Ingaba uhlala unxaniwe kwaye ukhupha umchamo omninzi? Masithethe nge-Nephrogenic Diabetes Insipidus.

Ngaba nawe uziva unxaniwe imini yonke? Nokuba usela amanzi angakanani na, usaziva ngathi awunawo amanzi aneleyo? Ngaba kufuneka uchame rhoqo kwaye ngobuninzi? Usenokucinga ukuba oku kuqhelekile, okanye unokucinga ukuba sisifo seswekile. Nangona kunjalo, oku kungaba luphawu lwesifo esingaqhelekanga esibizwa ngokuba yi-'Nephrogen Diabetes Insipidus'. Makhe sithethe ngale nto ngokulula, ngendlela onokuyiqonda.

Yintoni i-Nephrogen Diabetes Insipidus?

Ngamafutshane, i-nephrogenic diabetes insipidus yimeko apho izintso zakho zingakwaziyo ukulawula ngokufanelekileyo ubungakanani bolwelo emzimbeni wakho. Imizimba yethu ivelisa ihomoni ebizwa ngokuba yi-Antidiuretic Hormone, okanye i-ADH ngamafutshane. Abanye abantu bayibiza ngokuba yiVasopressin. Le homoni, i-ADH, "ixelela" izintso zethu ukuba zingakanani na amanzi ekufuneka akhutshwe emchameni kwaye mangakanani na ekufuneka agcinwe emzimbeni.

Izintso zomntu onesifo seswekile i-nephrogenic insipidus aziphenduli kakuhle kule hormone ye-ADH. Oko kukuthi, nangona i-hormone ye-ADH inika uphawu "lokugcina amanzi nokunciphisa umchamo," izintso aziwuphulaphuli. Okwenzekayo ke kukuba izintso zivelisa umchamo omninzi kunokuba kuyimfuneko. Oku kunokukhokelela ngokukhawuleza, ngamanye amaxesha ngendlela eyingozi, ekuphelelweni ngamanzi emzimbeni, oko kukuthi, ukunqongophala kwamanzi.

Ixhaphake kangakanani le meko?

Izazinzulu aziqinisekanga ukuba bangaphi abantu abane-nephrogenic diabetes insipidus, kodwa zikholelwa ukuba yimeko engaqhelekanga kakhulu . Oko kuthetha ukuba ayisosifo esifunyanwa ngumntu wonke.

Ngaba kukho iintlobo ezahlukeneyo zesifo seswekile i-insipidus?

Ewe, kukho iintlobo ezine zesifo seswekile insipidus. Masibone ukuba zeziphi:

• I-Central Diabetes Insipidus: Oku kwenzeka xa kukho umonakalo kwi-pituitary gland okanye kwi-hypothalamus engqondweni yakho. La ngamalungu engqondo yakho avelisa, agcine, aze akhuphe i-hormone i-ADH. Lo monakalo uthintela umzimba wakho ekulawuleni i-ADH ngendlela eqhelekileyo.
• I-Nephrogen Diabetes Insipidus: Kolu hlobo lwesifo seswekile esithetha ngalo namhlanje, izintso azikwazi ukuphendula ngokufanelekileyo kwi-hormone ye-ADH. Nangona i-hormone ye-ADH ikhona, izintso zibonakala zingayinaki.
• I-Dipsogenic Diabetes Insipidus: Ikwabizwa ngokuba yi-'Primary Polydipsia', oku kubangelwa sisiphene kwindlela yokulawula ukoma kwi-hypothalamus yakho. Oku kukwenza uzive unxaniwe kakhulu, uzive ufuna ukusela amanzi rhoqo , kwaye uchame kakhulu.
• Isifo seswekile sokukhulelwa i-Insipidus: Oku kwenzeka kuphela ngexesha lokukhulelwa. Ngamanye amaxesha i-enzyme eveliswa yi-placenta iqhekeza i-hormone ye-ADH. Oku kuyaphela emva kokuba umntwana ezelwe.

Yintoni umahluko phakathi kwe-Nephrogenic Diabetes Insipidus kunye ne-Diabetes Mellitus?

Lo ngumba obaluleke kakhulu abantu abaninzi abadideka ngawo. Xa sisiva igama elithi "iswekile," sicinga ngeswekile, elithetha iswekile. Nangona kunjalo, nangona ezinye zeempawu zesifo sikashukela se-nephrogenic kunye nesifo seswekile (ezifana nokuchama kakhulu kunye nokunxanwa kakhulu) zifana, ezi zifo zimbini zahlukile ngokupheleleyo.

