Ingabe unemfucuza eminingi egazini lakho? Lokhu kubizwa ngokuthi i-Azotemia!

Ingabe ngezinye izikhathi uzizwa ukhathele futhi unenkinga yokuchama? Noma ingabe udokotela wake wabheka ukuhlolwa kwegazi lakho wathi, "Kunemikhiqizo embalwa eyengeziwe egazini lakho"? Lokhu kungaba izimpawu zesimo esibizwa ngokuthi i-azotemia. Ake sixoxe ngalokhu ngokuningiliziwe, ngoba kubaluleke kakhulu empilweni yezinso zethu.

Kalula nje, i-azotemia yisimo lapho izinga lemikhiqizo engcolile egazini lakho, ikakhulukazi imikhiqizo engcolile ene-nitrogen, ikhuphuka kakhulu. Le mikhiqizo engcolile yakheka lapho amaprotheni ekudleni esikudlayo ephulwa. Aqala ukwakheka esibindini sakho. Bese ehamba ngegazi lakho aye ezinso zakho. Izinso ezinempilo zihlunga le mikhiqizo engcolile egazini lakho bese ziyikhipha emchameni wakho. Ngakho-ke uma izinso zakho zingasebenzi kahle, le mikhiqizo engcolile inqwabelana egazini lakho. Yilokho esikubiza ngokuthi i-azotemia.

Yiziphi izinhlobo eziyinhloko ze-Azotemia?

Kunezinhlobo ezintathu eziyinhloko ze-azotemia. Ake sibheke ukuthi ziyini. Lezi zihlukaniswa ngokusekelwe lapho inkinga ibangela khona ukuqoqana kwemfucuza.

1. I-Azotemia Yangaphambi Kwezinso

Lolu uhlobo oluvame kakhulu. Kwenzeka lapho izinso zakho zingatholi ukugeleza kwegazi okwanele. Cabanga ngakho njengesihlungi samanzi esingatholi amanzi anele okusebenza. Ngisho noma kungekho lutho olungalungile ngezinso zakho, uma zingatholi ukugeleza kwegazi okwanele, azikwazi ukuhlunga imfucuza.

Izinto ezingabangela lokhu yilezi:

• Ukulahlekelwa igazi okukhulu (isib. ukopha ngenxa yokulimala okukhulu, ukuhlinzwa)
• Ukugcinwa kwamanzi, okuwukuphelelwa amanzi emzimbeni (isib. ukungaphuzi amanzi anele, ukujuluka ngokweqile, ukuhlanza, uhudo)
• Ukwehluleka kwenhliziyo kwenzeka lapho inhliziyo ingapompi igazi ngendlela efanele.
• Izinguquko ekulinganisweni koketshezi emzimbeni ngenxa yesifo sesibindi (ukwehluleka kwesibindi).
• Ukusetshenziswa okuqhubekayo nokweqile kwemithi ethile, isibonelo, imithi yokubulala izinhlungu efana ne-ibuprofen ne-aspirin.
• Ukwehla kokugeleza kwegazi ezinso ngenxa yezinye izimo zezokwelapha.

2. I-Azotemia Yangaphakathi

Lolu hlobo luvame ukwenzeka lapho izinso ngokwazo zonakele. Lokho kusho ukuthi kukhona okungahambi kahle ngezinso ngokwazo. Lokhu kuthinta ngqo ikhono lezinso lokuhlunga.

Izizathu eziyinhloko kungaba:

• Izifo ezithinta izinso.
• Ukulimala kwezinso ngenxa yezifo ezinzima njenge-sepsis.
• Amahlule egazi ezinso.
• Eminye imithi, ikakhulukazi imithi yokwelapha ngamakhemikhali kanye neminye imithi elwa namagciwane.
• Ukulimala kwamaseli ezinso ngenxa yobuthi obufana nezidakamizwa, utshwala, kanye nezinye izibulala-zinambuzane.
• Ukulimala kwe-glomeruli, amayunithi okuhlunga ezinso.

