilifa).
• Ukuba uneengxaki zesakhiwo kwizintso zakho .
• Ukuba umnyama (ngenxa yezizathu ezithile zofuzo).
• Ukuba uneminyaka engaphezu kwama -60 ubudala .
• Ukuba sele uthatha amayeza okudambisa iintlungu ixesha elide , ingakumbi ii-NSAID (ii-Nonsteroidal Anti-inflammatory Drugs) onokuzifumana lula kwikhemesti.

Zithini iingxaki zokungasebenzi kakuhle kwezintso?

Izintso zenza imisebenzi eyahlukeneyo emizimbeni yethu. Ngoko ke xa izintso zingaphumeleli, zinokubangela iingxaki ezahlukeneyo. Umzekelo:

• Igazi elonyukayo.
• I-anemia. Oko kuthetha ukunqongophala kwegazi. Izintso zivelisa i-hormone enceda ekwenzeni iiseli ezibomvu zegazi. Xa izintso zonakele, ziyancipha.
• Isifo samathambo.
• Ulwelo olujikeleze imiphunga yakho.
• Umonakalo wemithambo-luvo.
• Ukungalingani kwe-electrolyte. Oku kuthetha utshintsho kubungakanani beetyuwa ezifana ne-sodium kunye ne-potassium egazini.

Kodwa ungacingi ukuba ngenxa yokuba ufunyaniswe uneengxaki zezintso, uza kufa. Ukuba ulandela isicwangciso sonyango sikagqirha wakho—esinokubandakanya amayeza, utshintsho kwindlela ophila ngayo, kunye nokunciphisa ityuwa nokutya okuthile—ungayilawula kakuhle imeko yakho. Nangona kunjalo, ukuba awumameli ugqirha wakho, izintso zakho zingaba mandundu kwaye ungade ufe.

Ngaba ukungasebenzi kakuhle kwezintso kwinqanaba lokugqibela kunokubangela ukufa?

Ewe, isifo sezintso esikwinqanaba lokugqibela (ESKD) sinokubulala. Kodwa njengoko benditshilo ngaphambili, ngonyango olufanelekileyo, uninzi lwabantu lunokuphila nokusilela kwezintso. Eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba akukho nyango lokusilela kwezintso. Oko kuthetha ukuba nangona unyango lukhona, izintso zakho aziyi kusebenza njengoko zazinjalo ngaphambi kokuba ube nesifo. Unyango lujolise ekugcineni umsebenzi oseleyo wezintso zakho ixesha elide kangangoko kunokwenzeka kwaye lunciphise ukuwohloka kwazo ngokukhawuleza.

Ifunyanwa njani ingxaki yokungasebenzi kakuhle kwezintso?

Ugqirha angasebenzisa uvavanyo oluhlukeneyo lokusebenza kwezintso ukuze abone ukuba izintso zakho zisebenza njani aze afumanise ukuba unesifo sezintso na. Ukuba ugqirha wakho ukrokrela ukuba usemngciphekweni wokungasebenzi kwezintso, ezi zivavanyo ezidla ngokwenziwa:

• Uvavanyo lwegazi: Olu vavanyo lujonga ukuba izintso zakho zisusa njani inkunkuma egazini lakho. Ugqirha uthatha isampuli encinci yegazi kumthambo osesandleni sakho esebenzisa inaliti encinci. Emva koko isampuli yegazi ivavanywa kwilebhu. Olu vavanyo lwegazi lukwasetyenziselwa ukujonga ixabiso le-eGFR elikhankanyiweyo ngaphambili.
• Uvavanyo lomchamo: Olu vavanyo lulinganisa izinto ezithile kumchamo wakho, ezifana neproteni okanye igazi. Kuya kufuneka uchamele kwisitya esikhethekileyo eofisini kagqirha okanye esibhedlele. Isampulu yomchamo iya kuvavanywa kwilebhu.
• Uvavanyo lokufota: Olu vavanyo luvumela ugqirha ukuba ajonge izintso zakho kunye nendawo ezingqongileyo ukuze abone ukuba kukho naziphi na iingxaki okanye ukuvaleka. Uvavanyo oluqhelekileyo lokufota luquka i-ultrasound yezintso , i-CT urogram, kunye ne -MRI .

Inyangwa njani ingxaki yezintso?

Unyango lokungasebenzi kakuhle kwezintso luxhomekeke kwisizathu kunye nobunzima bemeko. Oogqirha abanakukwazi ukunyanga ngokupheleleyo ukungasebenzi kakuhle kwezintso, kwaye yimeko esongela ubomi. Kodwa unyango lunokukunceda uphile ixesha elide kwaye ulawule iimpawu kunye neengxaki.

