Ngaba iingxaki zakho zezintso zingachaphazela amathambo akho? Masifunde nge-Renal Osteodystrophy!

Ngaba unesifo sezintso, okanye oko thina oogqirha sikubiza ngokuba sisifo sezintso esinganyangekiyo (CKD) ? Okanye ngaba ukho umntu omaziyo onesifo esinjalo? Abantu abaninzi bacinga ukuba xa sisithi isifo sezintso, sichaphazela izintso kuphela. Kodwa inyani yile, xa izintso zethu zingasebenzi kakuhle, zinokuba nefuthe elikhulu kwezinye iinkqubo ezininzi emzimbeni, ingakumbi inkqubo yethu yamathambo, oko kukuthi, amathambo ethu . Ngoko ke, namhlanje siza kuthetha ngemeko apho amathambo ethu aba buthathaka aze abangele iingxaki ngenxa yesifo sezintso. Oku kuthiwa yi- renal osteodystrophy ngokwezonyango. Nangona eli gama liyinkimbinkimbi kancinci, masiliqonde ngokulula.

Yintoni i-Renal Osteodystrophy?

Ngamafutshane, i-Renal Osteodystrophy sisifo samathambo esinokuchaphazela abantu abadala kunye nabantwana abanesifo sezintso esinganyangekiyo (CKD).

Ngoku, khangela, izintso zethu zinendima ebaluleke kakhulu. Oko kukulawula amanqanaba eeminerali ezifana necalcium kunye nephosphorus egazini lethu. Kwakhona, izintso zinoxanduva lokuvuselela i-vitamin D kunye nokuvelisa i-hormone ebizwa ngokuba yi -calcitriol , enceda ukugcina amathambo ethu eqinile.

Ngoko ke, xa izintso zingasebenzi kakuhle okanye zingasebenzi kakuhle, azikwazi ukulawula ubungakanani bezi minerali kunye nehomoni i-calcitriol. Kulapho ke amathambo ethu aqala ukuba buthathaka kancinci kancinci . Oku kwandisa umngcipheko wokuqhekeka kwamathambo ngokulula, nto leyo ethetha ukwaphuka kwamathambo .

Zeziphi iiminerali kunye neehomoni ezinceda ukugcina amathambo ethu esempilweni?

Kukho iiminerali ezibalulekileyo kunye neehomoni ezinceda ukugcina amathambo ethu ephilile kwaye enamandla. Masifunde kancinci ngazo.

• I-Calcium: Le yeyona nto iphambili emathanjeni ethu. Amathambo afana "nebhanki ye-calcium" emzimbeni wethu. I-calcium ayiqinisi amathambo kuphela, kodwa ikwabalulekile nakwezinye izinto ezininzi, njengokusebenza kwenkqubo yemithambo-luvo kunye nokusebenza kwemisipha. Izintso zethu zinceda ukulinganisela amanqanaba e-calcium egazini.
• I-Phosphorus: Njenge-calcium, i-phosphorus nayo ibaluleke kakhulu emathanjeni. Izintso zethu zisusa i-phosphorus engaphezulu engayidingiyo umzimba kwaye zigcina ibhalansi efanelekileyo phakathi kwe-calcium ne-phosphorus egazini.
• ICalcitriol: Olu luhlobo olusebenzayo lwevithamini D. Yenziwa zizintso zethu. Le hormone inceda ukulawula ubungakanani bekhalsiyam efunxwa yimizimba yethu ekutyeni esikutyayo kwaye ikwanceda ukusebenza kwamadlala ethu e-parathyroid.
• I-Fibroblast Growth Factor 23 (FGF23):Le yi-hormone eveliswa ngamathambo ethu. Inceda ekulawuleni amanqanaba e-phosphorus kunye ne-vitamin D. Amanqanaba e-FGF23 adla ngokuba phezulu kubantu abanesifo sezintso esingapheliyo.
• IHormone yeParathyroid (PTH): Le hormone iveliswa ziindlala ezine ezincinci ezikwi-thyroid gland entanyeni yethu. Ezi zibizwa ngokuba ziindlala ze-parathyroid. Umsebenzi wale hormone ye-PTH kukukhupha i-calcium emathanjeni xa umzimba udinga i-calcium kwaye ugcine inqanaba le-calcium egazini lizinzile.

Ziziphi iintlobo eziphambili ze-Renal Osteodystrophy?