3. I-Azotemia Yangemva Kwezinso

Lokhu kwenzeka uma kukhona ukuvaleka endaweni ethile ohlelweni lwakho lomchamo. Kufana nomsele ovalekile, okubangela amanzi ukuthi ahlangane esinyeni sakho. Lokhu kuvimbeka kungaba kuma-ureter, emapayipini aphakathi kwezinso zakho nesinye, esinyeni sakho, noma kwi-urethra yakho. Uma umchamo ungakwazi ukuphuma, ubuyela ezinso zakho, okubangela umonakalo.

Izizathu ezivame kakhulu yilezi:

• Ukuvuvukala okubangelwa izifo zomgudu womchamo (UTIs).
• Amatshe e-urethra noma amatshe esinyini.
• Ezinye izinhlobo zomdlavuza (isib. umdlavuza wendlala, umdlavuza wesibeletho).
• Ukwanda kwendlala ye-prostate kwabesilisa (i-benign prostatic hyperplasia).

Ingabe i-Azotemia iyafana nokwehluleka kwezinso?

Cha. I-Azotemia ayifani nokwehluleka kwezinso. Kodwa-ke, ukwehluleka kwezinso kuyimbangela eyinhloko ye-azotemia. Okusho ukuthi, lapho izinso zingasebenzi kahle, imfucuza iqoqana egazini, okuyikho i-azotemia. Ukwehluleka kwezinso kuyisimo esibanzi, lapho yonke imisebenzi yezinso ingaphazamiseka khona. I-Azotemia iyisibonakaliso esisodwa nje sokwehluleka kwezinso.

Sivame kangakanani lesi simo?

I-Azotemia empeleni iyisimo esivame kakhulu kunalokho ongakucabanga. Kutholakale ukuthi ingxenye enkulu yeziguli ezisezibhedlela, cishe u-16%, inalesi simo. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Ziyini izimpawu ze-Azotemia?

Ezimweni eziningi, ungase ungaziboni izimpawu ezinkulu kuze kube yilapho isimo sesibi kakhulu. Abanye abantu bangase bangakhombisi nhlobo izimpawu. Ezimweni ezinjalo, udokotela angase azithole kuphela lapho ehlola esinye isimo.

Kodwa-ke, abanye abantu bangase babe nezimpawu ezifana nalezi:

• Inani lomchamo okhiqizwayo lincipha kakhulu.
• Ukuzizwa ukhathele kakhulu (ukukhathala), ungakwazi ukwenza lutho.
• Isimo sokungakwazi ukugxila, umuzwa wokudideka.
• Isicanucanu nokuhlanza.
• Ubunzima bokuphefumula (ukuphelelwa umoya), uzizwe sengathi uzoquleka ngisho noma ukhuphuka izitebhisi ezimbalwa.
• Ubuhlungu besifuba.
• Ukuvuvukala, ikakhulukazi emilenzeni, emaqakaleni nasezinyaweni (i-edema).
• Ukuphazamiseka kwesigqi senhliziyo (arrhythmia), izinguquko kwisigqi sokushaya kwenhliziyo.
• Ukudla akunambitheki.

Uma isimo siba sibi kakhulu, kungase kube nokuquleka noma i-coma. Ngakho-ke, kubaluleke kakhulu ukunaka lezi zimpawu. Uma unezinye zalezi zimpawu, bona udokotela ngokushesha.

Yiziphi izimbangela ze-Azotemia?

Izimbangela ze-azotemia zincike ohlotsheni onalo. Ake sibheke izimbangela ezihlobene nezinhlobo ezintathu esixoxe ngazo ngaphambili ngokuningiliziwe.

• I-Azotemia Yangaphambi Kwezinso:Lokhu kuvame ukwenzeka lapho ukugeleza kwegazi ezinso kuthintwa ukulimala noma ukugula emzimbeni. Isibonelo:
• Ukuphelelwa amanzi emzimbeni. Lokhu kungabangelwa izinto ezifana nokungaphuzi amanzi anele, ukujuluka kakhulu (isib., lapho uzivocavoca elangeni, ukuzivocavoca), ukuhlanza, noma isifo sohudo.
• Ukopha kwegazi.
• Ukusha okukhulu.
• Ukwehluleka kwenhliziyo.
• Isifo sesibindi (ukwehluleka kwesibindi).

