Ingabe isifo sikashukela sithinta nezinso? Masiqaphele isifo sezinso esibangelwa yisifo sikashukela!

Ingabe unesifo sikashukela? Noma ingabe othile emndenini wakho noma kumngane wakho unesifo sikashukela? Khona-ke cishe uyazi ngezinkinga ezahlukahlukene ezihambisana nesifo sikashukela. Ngezinye izikhathi singase sesabe ngoba asizazi ngokugcwele lezi zinto. Namuhla sizokhuluma ngemiphumela isifo sikashukela esingaba nayo ezinso zethu. Lokhu kubizwa ngokuthi i-Diabetic Kidney Disease (DKD).

Kuyini Isifo Sezinso Esibangelwa Yisifo Sikashukela (Isifo Sezinso Esibangelwa Yisifo Sikashukela)?

Kalula nje, lokhu kuwukulimala kwezinso zakho ngenxa yesifo sikashukela. Siyazi ukuthi izinso ezimbili emzimbeni wethu zihlunga igazi futhi zisuse imfucuza . Cabanga ngezinso njengezihlungi ezimbili ezinkulu emzimbeni wethu. Lezi zihlunga imfucuza ene-nitrogen, isibonelo i-urea, imfucuza evela emisipheni (i-creatinine), kanye nobunye ubuthi obuningi bese zibukhipha ngomchamo. Akukhona lokho kuphela, izinso zisiza nokugcina ibhalansi yoketshezi kanye nama-electrolyte emzimbeni.

Izinso ngayinye ziqukethe amayunithi okuhlunga amancane angaphezu kwesigidi abizwa ngama-nephron. Ngaphakathi kwala ma-nephron, imithambo yegazi emincane ixhunywe ukuze yakhe isakhiwo esifana ne-mesh esibizwa ngokuthi i-glomeruli. Eqinisweni, la ma-glomeruli ayisinyathelo sokuqala sokuhlunga igazi. Avumela amanzi kanye nemfucuza encibilikisiwe ukuthi kudlule emangqamuzaneni awo angangeni kahle, abese ekhishwa emzimbeni njengomchamo.

Manje bheka, kwenzekani emzimbeni womuntu onesifo sikashukela? Umzimba wakhe awukwazi ukusebenzisa kahle ushukela esiwuthola ekudleni esikudlayo, okungukuthi, `(glucose)`. Khona-ke izinga `(glucose)` egazini liyakhula. Uma leli nani eliphakeme `(glucose)` likhona isikhathi eside, ulwelwesi olubucayi lwalawo `(glomeruli)` luqala ukonakala. Futhi ezinye izingxenye ze `(nephron)` nazo zingalimala. `(glomeruli)` ezilimele ngale ndlela azikwazi ukuhlunga igazi kahle. Khona-ke, okwenzekayo ukuthi ubuthi okufanele bukhishwe ngomchamo buqale ukuqongelela ngaphakathi emzimbeni.

Ingabe lesi simo sibucayi?

Yebo, isifo sezinso esibangelwa isifo sikashukela siyisimo esibi kakhulu . Uma singaphathwa kahle, singagcina siholele ekuhlulekeni kwezinso . Ukwehluleka kwezinso kungaba yingozi empilweni. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Yiziphi izigaba zesifo sezinso esibangelwa isifo sikashukela?

I-eGFR iyisilinganiso sokuthi izinso zakho zisebenza kahle kangakanani. I-eGFR iyisifinyezo sesilinganiso sokuhlunga esilinganiselwe se-glomerular. Kalula nje, ukubala ukuthi izinso zakho zihlunga kanjani imfucuza ngendlela ephumelela kakhulu. I-eGFR yomuntu ophilile icishe ibe yi-100. Leli nani lingehla liye ku-0, okusho ukuthi izinso zakho azisebenzi nhlobo.

Kunezigaba eziningana zanoma yisiphi isifo sezinso, okuhlanganisa nesifo sezinso esibangelwa isifo sikashukela:

• Isigaba I:I-GFR yakho ingama-90 noma ngaphezulu. Kuleli qophelo, izinso zakho kungenzeka ukuthi zilimele, kodwa zisasebenza kahle.
• Isigaba II: Inani le-GFR lingaba phakathi kuka-60 no-89. Izinso zonakele kakhulu kunasesigabeni sokuqala, kodwa zisasebenza kahle.
• Isigaba III: Inani le-GFR lingaba phakathi kuka-30 no-59. Kuleli qophelo, ukusebenza kwezinso kungase kwehle kancane noma kakhulu.
• Isigaba IV: Inani le-GFR lingaba phakathi kuka-15 no-29. Lokhu kusho ukuthi ukusebenza kwezinso kwehle kakhulu.
• Isigaba V: I-GFR ingaphansi kuka-15. Lokhu kusho ukuthi izinso ziseduze nokwehluleka ngokuphelele, noma zihlulekile.

Ubani onamathuba amaningi okuthola lesi sifo? Yiziphi izinto ezibangela ingozi?

