Ngaba wakha waphawula ukuba imilenze namaqatha akho ayadumba nje? Okanye wakha waphawula ukuba xa uchama, kuba negwebu? Ezi asizompawu zokuzityeshela nje. Zingaba ziimpawu zokuba kukho into engalunganga ngezintso zakho. Namhlanje siza kuthetha ngemeko engaqhelekanga kodwa ebalulekileyo echaphazela izintso zakho. Loo nto ibizwa ngokuba yiMembranous Nephropathy (MN).
Yintoni iMembranous Nephropathy (MN)?
Ngamafutshane, iMembranous Nephropathy (MN) yimeko apho inkqubo yakho yomzimba yokuzikhusela, inkqubo ekukhusela kwizifo, ihlasela izintso zakho. Ayimangalisi na loo nto? Ukuzikhusela kwethu kuyasihlasela.
Ngoku khangela, ngaphakathi kwezintso zethu, kukho izigidi zeefilitha ezincinci ezicoca igazi. Ezi sizibiza ngokuba yi-glomeruli . Njengesihluzo seti, ezi glomeruli zihluza inkunkuma engafunekiyo egazini zize ziyikhuphe emzimbeni njengomchamo. Omnye umsebenzi wezifilitha kukugcina izinto ezibalulekileyo ezifana neeproteni ezifunwa ngumzimba egazini.
Okwenzekayo kumntu one-MN kukuba inkqubo yomzimba yokuzikhusela, njengoko benditshilo, ihlasela kwaye yonakalise ezi zihluzo zibizwa ngokuba yi-glomeruli. Xa lo monakalo usenzeka, imingxunya kwiihluzo iba mikhulu. Emva koko iiproteni ezifunekayo emzimbeni ziqala ukuhluza ngesihluzo zize ziphume nomchamo. Le yingxaki esisiseko yesi sifo.
Le meko inokuvela ngequbuliso, okanye ikhule kancinci kancinci ngokuhamba kwexesha. Ngamanye amaxesha, abantu basenokungazi nokuba banale meko kangangeminyaka.
Kukho iintlobo ezimbini eziphambili zesi sifo.
Sizahlulahlula esi simo seMembranous Nephropathy (MN) zibe ziindidi ezimbini eziphambili. Olu hlu lwenziwa ngokusekelwe kwisizathu.
| Uhlobo lwesifo | Inkcazo |
|---|---|
| I-Primary Membranous Nephropathy (Idiopathic) | Olu lolona hlobo luxhaphakileyo (malunga nama-75% ezigulana). Okwenzekayo apha kukuba inkqubo yomzimba yokuzikhusela ihlasela izintso ngokuthe ngqo, ngaphandle kwesinye isifo. Oku kuthathwa njengemeko yokuzikhusela komzimba. |
| I-Secondary Membranous Nephropathy | Oku kwenzeka xa izintso zonakaliswe yenye imeko yezonyango, usulelo, okanye amayeza. Oku kuthetha ukuba izintso zonakaliswe ngenxa yesiphumo senye into. Malunga nama-25% ezigulana zinolu hlobo. |
Ngaba nawe unazo ezi mpawu?
Iimpawu eziphambili zesifo se-MN zibangelwa sisixa esikhulu seprotheyini esikhutshwa kumchamo, njengoko benditshilo ngaphambili. Kwizonyango, sibiza ukuqokelelwa kweempawu ezibangelwa sesi sifo se-Nephrotic Syndrome .
Iimpawu eziphambili zezi:
- Ukudumba: Ukudumba, ingakumbi emilenzeni, emaqatheni, ezinyaweni, kwaye ngamanye amaxesha ebusweni nasezandleni. Oku kudumba kwenzeka xa kukho ukuncipha kweproteni egazini, nto leyo ebangela ukuba amanzi kwimithambo yegazi angene kwizicubu.
- Umchamo onamagwebu amaninzi (iProteinuria): Ngenxa yobuninzi beproteni kumchamo, ungabonakala ngathi unegwebu, njengamanzi anesepha.
- Ukudinwa kakhulu nokudinwa: Usenokuziva udiniwe ngalo lonke ixesha kuba umzimba wakho ulahlekelwa ngamandla kunye nezondlo ozifunayo.
- Ukwanda kobunzima ngequbuliso: Oku akukhuli ngokwenene, kodwa kuyanda ngenxa yokugcinwa kwamanzi.
- I-cholesterol ephezulu: Xa inqanaba leeproteni egazini lihla, isibindi sethu sivelisa amafutha amaninzi kunye ne-cholesterol ukuze sibuyisele umzimba.