• I-Intrinsic Azotemia: Lokhu kwenzeka lapho izakhiwo ezinso, njengezihlungi ezincane (i-glomeruli), amapayipi amancane asiza ekumunceni amanzi, izakhamzimba, kanye namaminerali (ama-renal tubules), kanye nemithambo yegazi ezinso (i-renal vasculature), yonakele.
• Izimo ezibangela ukuvuvukala, isibonelo, izifo ezifana ne-vasculitis.
• Ukutheleleka kwezinso.
• Ubuthi (isib., eminye imithi, izinsimbi ezisindayo).
• Umonakalo obangelwa ukwehla kokugeleza kwegazi okuya ezinso isikhathi eside (ukuncipha kokuhamba kwegazi).

• I-Postrenal Azotemia: Lokhu kuvame ukwenzeka ngenxa yokuvaleka kwendlela yomchamo noma esinyeni.
• Ukuvuvukala okubangelwa izifo zomgudu womchamo (UTIs).
• Amatshe e-urethra.
• I-Hydronephrosis - Ukwanda kwezinso ngenxa yokugcinwa komchamo.
• Ukwanda kwendlala ye-prostate kwabesilisa (i-benign prostatic hyperplasia).
• Umdlavuza wohlelo lomchamo.

Ingabe i-Azotemia iyafana nokuphelelwa amanzi emzimbeni?

Cha, lokhu okubili akufani. Kodwa-ke, ukuphelelwa amanzi emzimbeni kuyimbangela enkulu ye-azotemia yangaphambi kwezinso. Okusho ukuthi, uma kungekho manzi anele emzimbeni, inani legazi eligeleza ezinso liyancipha, okungaholela ku-azotemia.

Izimbangela ezingaba khona zokuphelelwa ngamanzi emzimbeni yilezi:

• Ukungaphuzi amanzi anele.
• Ukujuluka kakhulu (isib. uma uzivocavoca elangeni, uzivocavoca).
• Ukuhlanza.
• Uhudo.
• Imithi ethile, isibonelo, imithi yokukhipha isisu (eyaziwa nangokuthi amaphilisi amanzi).

Ingabe lesi yisifo esithathelwanayo?

Cha, i-Azotemia ayisona isifo esithathelwanayo. Awukwazi ukusidlulisela komunye umuntu.

Ubani othinteka kakhulu yilesi simo?

I-Azotemia ingathinta noma ubani. Kodwa-ke, kungenzeka kakhulu ukuthi ivele uma uneminyaka engaphezu kwengu-65. Abantu abanezifo ezingamahlalakhona ezifana nesifo sikashukela kanye nomfutho wegazi ophezulu nabo basengozini enkulu.

Yiziphi izinkinga ezingaba khona ze-Azotemia?

Uma i-azotemia ingelashwa kahle, imfucuza egazini inganqwabelana ize ibe yingozi. Lokhu kubizwa ngokuthi i-uremia. I-uremia ivame ukubangelwa yisifo sezinso esingamahlalakhona (CKD). Uma ingelashwa, i-uremia ingaba yingozi.Futhi, ezinye izinkinga ezifana nesifo senhliziyo nezinkinga zesimiso sezinzwa zingavela.

Uyini umehluko phakathi kwe-Azotemia ne-Uremia?

Zombili lezi zimo zihlobene nezinso.

• I-Azotemia iwukugcwala kwe-nitrogen kanye neminye imikhiqizo engcolile egazini. Lokhu kungatholakala ngokuhlolwa kwelebhu.
• I-Uremia yisimo esenzeka lapho kukhona i-urea eningi kanye neminye imikhiqizo engcolile egazini. Okusho ukuthi, lapho isimo se-Azotemia siba sibi kakhulu, futhi kuvela izimpawu ezifana nokucasuka, ukuhlanza, ukukhathala, nokudideka, sibizwa ngokuthi i-Uremia.

Kalula nje, i-Azotemia ukwanda kwemikhiqizo engcolile egazini, kanti i-Uremia ukubonakala kwezimpawu kanye nokuwohloka kwesimo ngenxa yaleyo mikhiqizo engcolile.