Isifo seswekile i-Mellitus sisifo esixhaphake kakhulu. Sibangelwa kukunqongophala kwe-hormone i-insulin okanye kukungasebenzisi kakuhle i-insulin emzimbeni, nto leyo ebangela amazinga aphezulu eswekile egazini. Nangona kunjalo, i-nephrogenic diabetes insipidus yingxaki eyenzeka xa izintso zingaphenduli kwi-hormone ye-ADH kwaye ayinanto yakwenza namanqanaba eswekile egazini . Ngoko ke, kungcono ukungazidibanisi zombini ezi zinto, akunjalo?

Zithini izizathu zesifo seswekile i-Insipidus esibizwa ngokuba yi-Nephrogen Diabetes Insipidus?

Izintso zethu zinoxanduva lokucoca igazi nokususa inkunkuma kunye nolwelo olongezelelweyo emzimbeni njengomchamo. Ihomoni i-ADH (vasopressin) inceda ukugcina ulungelelwano phakathi kobungakanani bamanzi esiwaselayo kunye nobungakanani bomchamo esiwukhuphayo.

Khawuthelekelele, xa umntu ophilileyo ebila kakhulu okanye esela amanzi amancinci, amanqanaba e-ADH ayanda, exelela izintso ukuba 'zenze umchamo omncinci, zonge amanzi emzimbeni.' Ngokufanayo, xa kukho amanzi aneleyo emzimbeni, amanqanaba e-ADH ayancipha, exelela izintso ukuba 'kulungile, yenza umchamo ngoku.'

Nangona kunjalo, ukuba umzimba wakho awuphenduli kakuhle kwi-ADH, izintso zakho zivelisa umchamo omninzi kakhulu. Oku kwenzeka kwi-nephrogenic diabetes insipidus. Le meko inokuthi ifuzwe (ilifa) okanye ivele nangaliphi na ixesha ebomini bakho (ifunyenwe) .

I-insipidus yesifo seswekile esifunyenwe yi-nephrogenic

Olu lolona hlobo luxhaphakileyo. Lwenzeka xa into ethile iphazamisana nokukwazi komzimba ukuphendula kwi-ADH. Umzekelo, inokubangelwa ziimeko ezithile ezichaphazela izintso zakho. Ezi meko ziquka:

• I-Amyloidosis – Oku kwenzeka xa iproteni engaqhelekanga ifakwa kwizitho zomzimba kuquka nezintso.
• Iintlobo ezithile zomhlaza
• Isifo sezintso esingapheliyo
• Usulelo lwezintso, umzekelo, i-pyelonephritis
• Isifo sezintso esine-polycystic – Oku kwenzeka xa kwakheka ii-cysts ezizaliswe lulwelo kwizintso.
• Izintso zesiponji zeMedullary

Kukho ezinye izizathu ezichaphazela oku:

• Amayeza athile: Ingakumbi i-lithium (esetyenziselwa ezinye izifo zengqondo) xa isetyenziswa ixesha elide.
• Amanqanaba aphantsi e-potassium egazini (i-hypokalemia)
• Ukwanda kwamanqanaba e-calcium egazini (hypercalcemia)
• I-anemia yeseli yesickle
• Isifo sikaSjögren – Esi sisifo esichaphazela inkqubo yomzimba yokuzikhusela.
• Ukuvaleka kwendlela yomchamo – umzekelo, into efana nelitye lomchamo.

Isifo seswekile esidluliselwa kwi-insipidus esidluliselwa kwi-genetic nephrogenic diabetes

Oku kubangelwa kukuguquka kwezakhi zofuzo i-AVPR2 okanye i-AQP2. Ezi zakhi zofuzo zixelela umzimba ukuba mawongeze amanzi angakanani kumchamo. Xa ezi zakhi zofuzo zingenaso isiphene, izintso azikwazi ukuphendula kwi-ADH. Iimpawu zesifo seswekile i-nephrogenic insipidus, esizalwa naso, zihlala zivela kwiinyanga ezimbalwa zokuqala zobomi .

Zithini iimpawu zesifo seswekile i-Insipidus se-Nephrogen?