- Uxinzelelo lwegazi oluphezulu: Uxinzelelo lwegazi lunokunyuka xa izintso zingaphumeleli.
- Ubunzima bokuphefumla: Le meko inokwenzeka ukuba ulwelo luqokelelana lujikeleze imiphunga.
Kutheni oku kusenzeka? Zithini izizathu?
Izizathu ziyahluka ngokuxhomekeke kwiintlobo ezimbini esizixubushe ngaphambili.
Unobangela we-MN eyintloko
Ndithe i-primary MN yimeko yokuzikhusela komzimba. Okwenzekayo apha kukuba inkqubo yethu yomzimba yokuzikhusela ifumanisa ngempazamo iproteni ekhethekileyo ebizwa ngokuba yi-phospholipase A2 receptor (PLA2R) kwiifilitha zezintso (glomeruli) "njengotshaba." Emva koko, yenza ii-antibodies zokutshabalalisa le protein ye-PLA2R kwaye iyihlasele. Olu dabi lubangela ukuba ezo zifilitha zonakale kwaye iproteni iphume.
Izinto ezinokubangela i-MN yesibini
I-MN yesibini sisiphumo senye into. Nazi ezinye izinto ezinokuyichaphazela:
- Ezinye izifo ezibangelwa kukuzikhusela komzimba: Izifo ezifana neLupus kunye neRheumatoid Arthritis.
- Iintsholongwane: Iintsholongwane ezifana neHepatitis B, iHepatitis C, iMalariya, kunye neSyphilis.
- Umhlaza: Ingakumbi umhlaza wemiphunga kunye nomhlaza wamathumbu amakhulu.
- Amayeza:Ukusetyenziswa ixesha elide kwamayeza afana nee-NSAIDs kunye ne-penicillamine.
- Iityhefu: Ukuvezwa kwiisinyithi ezinzima ezifana ne-mercury.
Khumbula, ukuba unale mpawu, eyona nto ibalulekileyo kukubona ugqirha wakho ngokukhawuleza kwaye ufumane ingcebiso, endaweni yokuqikelela unobangela.
Zeziphi iingxaki ezinokubangela oku?
Ukuba i-MN ayinyangwa kakuhle, iingxaki ezinkulu zinokuvela ngokuhamba kwexesha.
- Umngcipheko ophezulu we-cholesterol kunye nesifo sentliziyo: Ukwanda kwamafutha egazini kwandisa umngcipheko wezifo ezifana nesifo sentliziyo kunye nesifo sohlangothi.
- Amahlwili egazi: Xa iproteni ikhutshwa kumchamo, iiproteni ezithintela ukujiya kwegazi nazo zikhutshwa emzimbeni. Oku kunokubangela ukuba amahlwili egazi akheke kwimithambo yemilenze. Oku sikubiza ngokuba yiDeep Vein Thrombosis (DVT) . Ukuba eli hlwili legazi liyaqhekeka lize libambeke emthanjeni emiphungeni, yimeko embi nesongela ubomi ebizwa ngokuba yiPulmonary Embolism (PE) .
- Ukungasebenzi kakuhle kwezintso: Ukuba isifo asilawulwa, umonakalo kwizintso uyanda kancinci kancinci, kwaye ekugqibeleni izintso zisenokungasebenzi ngokupheleleyo.
Ugqirha uyifumana njani le nto?
Ukuba unezi mpawu zingasentla, ugqirha wakho wosapho uza kukuthumela kwingcali yezintso (Nephrologist). Uza kwenza iimvavanyo ezininzi ukuze afumanise isifo ngokuchanekileyo.
| Uvavanyo | Ujonga ntoni? |
|---|---|
| Uvavanyo lomchamo | Bajonga ukuba ingakanani na iproteni kunye negazi elikwimchamo. |
| Uvavanyo lweGazi | Izinto ezifana ne -creatinine, i-blood urea nitrogen (BUN) , ezilinganisa ukusebenza kwezintso, kunye namanqanaba eeproteni zegazi (i-albumin) ziyajongwa. |
| Izinga lokuhluza iGlomerular (GFR) | Oku kwenziwa nangovavanyo lwegazi. Lulinganisa ukuba izintso zakho zicoca ngokukhawuleza kangakanani inkunkuma. |
| I-Biopsy yezintso | Le yeyona ndlela ilungileyo yokuqinisekisa isifo i-100% yexesha. Kusetyenziswa inaliti encinci, kuthathwa iqhekeza elincinci kakhulu lesicwili kwizintso lize lihlolwe phantsi kwemakroskopu. Oku kunokumisela ngokuchanekileyo ukuba utshintsho kunye nee-antibodies ezinxulumene nesifo se-MN zikhona na. |
Zithini iindlela zonyango zoku?