I-Azotemia itholakala kanjani?

Udokotela wezinzwa ungumuntu ongcono kakhulu wokuxilonga nokwelapha lesi simo. Uzothatha umlando wakho wezokwelapha, abuze ngezimpawu zakho, futhi enze ukuhlolwa ngokomzimba. Uma kusolwa ukuthi i-azotemia iyanda, uzoyala ukuhlolwa kwegazi kwe-urea nitrogen (BUN) kanye nokuhlolwa kwe-creatinine. I-Creatinine iwumkhiqizo ongcolile okhiqizwa yi-metabolism yemisipha. Amazinga aphezulu alokhu abonisa ukuthi izinso zakho azisebenzi kahle.

Uma unesifo sokopha noma uphuza noma yimiphi imithi, kufanele utshele udokotela wakho ngaphambi kokwenza ukuhlolwa kwe-BUN. Lokhu kuhlolwa kuhilela ukuthatha isampula encane yegazi emthanjeni osengalweni yakho bese ulithumela elebhu.

Iyini izinga le-BUN elibhekwa njenge-Azotemia?

Izinga elijwayelekile le-urea nitrogen egazini (BUN) liyahlukahluka kuye ngeminyaka yakho nobulili bakho. Uma umbiko webhulebhu ukhombisa inani eliphakeme kunezinga elijwayelekile, kungaba yi-azotemia.

Futhi, udokotela uzohlola izinga lakho le-serum creatinine. Kukhona nenani elijwayelekile lalokho, kuye ngeminyaka yakho nobulili bakho. Uma liphakeme kunalokho, libonisa inkinga yezinso.

Yiliphi izinga le-BUN elibonisa ukwehluleka kwezinso?

Odokotela abakuxilongi ukwehluleka kwezinso ngokusekelwe emazingeni e-BUN kuphela. Kodwa-ke, uma amazinga akho e-BUN kanye ne-creatinine ephezulu kakhulu kunokuvamile, futhi unezinye izimpawu, kungaba uphawu lokwehluleka kwezinso.

Yiziphi ezinye izivivinyo ezenziwayo ukuze kutholakale i-Azotemia?

Udokotela angenza ezinye izivivinyo eziningana:

• Ukuhlolwa Komchamo: Isampula yomchamo wakho ithathwa futhi ihlolwe elebhu ukuthola amakhemikhali, amaprotheni, amaseli egazi, nezinye izinto ezicashile.
• Ukuphuma komchamo: Lokhu kulinganisa ukuthi udlula umchamo ongakanani emahoreni angama-24.
• Ukuhlolwa kwezithombe: Kungenziwa i-CT scan noma i-ultrasound scan ukuze kuhlolwe izinso zakho, ama-ureter, kanye nesinye. Lokhu kungabheka ukuvaleka, amatshe, noma usayizi nesimo sezinso zakho.
• Ukuhlolwa kwezinso: Ngezinye izikhathi, lokhu kuhlolwa kwenziwa ukuze kutholakale ukuthi yimuphi umonakalo owenzekile ezinso zakho. Lokhu kuhilela ukwenza ukusika okuncane esikhumbeni sakho nokusebenzisa inalithi encane ukuthatha isampula encane kakhulu yezicubu ezinso zakho. Bese ithunyelwa elebhu ukuze ihlolwe.

Iphathwa kanjani i-Azotemia?

Ukwelashwa kwe-azotemia kuncike ohlotsheni onalo, imbangela, kanye nobunzima besimo. Isihluthulelo ukwelapha inkinga eyisisekelo ebangele i-azotemia. Udokotela uzokwenza izivivinyo ukuze athole imbangela. Izinketho zokwelapha zingafaka:

• Uketshezi lwe-IV: Uketshezi, njengosawoti, olunikezwa ngemithambo ukuze kwelashwe ukuphelelwa amanzi emzimbeni. Lokhu kwandisa ukugeleza kwegazi ezinso, okwenza kube lula ukuhlunga imfucuza.
• Imithi:
• I-Diuretics - susa uketshezi oluningi emzimbeni.
• Imithi yokulawula umfutho wegazi.
• Imithi ye-Adrenergic - Lezi zinemiphumela efana ne-adrenaline (i-epinephrine) futhi ngezinye izikhathi ziyasiza ekwandiseni ukugeleza kwegazi ezinso.
• Ama-Corticosteroids - anciphisa ukuvuvukala ezinso.
• Izandisi zevolumu ye-plasma - imithi esiza ekubuyiseleni i-plasma yegazi lapho kulahleke igazi eliningi.
• Ukufakwa kwe-stenting e-urethra: Uma kukhona ukuvaleka kwe-urethra, kufakwa ipayipi elincane ukusiza ukugeleza komchamo usuka ezinso uye kwesinye.
• I-Dialysis: Le nqubo isetshenziselwa ukususa imfucuza egazini uma izinso zingasebenzi kahle. Lokhu kungenziwa okwesikhashana noma isikhathi eside.

Kwenzekani uma ngine-Azotemia?

Uma lesi sifo sitholakala kusenesikhathi futhi selashwa kahle, abantu abaningi bangalulama. Ikakhulukazi uma inkinga ebangela i-prerenal noma i-postrenal azotemia ixazululwa, izinso zingase zilulame.

Kodwa-ke, uma ingelashwa, i-azotemia ingandisa ingozi yokuthola ezinye izimo ezimbi, njengesifo sezinso esingamahlalakhona (CKD) , futhi ingaholela ekufeni. Ngakho-ke, kubaluleke kakhulu ukulandela uhlelo lokwelashwa udokotela wakho akunikeza lona ngqo.

Ingabe i-Azotemia ingavinjelwa?

Yebo, ungasiza ekuvimbeleni ukuthuthukiswa kwe-azotemia ngokunakekela izinso zakho nangokulandela lawa macebiso:

• Sebenzisa imithi ethile ngokucophelela:Eminye imithi, njengemithi elwa nokuvuvukala engeyona i-steroidal (ama-NSAID) (isib. i-ibuprofen), eminye imithi elwa namagciwane (isib. i-penicillin, ama-sulfonamides), kanye nezinye izithako zemithi, ingalimaza izinso zakho uma uzithatha ngobuningi. Ungayithathi le mithi njalo ngaphandle kokubonisana nodokotela wakho. Buza udokotela wakho ngesilinganiso esiphephile sakho.
• Yelapha ukopha: Uma ukugeleza kwegazi kuya ezinso kuncipha, i-azotemia yangaphambi kwezinso ingavela. Uma kukhona inxeba, faka ibhandishi bese uliqinisa. Uma unenxeba elibi, funa iseluleko sikadokotela ngokushesha.
• Hlola isifo sezinso: Uma othile emndenini wakho enesifo sezinso, kungumqondo omuhle ukubuza udokotela wakho ukuthi usengozini yini. Abantu abanesifo sikashukela kanye nomfutho wegazi ophakeme kufanele bahlolwe izinso zabo njalo.
• Gwema ukuphelelwa amanzi emzimbeni: Umuntu omdala kufanele aphuze cishe izingilazi zamanzi eziyi-8 (amalitha angu-2-3) ngosuku. Umchamo wakho kufanele ucace noma ube phuzi kancane. Uma kumnyama, udinga ukuphuza amanzi amaningi. Phuza amanzi amaningi, ikakhulukazi ngezinsuku ezishisayo nalapho uzivocavoca.
• Lawula ukuphuza kwakho utshwala: Utshwala bungalimaza izinso zakho futhi buthinte ukuhlungwa kwegazi. Bungabangela nokuphelelwa amanzi emzimbeni. Abesifazane kufanele baphuze okungaphansi kokukodwa ngosuku. Abesilisa kufanele baphuze okungaphansi kokubili.
• Yidla ukudla okunempilo okukufanele: Yidla izithelo, imifino, kanye nokudla okusanhlamvu okuningi. Nciphisa ukudla usawoti (i-sodium). Ukudla usawoti omningi kungabangela umfutho wegazi ophakeme, okungathinta izinso zakho, futhi kwandise ingozi yakho yokuthola amatshe.
• Vivinya umzimba njalo: Kufanele uvivinye umzimba okungenani imizuzu engama-30 ngosuku, izinsuku ezi-5 kuya kweziyi-7 ngesonto. Lokhu kungasiza futhi ekulawuleni isifo sikashukela kanye nomfutho wegazi ophakeme.
• Yeka ukubhema: Ukubhema konakalisa imithambo yegazi. Kungathinta nokugeleza kwegazi ezinso.