Khawucinge nje, umazi umntu, masithi uSumana. USumana unxaniwe kakhulu imini yonke. Usebenza nebhotile enkulu yamanzi kufutshane. Kodwa kungekapheli neyure emva kokusela, unxaniwe kwakhona, kwaye kufuneka aye kwindlu yangasese rhoqo, kwaye uchama kakhulu. Ngamanye amaxesha uvuka kabini okanye kathathu ebusuku ukuze achame. Wacinga, 'Mhlawumbi kungenxa yokuba ndisela amanzi amaninzi kakhulu.' Kodwa ezi ziimpawu eziphambili ze-nephrogenic diabetes insipidus.

Umntu onesifo seswekile i-insipidus unokuba neempawu ezifana nezi:

• Iimpawu zokuphelelwa ngamanzi emzimbeni: Umlomo owomileyo, imilebe eqhekekileyo, ukudinwa kakhulu, ukuziva unesizungu, kwaye ngamanye amaxesha unamehlo aluhlaza okwesibhakabhaka xa umi. Cinga ngako njengokuhlala elangeni ixesha elide ngaphandle kwamanzi.
• I-Polydipsia: Ukuziva ngathi awufumani manzi aneleyo nokuba usela kangakanani na.
• Ukuchama kakhulu (iPolyuria): Ukuba umntu omdala uchama ngaphezu kweelitha ezi-3 ngosuku (ngesiqhelo phakathi kweelitha ezi-5-20!), kwaye ukuba umntwana uchama ngaphezu kweelitha ezi-2 ngosuku, kuyarhaneleka. Umchamo nawo unombala okhanyayo kakhulu, njengamanzi.

Ukuba umntwana omncinci unale meko, unokubonisa iimpawu ezifana nezi kuba engazi ukuba athethe njani:

• Urhudo
• Ukungakwazi ukukhula nokunyuka kwesisindo – Ayityebi okanye ikhule ibe nde kunezinye iintsana.
• Umkhuhlane oqhelekileyo
• Ukungazoli rhoqo kunye nokukhala (Ukucaphuka) - umntwana ubonakala ekhathazekile.
• Ukulahlekelwa ngumdla wokutya, ukuncipha kokutya ubisi
• Ukuxhuzula – Olu luphawu oluyingozi.
• Ukuhlanza
• Ukutshintsha iinapukeni ezimanzi rhoqo.

Ifunyanwa njani i-Nephrogen Diabetes Insipidus?

Ukuba unale mpawu, into yokuqala omawuyenze kukubona ugqirha. Uza kukubuza imibuzo, akuhlole, kwaye, ukuba kuyimfuneko, acele iimvavanyo ezifana nezi:

• Uvavanyo lwegazi: Jonga inqanaba lee-electrolytes, ezifana ne-sodium, emzimbeni, kunye nokusebenza kwezintso.
• Uvavanyo lomchamo:Jonga ubungakanani bomchamo (ukuba unciphile kangakanani), kunye nokuba yintoni esemchameni.
• Uvavanyo lokungafumani manzi: Oku kuquka ukungaseli naluphi na ulwelo kangangeeyure ezininzi, uze emva koko ujonge ubunzima bakho, ukuphuma komchamo, kunye nobungakanani begazi nomchamo ngeyure nganye. Olu luvavanyo olunzima, kodwa lubaluleke kakhulu ekuxilongweni. Le yindlela ekuphela kwayo yokufumanisa ngokuchanekileyo ukuba izintso ziyasabela kwi-ADH. Olu vavanyo lwenziwa phantsi kweliso likagqirha esibhedlele.
• Uvavanyo nge-hormone ye-ADH: Ngamanye amaxesha, i-hormone ye-ADH inikwa njengenaliti kunye novavanyo lokunqongophala kwamanzi, emva koko kujongwa ukuba ingaba ubuninzi bomchamo buyatshintsha na. Kwi-nephrogenic diabetes insipidus, nokuba i-ADH inikwe, ubuninzi bomchamo abutshintshi kangako.
• I-MRI scan ye-pituitary gland yakho (i-Magnetic resonance imaging): Ukuba ukrokrela imeko efana ne-central diabetes insipidus, khangela naziphi na iingxaki engqondweni.
• Uvavanyo lwemfuza: Ukuba kukho umntu kusapho lwakho onesifo seswekile insipidus, okanye ukuba ukrokrela ukuba sisifo esizuzwe njengelifa.