Ukuba izintso zakho ziyayeka ukusebenza kakuhle kancinci kancinci, ugqirha angasebenzisa iindlela ezahlukeneyo ukujonga impilo yakho nokugcina ukusebenza kwezintso ixesha elide kangangoko kunokwenzeka. Ezi ndlela zingabandakanya:

• Uvavanyo lwegazi rhoqo.
• Ukujonga uxinzelelo lwegazi rhoqo.
• Amayeza.

Ukuba unesifo sezintso esikwinqanaba lokugqibela , udinga unyango ukuze uhlale uphila. Kukho iindlela ezimbini eziphambili zonyango lokungasebenzi kakuhle kwezintso: i-dialysis kunye nokufakelwa kwezintso .

Amayeza okungasebenzi kakuhle kwezintso

Ngokuxhomekeke kwisizathu sesifo sakho sezintso, ugqirha angakunika elinye okanye ngaphezulu kwala mayeza alandelayo:

• Ii-Angiotensin-converting enzyme (ACE) inhibitors okanye ii-angiotensin II receptor blockers (ARBs): La mayeza anceda ekunciphiseni uxinzelelo lwegazi.
• I-Diuretics: Ezi zinceda ekususeni ulwelo olugqithisileyo emzimbeni. Abanye abantu bazibiza ngokuba 'ziipilisi zamanzi'.
• IiStatins: Ezi zinceda ekunciphiseni amanqanaba akho e-cholesterol.
• Ii-Erythropoietin-stimulating agents: Ezi zinceda ekwenzeni iiseli ezibomvu zegazi ukuba une-anemia.
• I-Vitamin D kunye neCalcitriol: Ezi zinceda ekuthinteleni ukulahleka kwamathambo.
• Izihlanganisi ze-phosphate: Ezi zinceda ukususa i-phosphorus engaphezulu egazini lakho.

I-Dialysis

I-Dialysis yindlela yokunceda umzimba wakho ucoce igazi. Cinga ngayo njengokunika izintso zakho ithuba lokuphumla ukuze zingabi namsebenzi unzima kangako. Kukho iintlobo ezimbini ze-dialysis:

• I-Hemodialysis: Lo ngumatshini ococa igazi lakho rhoqo. Abantu abaninzi abaneengxaki zezintso baya esibhedlele okanye kwiziko le-dialysis ukuze bahlaziywe nge-hemodialysis iintsuku ezintathu ukuya kwezine ngeveki. Oku kunokuba nzima kancinci, njengoko kufuneka uqhagamshelwe kumatshini iiyure ezininzi ngexesha.
• I-Peritoneal dialysis:Kule nkqubo, ugqirha ufaka ityhubhu encinci (i-catheter) phantsi kwesikhumba sesisu sakho aze ayidibanise nebhegi equlethe ulwelo lwe-dialysis. Olu lwelo luphuma kwibhegi luye kwisisu sakho, apho lususa khona inkunkuma kunye nolwelo olongezelelweyo luze lubuyele kwibhegi. Ngamanye amaxesha, i-peritoneal dialysis ingenziwa ekhaya.

Ukufakelwa Kwezintso

Kwi-kidney transplant, ugqirha wotyando utshintsha izintso zakho ezonakeleyo nge-kidney ephilileyo. Le kidney ephilileyo (i-donor organ) inokuvela kumnikeli oswelekileyo okanye kumnikeli ophilayo. Ungaphila kakuhle nge-kidney enye ephilileyo. Ukuba u-kidney transplanted, kuya kufuneka uthathe amayeza ubomi bakho bonke ukuthintela umonakalo kwi-kidney efakelweyo. La mayeza asebenza ukuthintela umzimba wakho ukuba ungalamkeli i-kidney entsha.

Ngaba kunokwenzeka ukuba uphile emva kokungasebenzi kakuhle kwezintso kwinqanaba lokugqibela?

Kuxhomekeke kwizinto ezininzi. Ngonyango olufanelekileyo, ungaphila ubomi obonwabisayo nobanelisayo. Nangona kunjalo, kufuneka ulindele ukuba uza kufuna unyango ubomi bakho bonke. Khumbula, isifo sezintso okanye ukungasebenzi kakuhle kwezintso akunakubuyiselwa umva , kunokuncitshiswa kuphela.

Ungayithintela njani ingxaki yezintso?

Nangona ukungasebenzi kakuhle kwezintso kunye nesifo sezintso esinganyangekiyo (CKD) zingenakukwazi ukubuyiselwa umva, kukho izinto onokuzenza ukukhusela ukusebenza kwezintso zakho. Imikhwa esempilweni kunye nezenzo ezisempilweni zinokunciphisa isantya apho izintso zakho zilahlekelwa khona ukusebenza.

