Ngaba ugqirha ukuxelele ukuba unengxaki yezintso okanye ubuthathaka? Okanye ukhe weva ukuba umntu omaziyo unesifo sezintso? Kuqhelekile ukuba uzive usoyika kwaye ukhathazekile xa usiva la mazwi. Kodwa ukuba siyazi oku, olo loyiko lunokuncipha kakhulu. Ngoko ke namhlanje, masithethe ngesi sifo sezintso esihlala ixesha elide, oko kukuthi, `Isifo Sezintso Esingapheliyo (CKD)`, zithini izigaba zaso ezahlukeneyo, kunye nento esifanele siyenze kwinqanaba ngalinye.
Kutheni isifo sezintso (CKD) sahlulwe ngokwamanqanaba?
Ngamafutshane, i-CKD yimeko apho ukusebenza kwezintso kuyehla kancinci kancinci ngokuhamba kwexesha. Oku akwenzeki ngaxeshanye. Yiyo loo nto oogqirha behlukanisa esi sifo ngokwamanqanaba oku-1 ukuya kwelesi-5 ukuze baqonde ubunzulu baso.
Cinga ngezinyuko. Xa usephezulu kwezinyuko, izintso zakho zisebenza kakuhle. Njengoko usehla, ukusebenza kwazo kuyehla.
- Amanqanaba okuqala (amanqanaba 1-3): Ngeli xesha, izintso zakho zisasebenza kakuhle okanye zikwinqanaba eliqhelekileyo . Kwiimeko ezininzi, akukho zimpawu zibalulekileyo kweli nqanaba.
- Amanqanaba okugqibela (amanqanaba 4-5): Ngeli nqanaba, ukusebenza kwezintso kuye kwehla kakhulu. Ekupheleni kwenqanaba, izintso zisenokuba zingasebenzi kakuhle ngokupheleleyo.
Kodwa oku akuthethi ukuba isifo sezintso somntu wonke siya kuqhubeka siye kwinqanaba lesi-5. Ngonyango olufanelekileyo kunye notshintsho kwindlela yokuphila, abantu abaninzi banokulawula esi sifo kwinqanaba laso langoku kwaye balibazise ukuqhubela phambili kwaso ixesha elide.
Zichongwa njani ezi zigaba? Yintoni i-GFR?
Kulungile, ngoku masibone ukuba ugqirha angakuxelela njani kanye kanye ukuba ukuliphi inqanaba. Oku kuqinisekiswa ikakhulu ngokujonga "isantya sokuhluza" kwezintso zakho.
Izintso ezimbini emzimbeni wethu zifana nezihluzo zamanzi ezimbini. Umsebenzi ophambili wezintso kukucoca nokucoca inkunkuma engafunekiyo, amanzi angaphezulu kunye neetyuwa egazini kwaye zikhuphe njengomchamo. Kukho izigidi zeeyunithi ezincinci kakhulu ngaphakathi kwezintso ezenza le nkqubo yokucoca. Sizibiza ngokuba yi-`(nephrons)`. Isihluzo esiphambili kwi-nephrons nganye sibizwa ngokuba yi-`(glomerulus)`.
Umlinganiselo wokuba igazi lakho licocwa ngokukhawuleza kangakanani ngezi zihluzo ubizwa ngokuba yiGlomerular Filtration Rate , okanye iGFR .
Xa izintso zonakele, eli zinga lokucoca (i-GFR) liyehla. Ngenxa yokuba kunzima ukulinganisa le GFR ngokuthe ngqo, oogqirha balinganisa ubungakanani benkunkuma ebizwa ngokuba yi-"creatinine" egazini lakho baze bayisebenzisele ukubala i-GFR yakho besebenzisa i-equation ekhethekileyo, efana neminyaka yakho kunye nesini. Oku sikubiza ngokuba yi-GFR eqikelelweyo , okanye i-eGFR.Eli lixabiso elibhalwe njenge-eGFR kwingxelo yakho yegazi.
Ukongeza, uvavanyo lomchamo lwenziwa ukujonga iproteni (i-albumin) kumchamo. Ngamanye amaxesha, nokuba i-eGFR iqhelekile, iproteni kumchamo inokuba luphawu lokuqala lokonakala kwezintso.
Amanqanaba e-CKD kunye nentsingiselo yawo
Eli lixabiso le-eGFR elisetyenziselwa ukwahlula izigaba ezi-5 ze-CKD. Ungaliqonda ngokulula ngokujonga le theyibhile.
| Iqonga | Ixabiso le-eGFR (mL/min) | Imeko Yezintso |
|---|---|---|
| Isigaba 1 | 90 nangaphezulu | Kukho umonakalo omncinci kwizintso, kodwa izinga lokuhluza liqhelekile. |
| Isigaba sesi-2 | 60 - 89 | Kukho umonakalo omncinci kwizintso kunye nokwehla okuncinci kwesantya sokuhluza. |
| Isigaba 3a | 45 - 59 | Kukho umonakalo ophakathi kwizintso kwaye izinga lokuhluza liphantsi kakhulu. |
| Isigaba 3b | 30 - 44 | Umonakalo ophakathi kwizintso kunye nokuncipha ngakumbi kwesantya sokuhluza. |
| Inqanaba lesi-4 | 15 - 29 | Izintso zonakele kakhulu. Izinga lokuhluza liphantsi kakhulu. |
| Inqanaba lesi-5 | Ngaphantsi kwe-15 | Ukungasebenzi Kwezintso. Kule nqanaba, kufuneka i-dialysis okanye ukufakelwa kwezintso. |
Zeziphi iimpawu ezinokubonakala kwinqanaba ngalinye?
Enye yezinto ezikhethekileyo ze-CKD kukuba iimpawu ziyahluka ngokuxhomekeke kwinqanaba.