Ngaba ikho indlela yokunyanga isifo seswekile i-Insipidus se-Nephrogen?

Inyaniso kukuba, okwangoku akukho nyango lupheleleyo lwesifo seswekile se-nephrogenic insipidus.

Kodwa ungakhathazeki. Ingalawuleka. Ugqirha wakho unokukwazi ukutshintsha amayeza owasebenzisayo abangela ingxaki (njenge-lithium). Kwakhona, ukuba kukho enye imeko engaphantsi (njengesifo sezintso okanye ukungalingani kwe-calcium/potassium), ukuyinyanga ngokufanelekileyo ngamanye amaxesha kunokubuyisela okanye kulawule i-nephrogenic diabetes insipidus.

Ngoko ke uyiphatha njani le nto?

Kwimeko apho ingenakulungiseka (umzekelo, ukuzalwa kwayo), unyango lujolise kakhulu ekuthinteleni ukuphelelwa ngamanzi emzimbeni kunye nokugcina umgangatho wobomi ulungile. Oku kungabandakanya:

• Sela amanzi rhoqo: Le yeyona nto ibalulekileyo. Ufanele usele amanzi imini yonke, nanini na xa unxaniwe. Qiniseka ukuba usela amanzi amaninzi, ingakumbi ngeentsuku ezishushu, xa uzilolonga, okanye xa ubila. Gcina ibhotile yamanzi kufutshane ebusuku.
• Utshintsho kwindlela yokutya:
• Ukutya okungenatyuwa ingako: Ukutya ityuwa eninzi kwandisa ukoma kunye nokuchama.
• Ukutya okungenaproteni eninzi: Ngamanye amaxesha unokuxelelwa ukuba unciphise iiproteni, kuba amanzi nawo ayafuneka ukuze kukhutshwe inkunkuma eveliswa ngexesha lokugaya iiproteni.
• Amayeza anciphisa ukuphuma komchamo:
• I-Thiazide diuretics:Okumangalisayo kukuba, la mayeza okukhupha umchamo, xa enikwa abantu abanesifo seswekile esibizwa ngokuba yi-nephrogenic diabetes insipidus, anciphisa umchamo abawuvelisayo. Kunzima kancinci, kodwa aluncedo.
• I-Amiloride: Inganikwa kunye ne-thiazides, ingakumbi kwi-NDI ebangelwa yi-lithium.
• Amayeza Angasebenzisi I-steroidal Anti-Inflammatory Drugs (NSAIDs): Umzekelo, i-indomethacin. La mayeza anceda ekwenzeni izintso zibe buthathaka kancinci kwi-ADH.

Zeziphi ukutya neziselo ekufuneka umntu onesi sifo aziphephe?

Ugqirha wakho angakuxelela ukuba unciphise utywala, iziselo ezine-caffeine (ezifana nekofu, iti, kunye nezinye iziselo ezibandayo), ukutya okunetyuwa (okufana neepickles, inyama eyomileyo, iisoseji, kunye neetships), kwaye mhlawumbi nokutya okuneproteni eninzi, njengoko oku kunokubangela ukuba umzimba wakho ulahlekelwe ngamanzi amaninzi kwaye kwandise ulwelo lwakho.

Ngaba kukho iindlela zokuthintela i-Nephrogenic Diabetes Insipidus?

Akukho maqhinga aqinisekisiweyo okuthintela oku. Ingakumbi uhlobo lokuzalwa alunakuthintelwa. Nangona kunjalo, kuhlobo olufunyenweyo:

• Ukuba usela amayeza anokubangela i-NDI, njenge-lithium, kubalulekile ukuthetha nogqirha wakho ngayo kwaye uhlole ukusebenza kwezintso zakho rhoqo.
• Umngcipheko ungancitshiswa ngokunyanga ngokukhawuleza nangokufanelekileyo iingxaki zempilo ezisisiseko (isifo sezintso, ukungalingani kwe-electrolyte).

Ukuba ndinayo le meko, ndimele ndilindele ntoni?

Ezi zezona ndaba zimnandi. Ngonyango olufanelekileyo nendlela yokuphila enempilo , abantu abane-nephrogenic diabetes insipidus badla ngokuba neengxaki ezimbalwa kwaye banokuphila ubomi obuqhelekileyo. Ungasebenza kwaye wonwabele ubomi njengesiqhelo.