Amathambo ayakhula xa sisebancinci. Kodwa nangona sikhula, amathambo ethu akahlali nje apho. Ahlala ehlaziywa kwaye elungiswa. Njengokususa izitena ezindala nokufaka ezintsha ukwakha udonga, izicubu ezindala zamathambo ziyaqhekeka kwaye kwakheka izicubu ezintsha zamathambo. Le nkqubo siyibiza ngokuba "kukutshintsha kwamathambo."

I-Renal Osteodystrophy inokwenzeka ukuba olu tshintsho lwethambo lukhawuleza kakhulu okanye lucotha kakhulu. Kukho iintlobo ezine eziphambili:

• I-Osteitis Fibrosa: Le yimeko apho izicubu zethambo ziqhekeka ngokukhawuleza. Oku kubangelwa kukunyuka kwamanqanaba e-parathyroid hormone (PTH). Oku kubizwa ngokuba yi -hyperparathyroidism .
• I-Osteomalacia: Le yimeko apho izicubu zamathambo ziqhekeka khona, kodwa ithambo elitsha lenziwa kancinci kakhulu. Amathambo aba yi-sponge kwaye abe buthathaka. Oku kunokubangelwa kukungabikho kwe-vitamin D, ubuthi besinyithi, kunye nokuveliswa kakhulu kwe-hormone ye-FGF23 ngenxa yeentlobo ezithile zomhlaza.
• Isifo Samathambo Esitshintshatshintshayo: Esi sisifo apho ukwakheka nokulungiswa kwezicubu zamathambo kuncipha kakhulu. Isizathu esiphambili soku kukuncipha kwamanqanaba e-parathyroid hormone (PTH).
• I-Mixed Renal Osteodystrophy: Le meko idibanisa iimpawu ze-Osteitis Fibrosa kunye ne-Osteomalacia.

Ngoku masithethe ngezi ntlobo ngeenkcukacha ezithe vetshe.

I-Osteitis Fibrosa

Sihlala sisiva ukuba abantu abanesifo sezintso esinganyangekiyo banezinga eliphezulu le-parathyroid hormone (PTH). I-PTH inoxanduva lokukhupha i-calcium emathanjeni iye egazini ukuze ilinganise inqanaba le-calcium egazini. Nangona kunjalo, ukuba inqanaba le-PTH liphezulu kakhulu, litsala i-calcium eninzi emathanjeni. Oku kunokukhokelela ekwakhiweni kwee-cysts ezine-fibrous ngaphakathi emathanjeni, nto leyo ewenza amathambo abe buthathaka.

Kukho izizathu ezahlukeneyo zokuba amanqanaba e-PTH anokunyuka:

• Ukunqongophala kweCalcitriol: Xa izintso zonakele, azikwazi ukuvelisa iCalcitriol ngokufanelekileyo, nto leyo enyusa imveliso yePTH.
• Amanqanaba e-FGF23 anyukileyo:Oku kungaba luphawu lokuqala lwesifo sezintso. Kungaba yindlela amathambo asabela ngayo ekuthinteleni ukwanda kwamanqanaba e-phosphorus egazini.
• Ukwanda kwe-phosphorus: Kwisifo sezintso esingapheliyo, i-phosphorus iqokelelana egazini kuba izintso azikwazi ukuyisusa ngokufanelekileyo. Oku kukwakhuthaza ukuveliswa kwe-PTH.

I-Osteomalacia

Eyona nto ibangela le meko kukungabikho kwevithamini D. Oku kuqhelekile kubantu abanesifo sezintso esihlala ixesha elide.

Kwakhona, ezinye iimetali zinokubangela i-osteomalacia ngenxa yobuthi bemetali . Umzekelo, iimetali ezifana ne-aluminium ziphazamisa ukwakheka nokugcinwa kwamathambo. Ngaphambili, amanye amayeza awayesetyenziselwa ukulawula amanqanaba e-phosphorus (ii-phosphate binders) ayene-aluminium. Nangona kunjalo, la mayeza awasacetyiswa kubantu abanesifo sezintso, ingakumbi abo bakwi-dialysis . Ii-non-aluminium phosphorus binders ziyafumaneka ngoku. Xa zithathwa kunye nokutya, zithintela i-phosphorus ekutyeni ukuba ingangeni egazini.

Ezinye iintlobo zomhlaza zinokubangela ukuveliswa kakhulu kwehomoni i-FGF23, nto leyo enokubangela i-osteomalacia kunye nokuqhekeka kwamathambo.