Isigaba 1 nesesi-2
Kule zigaba zokuqala, uninzi lwabantu alunazo iimpawu kuba izintso zabo zisasebenza kakuhle. Idla ngokufunyanwa ngengozi xa kwenziwa uvavanyo lwegazi okanye lomchamo lwenye imeko, okanye xa kuhlolwa uxinzelelo lwegazi. Kodwa abanye abantu banokubona izinto ezifana nezi:
- Ukudumba kwezandla, iinyawo, okanye amaqatha
- Usulelo oluqhelekileyo lwendlela yomchamo
- Umchamo onogwebu
Isigaba 3a kunye ne-3b
Njengoko ukusebenza kwezintso kuncipha ngakumbi, umzimba uba nexesha elinzima lokuziqhelanisa nako. Kulapho ke abantu abaninzi baqala khona ukufumana iimpawu.
- Ukudumba kwemilenze namaqatha
- Ukunciphisa umzimba kunye nokulahlekelwa ngumdla wokutya
- Ndiziva ndidiniwe kwaye ndingenabomi
- Ukuqaqamba kwemisipha
- Ubunzima bokuphefumla
- Ukungalali
- Ulusu olurhawuzelelayo
- Ukusoloko ufuna ukuchama, ingakumbi ebusuku
- Umchamo onogwebu okanye omnyama
Amanqanaba 4 kunye ne-5
Ngeli xesha, izintso azisasebenzi kakuhle, kwaye inkunkuma evela emzimbeni iqala ukuqokelelana egazini. Oku kunokukhokelela kwiingxaki ezinkulu. Ukongeza kwiimpawu ezikhankanyiweyo apha ngasentla, oku kulandelayo kunokuvela:
- Ubunzima bokugxila
- Intloko ebuhlungu
- Intlungu yesisu esisezantsi
- Ukurhawuzelela ezandleni nasezinyaweni
- Isicaphucaphu nokuhlanza
- Ukuyeka ukuchama okunciphileyo okanye okupheleleyo
- Umphefumlo ombi
- Ukutshintsha kombala wolusu (ukujika kube ngwevu okanye kube tyheli)
Ziziphi iindlela zonyango lwesifo sezintso?
Akukho nyango lwe-CKD okwangoku. Nangona kunjalo, unyango lunokulawula iimpawu kwaye lunciphise ukuqhubela phambili kwesi sifo. Iindlela zonyango ziyahluka ngokuxhomekeke kwinqanaba lesifo.
Unyango lwezigaba 1 kunye ne-2
Eyona njongo iphambili ngeli xesha kukuthintela ukonakala kwezintso. Ugqirha wakho angacebisa oku kulandelayo:
- Ukuba uyatshaya, yeka ngoko nangoko.
- Ukutya ukutya okunempilo, ityuwa encinci kunye neoyile encinci.
- Ukuzilolonga rhoqo.
- Ukulawula ubunzima bomzimba.
- Ukuba unesifo seswekile, lawula amanqanaba eswekile egazini lakho kakuhle.
- Ukuba une-high blood pressure, yilawule.
Unyango lwezigaba 3a kunye ne-3b
Kule nqanaba, kunye notshintsho kwindlela yokuphila, amayeza anokufuneka ukulawula esi sifo.
- Amayeza oxinzelelo lwegazi oluphezulu: Nokuba awunalo uxinzelelo lwegazi oluphezulu, amanye amayeza anokunciphisa umonakalo kwizintso zakho.
- Amayeza okwehlisa i-cholesterol.
- Amayeza esifo seswekile: Amanye amayeza, ingakumbi i-SGLT2 inhibitors, anikwa ukukhusela izintso nakubantu abangenaso isifo seswekile.
- I-Diuretics: Inceda ekususeni ityuwa namanzi angaphezulu emzimbeni.
- Amanye amayeza: Iipilisi ze-iron okanye ezinye iivithamini zokugcina amathambo eqinile kwaye kuthintelwe i-anemia.
Unyango lwezigaba 4 kunye ne-5
Xa izintso ziphantse zangasebenzi, amayeza ewodwa awasanele ukugcina umzimba uphilile. Iindlela ezimbini eziphambili zonyango kweli nqanaba zezi:
- I-Dialysis: Umatshini osusa igazi kwizintso zakho.
- Ukufakelwa kwezintso: Ukufakelwa kwezintso eziphilileyo emzimbeni ngotyando.
Zonke ezi ndlela zonyango zigqitywa ngugqirha wakho emva kokuhlolwa kakuhle kwempilo yakho. Kungoko ke , kubaluleke kakhulu ukuxoxa ngazo nogqirha wakho rhoqo kwaye ulandele iingcebiso zakhe.
Umyalezo Wokuya Ekhaya
- I-CKD sisifo esiye sinciphise ukusebenza kwezintso kancinci kancinci ngokuhamba kwexesha.
- Esi sifo sahlulwe sahlulwe saya kwizigaba 1 ukuya kwi-5 ngokuxhomekeke kubunzima baso, kwaye kusetyenziswa umlinganiselo obizwa ngokuba yi-eGFR koku.
- Kwinqanaba lokuqala, akubikho zimpawu. Ngoko ke, ukuba unezinto ezinobungozi ezifana nesifo seswekile okanye uxinzelelo lwegazi oluphezulu, kubaluleke kakhulu ukuba uhlolwe rhoqo ngugqirha.
- Nangona i-CKD ingenakunyangwa ngokupheleleyo, ukuba mandundu kwesi sifo kunokulawulwa ngonyango olufanelekileyo kunye notshintsho kwindlela esiphila ngayo.
- Soloko uthetha ngokukhululekileyo nogqirha wakho malunga nemeko yakho, inqanaba, kunye nonyango.
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