Nangona kunjalo, ukuba ayiphathwa kakuhle, oku kunokukhokelela kwiingxaki ezinkulu. Makhe sijonge ukuba zeziphi:

• Ukuphelelwa ngamanzi emzimbeni: Le yeyona ngxaki ixhaphakileyo neyona inzima. Ukuphelelwa ngamanzi emzimbeni kakhulu kunokukhokelela ekulahlekelweni zingqondo, ukuxhuzula, kunye nokungasebenzi kakuhle kwezintso.
• Ukuphazamiseka kwe-electrolyte: Olu lutshintsho kubungakanani be-electrolytes (ezifana ne-sodium kunye ne-potassium) emzimbeni. Oku kunokuchaphazela isantya sentliziyo kunye nokusebenza kwemithambo-luvo.
• Izifo: Izinto ezifana nezifo zomchamo (UTI) kunye nezifo zezintso.
• Ukulibaziseka kokukhula, umonakalo wengqondo kunye nokukhubazeka kwengqondo kwiintsana. Oku kuyingozi kakhulu kubantwana abancinci. Ngoko ke, ukuba umntwana unezi mpawu, unyango kufuneka luqalwe ngoko nangoko.
• Ukungasebenzi kakuhle kwezintso: Kunokwenzeka kwixesha elide ukuba akulawuleki kakuhle.
• I-Hydronephrosis: Ngenxa yokuba isinyi sihlala sigcwele, umchamo uyabuyela umva kwaye izintso ziyadumba.

Ufanele ufune nini ingcebiso kagqirha?

Ukuba unamathandabuzo okanye uxhalabile malunga nobungakanani bomchamo owukhuphayo, ingakumbi ukuba ukhupha umchamo omninzi ngenxa yokuchama kakhulu, qiniseka ukuba ubonana nogqirha.

Ubungakanani bomchamo umntu omdala adlula kuwo ngosuku bungahluka kumntu nomntu, ingakumbi kuxhomekeke ekubeni basela amanzi angakanani na. Kodwa ukuba uchama ngaphezu kweelitha ezi-2-3 ngosuku (ezinye iinkcazo zithi ngaphezu kweelitha ezi-3), okanye ukuba uchama rhoqo (ngaphezu kwezihlandlo ezisixhenxe okanye ezisibhozo ngosuku) , oko kungaba luphawu lwengxaki.

Ngaphambi kokuba uye kugqirha, kunceda kakhulu ukugcina idayari yokuba usela amanzi angakanani kwaye uvelisa umchamo ongakanani (ulinganiswe ukuba kunokwenzeka). Oku kuya kwenza kube lula kugqirha ukuqonda imeko yakho.

Ngoko ke, zeziphi izinto esifanele sizikhumbule kweli bali? (Umyalezo Wokubuyela Ekhaya)

Isifo seswekile i-Nephrogenic Diabetes I-Insipidus yimeko engaqhelekanga apho izintso zakho zingasabeli kakuhle kwi-hormone i-ADH emzimbeni wakho, nto leyo ebangela ukuba uvelise umchamo omninzi kakhulu. Oku kunokukhokelela ekuphelelweni ngamanzi emzimbeni ngokukhawuleza.

• Iimpawu eziphambili kukunxanwa kakhulu kunye nokuchama okugqithisileyo, okumanzi .
• Oku akufanele kudidaniswe nesifo seswekile; kule meko, inqanaba leswekile egazini liqhelekile.
• Le meko inokubakho xa umntu ezalwa okanye ikhule kamva ebomini.
• Nangona kungekho ndlela ipheleleyo yonyango, ngonyango olufanelekileyo kunye notshintsho kwindlela ophila ngayo (ingakumbi ukusela amanzi aneleyo kunye nokulawula ukutya kwakho), ungaphila ubomi obuqhelekileyo nobunempilo.
• Ukuba ukrokrela ukuba wena okanye umntwana wakho unezinye zezi mpawu, funa ingcebiso kagqirha ngokukhawuleza. Musa ukoyika, kodwa eyona nto ibalulekileyo kukwaziswa uze uthathe amanyathelo afunekayo. Awuwedwa, kwaye oogqirha banokukunceda.

Isifo seswekile i- Nephrogenic diabetes insipidus, isifo sezintso, ukuchama kakhulu, ukoma kakhulu, i-ADH, i-vasopressin, ukuphelelwa ngamanzi emzimbeni