Ukuba une-CKD okanye ukungasebenzi kakuhle kwezintso, kungcono ukwenza ezi zinto zilandelayo:

• Jonga ukusebenza kwezintso zakho rhoqo (vavanywa njengoko ugqirha wakho ecebisa).
• Ukuba unesifo seswekile, gcina amanqanaba eswekile egazini lakho ekwinqanaba eliqhelekileyo .
• Gcina inqanaba loxinzelelo lwegazi lakho likwinqanaba eliqhelekileyo .
• Kuphephe ukusebenzisa iimveliso zecuba (ezifana nokutshaya).
• Kuphephe ukutya okune potassium eninzi kunye ne sodium (ityuwa) . Kungcono ukubuza ugqirha okanye ingcali yesondlo ngale nto, kuba ezinye iziqhamo kunye nemifuno nazo zinee potassium eninzi.
• Qiniseka ukuba uya rhoqo kwi-aphoyintimenti ecwangcisiweyo nogqirha wakho.

Yintoni onokuyilindela ukuba unesifo sezintso?

Akukho nyango lupheleleyo lokungasebenzi kakuhle kwezintso. Nangona kunjalo, ngokuxilongwa ngokuchanekileyo kunye nonyango, ungaphila ixesha elide ngaphandle kotshintsho olukhulu kumgangatho wobomi bakho.

Ufanele uye nini kugqirha?

Ukuba unezinto ezinokubangela ukungasebenzi kakuhle kwezintso, bona ugqirha. Oko kuthetha ukuba:

• Ukuba une- high blood pressure .
• Ukuba ubona utshintsho kwindlela yakho yokuchama (ukuchama rhoqo, ukuchama kancinci, umchamo onamagwebu, igazi).
• Ukuba unenkungu engqondweni okanye ubunzima bokugxila.
• Ukuba unesicaphucaphu okanye uhlanza .
• Ukuba unesifo seswekile .
• Ukuba kukho umntu kusapho lwakho okhe waba nesifo sezintso .
• Ukuba ukhe waba nengxaki yezintso ngaphambili (umz., ukungasebenzi kakuhle kwezintso ngequbuliso).
• Ukuba uthatha ii-NSAID rhoqo .

Ukuba unento efana nale, ungayinaki. Kububulumko ukubona ugqirha ngokukhawuleza kwaye ufumane ingcebiso.

Yeyiphi imibuzo omele uyibuze ugqirha?

Cinga ngokubuza ugqirha wakho le mibuzo malunga nokungasebenzi kakuhle kwezintso:

• Uqiniseka njani ukuba ndinesifo sezintso?
• Ukuba andinangxaki yezintso, yeyiphi enye imeko endinokuba nayo?
• Yintoni ebangela ukungasebenzi kakuhle kwezintso zam?
• Ngaba ndiyayidinga i-dialysis?
• Luhlobo luni lwe-dialysis olucebisayo?
• Ingaba ndifanelekile na ukufakelwa izintso?
• Luhlobo luni lwamayeza ondicebisa wona?
• Ngaba kufuneka ndenze naluphi na utshintsho kwindlela enditya ngayo?
• Kufuneka ndize kangaphi ukuze ndifumane unyango?

Kufuneka kuqwalaselwe nini ukhathalelo lwe-hospice xa izintso zingasebenzi kakuhle?

Ukugqiba ukuba lixesha lini lokuba wena okanye umntu omthandayo afumane unyango lwe-hospice sisigqibo somntu ngamnye. Iqela lakho lezonyango linokukunceda ukhethe ukuba yintoni efanelekileyo kwimeko yakho. Injongo yonyango lwe-hospice kukubonelela ngentuthuzelo kunye nenkxaso kubantu abanesifo esikwinqanaba lokugqibela, njengokungasebenzi kakuhle kwezintso. Unyango lwe-hospice kwimeko yokungasebenzi kakuhle kwezintso ludla ngokwenzeka xa unyango olufana ne-dialysis okanye ukufakelwa kwezintso lungasasebenzi okanye lungenakwenziwa.

Ngoko ke, zeziphi izinto ekufuneka sizikhumbule kuzo zonke ezi zinto?

Izintso zizinto ezibalulekileyo emzimbeni wethu. Zisusa inkunkuma kunye nolwelo olongezelelweyo. Ukuba izintso zakho ziyasilela, oko kuthetha ukuba azisebenzi kakuhle. Ukuba azinyangwa, oku kunokuba yingozi. Kodwa ungakhathazeki, i-dialysis okanye ukufakelwa kwezintso kunokukunceda uqhubeke uphila ubomi obuhle. Isicwangciso sakho sonyango sinokubandakanya ukuthatha amayeza kunye nokulandela ukutya okukhethekileyo. Qiniseka ukuba ugcina onke amadinga akho nogqirha wakho. Ukuba unemibuzo okanye iinkxalabo malunga nonyango lwakho, amayeza, utshintsho lwendlela yokuphila, okanye nantoni na enye kwisicwangciso sakho sonyango, thetha nogqirha wakho.

Ukungasebenzi kakuhle kwezintso , isifo sezintso, isifo seswekile, uxinzelelo lwegazi oluphezulu, i-dialysis, ukufakelwa kwezintso