Isifo Samathambo Esiguquguqukayo

Kulapho ukwakheka nokulungiswa kwezicubu zamathambo kuncipha kakhulu. Le meko ixhaphake kakhulu kubantu abanesifo sezintso esinzima nakwabo bakwi-dialysis. Isizathu esiphambili soku kukuba ubungakanani be-calcium kunye ne-vitamin D emzimbeni buphezulu kakhulu . Xa kunyangwa isifo sezintso, ngamanye amaxesha kufuneka kunikwe i-calcium eyongezelelweyo kunye ne-vitamin D. Nangona oku kunceda ekuthinteleni i-osteodystrophy yezintso, ebangelwa kukuguquka kwamathambo okuphezulu, ngamanye amaxesha kunokubangela ukuba amanqanaba e-parathyroid hormone (PTH) ehle kakhulu.

Kukho ezinye izizathu ezininzi:

• I-Continuous Peritoneal Dialysis: Olu luhlobo lwe-dialysis. Apha, igazi licocwa ngaphakathi kwisisu. Oku kwahlukile kwi -hemodialysis , eyenziwa ngomthambo osengalweni yakho. Ezinye ii-peritoneal dialysis fluids zine-calcium eninzi. Oku kunokubangela amanqanaba aphantsi e-PTH.
• Isifo seswekile: Kwisifo seswekile, ukunyuka kwamanqanaba eswekile egazini kunye nokwehla kwamanqanaba e-insulin nako kunokunciphisa ukuveliswa kwe-PTH.

Yintoni i-CKD-MBD (Chronic Kidney Disease-associated Mineral and Bone Disorder)?

Xa ibhalansi yeeminerali kunye neehomoni egazini lethu iphazamiseka, inokuchaphazela intliziyo kunye nemithambo yegazi yethu. I-CKD-MBD (Chronic Kidney Disease Mineral and Bone Disorder) ligama elibanzi eliquka iimeko ezifana ne-Renal Osteodystrophy kunye nesifo sentliziyo esinxulumeneyo.

Ngamafutshane, xa i-calcium kunye ne-phosphorus egazini ziphezulu kakhulu, kunokukhokelela kwisifo sentliziyo. Isizathu sale nto yinkqubo ebizwa ngokuba yi-calcification . Oko kukuthi, i-calcium iyaqokelelana ize ihlale ngaphakathi kwemithambo yegazi. Oku kunokubangela ukuba iindonga zemithambo yegazi ziqine kwaye ziqine. Oku kubizwa ngokuba yi-atherosclerosis . Oku kunokukhokelela kwiimeko ezinzulu ezifana noxinzelelo lwegazi oluphezulu, ukuhlaselwa yintliziyo, kunye ne-stroke. Khawucinge ukuba ingxaki yezintso inokufikelela phi!

Ixhaphake kangakanani i-Renal Osteodystrophy?

Kuqikelelwa ukuba malunga ne-15% yabantu abadala eMelika banesifo sezintso esinganyangekiyo. Uninzi lwabo lunokuba ne-osteodystrophy yezintso. Lo monakalo wethambo unokuba mkhulu ngakumbi emva kokuba izintso zingasebenzi ngokupheleleyo, nasemva kokwenza i-dialysis ixesha elide. Le meko ixhaphakile naseSri Lanka.

Zithini izizathu ze-Renal Osteodystrophy?

Isizathu esiphambili sisifo sezintso esinganyangekiyo (CKD) . Isifo sezintso siphazamisa amanqanaba eeminerali kunye nama-hormone, kwaye siphazamisa nenkqubo eqhelekileyo yokulungiswa kwamathambo (ukuguquka kwamathambo). Ukuba oku kuguquka kwamathambo kukhawulezile kakhulu okanye kucotha kakhulu, zombini ezi zinto zinokukhokelela ekubeni amathambo abe buthathaka.

Ziziphi iimpawu ze-Renal Osteodystrophy?

Iimpawu eziphambili ziintlungu zamathambo kunye nokuqhekeka kwamathambo . Abanye abantu basenokungabi nazo iimpawu kwaphela kwisigaba sokuqala sesi sifo. Leyo yeyona nto yoyikisayo.

Abantwana abancinci abanesifo sezintso banokuba nokuphazamiseka kokukhula ngenxa ye-renal osteodystrophy. Basenokuba nokukhubazeka kwamathambo okubizwa ngokuba yi-rickets . I-Rickets luhlobo lobuntwana lwesifo se-osteomalacia. Oku kuthetha ukuba amathambo ayathamba aze athambe.