Ngizinakekela kanjani?

Udokotela uzokwakha uhlelo lokwelashwa olukufanele. Lokhu kungafaka phakathi imithi, izinguquko zendlela yokuphila, noma ngisho nenqubo yezokwelapha. Lokhu kuhlanganisa nokuphuza imithi yakho ngokucophelela, ukugwema ukuphelelwa amanzi emzimbeni, kanye nokuzivocavoca njalo. Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo.

Kufanele ngimbone nini udokotela?

Uma udokotela ekuxilonga ukuthi une-azotemia, gcina ama-aphoyintimenti okulandelela njalo. Futhi, bona udokotela wakho uma ubona noma yiziphi izinguquko ezimpawu zakho noma uma uqala ubuhlungu obusha. Tshela nodokotela wakho uma kuvela noma yiziphi izimpawu ezibalwe ngenhla.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma uzwa izimpawu zokwehluleka kwezinso okukhulu, iya ekamelweni eliphuthumayo ngokushesha. Izimpawu zingase zihlanganise:

• Inani lomchamo odlulile linciphile kakhulu noma alikho nhlobo.
• Ukuvuvukala, ikakhulukazi emaqakaleni nasezinyaweni.
• Ukuzwa ukunambitheka kwensimbi emlonyeni.
• Ukukhathala okukhulu.
• Isicanucanu nokuhlanza.
• Uhudo.
• Ubuhlungu besisu.
• Ukuquleka.
• Ukulahlekelwa ukwazi (i-coma).

Ngezikhathi ezinjengalezi, ukuthola ukwelashwa okusheshayo kungasindisa impilo.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Kungumqondo omuhle ukubuza le mibuzo uma ubona udokotela:

• Wazi kanjani ukuthi ngine-Azotemia?
• Uma ngingenayo i-Azotemia, yisiphi esinye isimo enginaso?
• Yiziphi izivivinyo ozenzayo ukuze uxilonge i-Azotemia?
• Uhlobo luni lwe-azotemia enginalo? Lubangelwa yini?
• Yikuphi ukwelashwa okuncomayo?
• Yiziphi izingozi noma imiphumela emibi yokwelashwa okuncomayo?
• Uhlobo luni lokunakekelwa okulandelayo engizodinga ngemva kokwelashwa?
• Ingabe izinso zami zonakele unomphela?
• Ungangithumela kudokotela wezinzwa?
• Yiziphi izinguquko okudingeka ngizenze ekudleni kwami ​​​​nasendleleni yami yokuphila?

Umyalezo Wokugcina Wokuya Nasekhaya

I-Azotemia yisimo esivamile lapho imfucuza inqwabelana egazini lakho. Lokhu kwenzeka lapho izinso zakho zonakaliswe ukulimala noma ukugula futhi zingakwazi ukusebenza kahle.

Njengoba ngokuvamile kungekho zimpawu, ungase ungazi nokuthi unalesi simo. Kungaba yinto eshaqisayo ukuthola into efana nale ngokuzumayo. Kodwa-ke, odokotela bangenza izivivinyo ukuthola imbangela futhi bakunikeze ukwelashwa okungcono kakhulu. Khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka onakho. Bazophendula imibuzo yakho, bakunikeze ukwesekwa okudingayo, futhi bakunikeze iseluleko sendlela engcono kakhulu yokwelapha i-Azotemia nokuthi ungazinakekela kanjani izinso zakho. Ngakho-ke ungesabi, landela iseluleko sezokwelapha esifanele. Ukutholwa kusenesikhathi nokwelashwa okufanele kungavikela izinso zakho.

I- Azotemia, Izinso, Ukungcola Kwegazi, I-BUN, I-Creatinine, Isifo Sezinso, I-Nitrogen