Unyango luxhomekeke kuhlobo lwe-MN onalo kunye nokuba iimpawu zakho zinzima kangakanani. Injongo ephambili yonyango kukunciphisa iimpawu kunye nokuthintela isifo ukuba singabi mandundu.
Enye okanye ezingaphezulu kwezi zilandelayo zingasetyenziswa njengonyango:
- Amayeza oxinzelelo lwegazi: Amayeza afana ne -ACE inhibitors kunye nee-ARB alawula uxinzelelo lwegazi kwaye anciphisa nokukhutshwa kweproteni kumchamo.
- I-Diuretics: Ezi zikwabizwa ngokuba "ziipilisi zamanzi." Zinceda ekunciphiseni ukudumba ngokususa ulwelo olugqithisileyo emzimbeni njengomchamo.
- Amayeza okwehlisa i-cholesterol (ii-Statins): La mayeza anikwa ukulawula amanqanaba aphezulu e-cholesterol egazini.
- Izithibi zegazi: Ezi zisetyenziselwa ukunciphisa umngcipheko weengxaki ezifana ne-DVT.
- Izinto ezithintela amasosha omzimba: Amayeza afana ne -corticosteroids anikwa ukuthintela ukusebenza kwenkqubo yomzimba yokuzikhusela kunye nokuzama ukuyithintela ekuhlaseleni izintso.
- Utshintsho kwindlela yokutya: Kubaluleke kakhulu ukunciphisa ukutya okunetyuwa eninzi namafutha amaninzi . Ugqirha wakho uza kukunika iingcebiso malunga nokutya okufanelekileyo.
Ukuba olu nyango luqhelekileyo alwanelanga ukulawula isifo, ugqirha angaqhubeka nonyango olunamandla ngakumbi olubizwa ngokuba yi-immunotherapy . Amayeza afana neRituximab kunye neCyclophosphamide asetyenziselwa ukutshabalalisa iiseli ezivelisa ii-antibodies ezihlasela izintso.
Kumntu one-MN yesibini, ukunyanga unobangela oyintloko (umz., usulelo lwe-hepatitis, i-lupus) kunokuthintela okanye kunciphise umonakalo wezintso.
Ukuba isifo sifikelela kwinqanaba elibi kakhulu kwaye sibangela ukungasebenzi kakuhle kwezintso, i-dialysis okanye ukufakelwa kwezintso kunokufuneka.
Ubomi bunjani ngesi sifo?
Indlela esi sifo esihamba ngayo iyahluka kumntu nomntu. Kwabanye abantu, esi sifo siyaphela ngokupheleleyo ngonyango oluncinci okanye kungekho nyango. Kwabanye, esi sifo sihlala iminyaka.
Eyona nto ingcono kukuba bangaphantsi kwe-15% abantu abane-MN abaqhubeka nokungasebenzi kakuhle kwezintso, nto leyo ethetha ukuba uninzi lwabo lunokuphila ubomi obuqhelekileyo ngonyango.
Kodwa eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba esi sifo sinokuphinda sibuye nasemva konyango. Kungoko ke, kubalulekile ukutyelela iikliniki kwaye uvavanywe ngamaxesha amiselweyo njengoko kuchaziwe yingcali yakho yezintso. Emva koko, ukuba kukho iimpawu zesifo esiphinda sibuye, unyango lunokuqaliswa ngoko nangoko.
Umyalezo Wokuya Ekhaya
- Ukuba uneentlungu ezingaziwayo emilenzeni, ezinyaweni, okanye ebusweni, okanye uqaphela igwebu eligqithisileyo kumchamo wakho, musa ukulibazisa. Bona ugqirha wakho ngoko nangoko.
- I-Membranous Nephropathy (MN) yimeko yokuzikhusela komzimba apho inkqubo yakho yokuzikhusela yomzimba ihlasela izintso zakho.
- Uvavanyo lwezintso lubaluleke kakhulu ukuze kuchongwe ngokuchanekileyo esi sifo.
- Nangona esi sifo singenakunyangwa ngokupheleleyo, kukho unyango olusebenzayo kakhulu lokulawula iimpawu, ukunciphisa umonakalo kwizintso, kunye nokuthintela iingxaki.
- Ukulandela imiyalelo kagqirha wakho ngokuchanekileyo nokuya kwiikliniki ngexesha elifanelekileyo kubalulekile ekugcineni impilo yezintso zakho.
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