I-Renal Osteodystrophy ifunyanwa njani?

Ugqirha wakho uza kumamela ngenyameko iimpawu zakho, imbali yakho yezonyango, kunye nokuba kukho nabani na kusapho lwakho okhe waba nezigulo ezifanayo. Emva koko, baza kwenza uvavanyo lomzimba.

Kukho iimvavanyo ezininzi ezisetyenziselwa ukuchonga ngokuchanekileyo le meko:

• Uvavanyo lwegazi: Olu vavanyo lujonga amanqanaba e-calcium, i-phosphorus, i-vitamin D, kunye ne-parathyroid hormone (PTH) egazini. Lukwalinganisa nezinye iimpawu zokuguquka kwamathambo, ezifana ne -alkaline phosphatase . Ukuba unesifo sezintso esihlala ixesha elide, ugqirha wakho uya kwenza olu vavanyo lwegazi rhoqo ukujonga utshintsho kula manqanaba.
• I-Bone Biopsy: Oku kuquka ukuthatha iqhekeza elincinci lesicubu ethanjeni uze ulivavanye kwilebhu. Oku kunokunika umbono olungileyo ngobuninzi kunye nokwakheka kwethambo. Nangona kunjalo, olu ayilovavanyo luqhelekileyo.
• Uvavanyo loxinano lwamathambo: Olukwabizwa ngokuba yi-DEXA scan , lulinganisa amandla amathambo akho kunye nomngcipheko wokuqhekeka kwawo.
• Uvavanyo lokufota: Uvavanyo olufana ne -X-ray , i-CT scans , kunye ne -MRIs lunokujonga utshintsho emathanjeni. Ii-CT scans kunye ne-echocardiograms ( i-scan yentliziyo) zikwasetyenziswa ukukhangela i-calcium deposits (calcification) kwimithambo yegazi.

Khumbula, ayinguye wonke umntu omele enze zonke ezi vavanyo. Ugqirha wakho uya kugqiba ukuba zeziphi iimvavanyo ezibaluleke kakhulu ngokwemeko yakho.

Ziziphi iindlela zonyango lwe-Renal Osteodystrophy?

Unyango olufumanayo luya kuxhomekeka ekubeni ungakanani umonakalo owenziwe emathanjeni akho, kwinqanaba lesifo sakho sezintso, nokuba ukuguquka kwamathambo akho kuyakhawuleza okanye kuyacotha. Kukho iindlela ezininzi zonyango eziphambili:

• Utshintsho kwindlela yokutya: Ugqirha wakho unokucebisa ukutya okune-phosphorus ephantsi . Oku kuthetha ukunciphisa ukutya okune-phosphorus eninzi (ukutya okucutshungulwayo nokupakishweyo) - okufana nokutya okusemathinini, ii-noodles ezikhawulezayo, kunye neesoseji. Ukuba isifo sakho sezintso sibi kakhulu, kunokufuneka unciphise ukutya okune-phosphorus eninzi ngokwemvelo (umzekelo, ezinye iimveliso zobisi, amantongomane, kunye nenyama neentlanzi ezomisiweyo).
• Amayeza kunye nezongezo: Ezi zinokunceda ukulinganisela amanqanaba eeminerali kunye nama-hormone. Umzekelo, izongezo ze-calcium kunye ne-vitamin D, amayeza anciphisa amanqanaba e-parathyroid hormone (PTH), kunye ne-phosphorus binders zinokunikwa. Oogqirha ngoku badla ngokucebisa izinto zokubopha i-phosphorus ezingezizo i-calcium kuba i-calcium eninzi inokukhokelela kwisifo samathambo esingaguquguqukiyo.
• Utyando lwe-Parathyroid: Ukuba ezinye iindlela zonyango azisebenzanga, utyando lunokwenziwa. Oku kubandakanya ukususa i-parathyroid gland enye okanye ezingaphezulu. Oku kubizwa ngokuba yi-parathyroidectomy . Ngokwesiqhelo, kushiyeka ubuncinci i-parathyroid gland enye. Oku kunokunceda ukuthintela amanqanaba e-PTH ukuba awe phantsi kakhulu aze abangele isifo samathambo esingashukumiyo.

Ukongeza kuko konke oku, ugqirha wakho uya kukunceda ulawule isifo sakho sezintso. Ngokulandela isicwangciso sonyango ngokufanelekileyo, unokuthintela ukonakala okungakumbi emathanjeni akho.

Ngaba i-Renal Osteodystrophy ingathintelwa?

Kunzima ukuyithintela ngokupheleleyo i-Renal Osteodystrophy. Nangona kunjalo, ngokulawula kakuhle isifo sezintso esingapheliyo (CKD), le meko inokulawulwa kwaye inkqubela yayo yehle.Oko kuthetha ukuba ukuthatha amayeza anikwe ngugqirha ngexesha, ukulandela ukutya okumiselweyo, kunye nokwenza unyango lwe-dialysis ngokufanelekileyo kubaluleke kakhulu. Kwakhona, ukuzilolonga, ukuyeka ukutshaya, kunye nokunciphisa ukusetyenziswa kotywala nako kuyanceda.

Yintoni enokulindelwa ngumntu one-Renal Osteodystrophy?

Akukho nyango luhlala luhleli lwale meko ngaphandle kokufakelwa izintso . Abantu abanesifo sezintso esihlala ixesha elide balahlekelwa kancinci kancinci kukusebenza kwezintso. Abantu abaninzi ekugqibeleni baba nokungasebenzi ngokupheleleyo kwezintso baze bafune i-dialysis. I-Renal Osteodystrophy yingxaki eqhelekileyo yale nkqubo.

Kwakhona, abantu abaninzi abanesifo sezintso esinganyangekiyo nabo banesifo sentliziyo. Isifo sentliziyo singunobangela wokufa okuninzi ngenxa yokungasebenzi kakuhle kwezintso.

Kodwa ungakhathazeki. Ugqirha wakho uza kujonga rhoqo amanqanaba akho eeminerali kunye neehormone aze akucebise ngonyango lokukhusela amathambo kunye nentliziyo yakho.

Ufanele uthethe nini nogqirha?

Ukuba unesifo sezintso esinganyangekiyo (CKD), qiniseka ukuba uxelela ugqirha wakho ukuba uva iintlungu zamathambo okanye ukuqina kwawo . Oku kungaba luphawu lwe-renal osteodystrophy.

Abantu abaninzi bafumanisa ukuba banesifo sezintso esinganyangekiyo xa sele sihambele phambili. Ngoko ke, ukuvavanywa rhoqo ngugqirha kunokunceda ekufumaneni isifo sezintso kwangethuba. Ukuba siyenzeka, ungathatha amanyathelo okuthintela ukuba singabi mandundu. Oku kubaluleke kakhulu ukuba unesifo sezintso (umz., ukutyeba kakhulu, ukuba nesifo seswekile, ukuba nembali yentsapho yesifo sezintso, isifo sentliziyo, okanye uxinzelelo lwegazi oluphezulu).

Umyalezo Wokuya Ekhaya

Kulungile, makhe siphinde sichaze ezinye zezinto ekufuneka uzikhumbule koko sithethe ngako:

• I-Renal Osteodystrophy sisifo samathambo esibangelwa sisifo sezintso esinganyangekiyo (CKD).
• Xa izintso zingasebenzi kakuhle, amanqanaba e -calcium, i-phosphorus, kunye ne-vitamin D egazini ayaphazamiseka, kwaye amathambo anokuba buthathaka.
• Iintlungu zamathambo kunye nokuqhekeka kwemithambo zezona mpawu ziphambili, kodwa kusenokwenzeka ukuba kungabikho zimpawu ekuqaleni.
• Oogqirha baxilonga le meko ngovavanyo lwegazi kunye neeskeni.
• Unyango luquka ukulawula ukutya, amayeza, kwaye ngamanye amaxesha notyando.
• Eyona ndlela ilungileyo yokulawula le meko kukulawula kakuhle isifo sezintso.
• Ukuba unesifo sezintso kwaye uziva iintlungu emathanjeni akho, bonana nogqirha ngokukhawuleza.
• Ukuhlolwa rhoqo ngugqirha kunokunceda ekufumaneni isifo sezintso kwangethuba.

Nangona le meko ingenakunyangeka ngokupheleleyo, ngonyango olufanelekileyo kunye nokulandela iingcebiso zonyango, ungaphila ubomi obusemgangathweni. Ngoko ke musa ukoyika, thetha nogqirha wakho, uze wenze izinto ezifunekayo.

I- osteodystrophy yezintso, isifo sezintso, isifo samathambo, i-calcium, i-phosphorus, i-vitamin D, i-parathyroid hormone, i-CKD-MBD