Noma ubani onesifo sikashukela sohlobo 1 noma sohlobo 2 angaba nesifo sezinso. Kodwa-ke, abanye abantu basengozini enkulu. Isibonelo:

• Abantu abamnyama
• Abantu baseMelika baseNdiya, aboMdabu base-Alaska, noma abantu bezizwe zokuqala
• Abantu basePolynesia
• Abantu baseMaori

Kunezinye izinto eziyingozi:

• Ukuba nesifo sezinso emndenini.
• Ukuba nomfutho wegazi ophakeme.
• Ukusetshenziswa kwemikhiqizo kagwayi (njengogwayi).
• I-Hyperglycemia yisimo lapho amazinga kashukela egazini ehlala ephezulu njalo.
• Amazinga aphezulu e-cholesterol egazini (i-Hyperlipidemia).

Sivame kangakanani lesi sifo?

Isifo sezinso esibangelwa isifo sikashukela siyisifo esivame kakhulu . Siyimbangela ehamba phambili yesifo sezinso esisesigabeni sokugcina emhlabeni jikelele. Kulinganiselwa ukuthi cishe abantu abangu-40% abanesifo sikashukela bahlushwa yilesi sifo sezinso.

Yiziphi izimpawu zesifo sezinso esibangelwa isifo sikashukela?

Ezimweni eziningi, izimpawu ezisobala azibonakali kuze kube yilapho u-80% kuya ku-90% wezinso sewonakele. Uma izimpawu zivela, ungase uqaphele izinto ezinjengalezi:

• Ukuvuvukala kobuso, izandla, kanye nemilenze (i-edema).
• Isicanucanu nokuhlanza.
• Ukuzizwa ukhathele noma ukhathele njalo.
• Ubunzima bokuphefumula (ukuphelelwa umoya).
• Ukudla akunambitheki.
• Umchamo onegwebu noma onamaqhubu.
• Ubunzima bokugxilisa ingqondo noma ukuzizwa udidekile.
• Isikhumba esomile nesilumayo.
• Ukuqaqamba kwemisipha.
• Kudingeka ukunciphisa inani le-insulin elithathwayo (kulabo abathatha imithi yesifo sikashukela).

Ziyini izimpawu eziqalayo?

Isifo sezinso esibangelwa isifo sikashukela ngokuvamile asibonisi zimpawu ezigabeni zokuqala.. Ungase ube neprotheyini emchameni wakho (i-proteinuria). Kodwa lokhu kungatholakala kuphela udokotela owenza ukuhlolwa komchamo.

Kubangelwa yini lokhu? Ingabe kuyathelelana?

Isizathu esiyinhloko salokhu ukuba nesifo sikashukela sohlobo 1 noma uhlobo 2.

Cha, lesi akusona isifo esithelelanayo. Awukwazi ukusabalalisa lesi sifo komunye umuntu.

Uthola kanjani ukuthi unesifo sezinso esibangelwa isifo sikashukela?

Uma unesifo sikashukela, kubalulekile ukubona udokotela wakho njalo ezinyangeni ezintathu kuya kweziyisithupha ukuze ahlolwe, njengoba kunconywa udokotela wakho. Uma udokotela wakho esola ukuthi unesifo sezinso esihlobene nesifo sikashukela, uzoyala ukuhlolwa okuthile.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lokhu?

Ukuhlolwa okulandelayo kusiza ekuxilongeni lesi sifo:

• Ukuhlolwa komchamo:

Lokhu kuhilela ukuthatha isampula yomchamo wakho bese uwuhlola ukuze kubonakale ukuthi unjani, ukwakheka kwamakhemikhali, kanye nokuhlolwa nge-microscope. Udokotela wakho angasebenzisa i-dipstick ukwenza lokhu kuhlolwa. Angase futhi ancome izinhlobo ezahlukene zokuhlolwa komchamo. Ekuhlolweni kwe-dipstick, uchamela esitsheni esikhethekile. Bese kufakwa ucezu lwephepha (i-dipstick) olunamakhemikhali afakwe kuwo. Uma kukhona iphrotheni (i-albumin) emchameni, ucezu luzoshintsha umbala.

Uma udokotela wakho edinga isilinganiso esinembile, angase acele ukuhlolwa kwephrotheni yomchamo . Lokhu kuhilela ukuthumela isampula yomchamo wakho elebhu ukuze kubhekwe isilinganiso sephrotheni ne-creatinine emchameni wakho (isilinganiso sephrotheni ne-creatinine). Uma lesi silinganiso siphezulu kakhulu, kungaba uphawu lwesifo sezinso esihlobene nesifo sikashukela.

• Ukuhlolwa kwegazi:

Ukuhlolwa kwe-eGFR kulinganisa ikhono lezinso zakho lokuhlunga igazi. Udokotela wakho uzothatha inani elincane legazi emthanjeni osengalweni yakho bese esebenzisa izinga le-creatinine egazini kanye nolwazi oluyisisekelo lwezempilo ukuze abale i-eGFR yakho.

• Ukuhlolwa kwezithombe:

Lezi zivivinyo zingasiza udokotela wakho ukuthi athole umbono wempilo yezinso zakho.

• Ukuhlolwa kwe-Ultrasound: Lokhu kungahlola isakhiwo kanye nosayizi wezinso.
• Ama-MRI kanye nama-CT scan: Lokhu kungabona ngokucacile imithambo yegazi kanye nokunikezwa kwegazi ezinso.

• Ukuhlolwa kwezinso:

Kule nqubo, udokotela uthatha ingxenye encane yezicubu ezinso lakho bese eyihlola ngaphansi kwe-microscope elabhorethri. Ngaphambi kokwenza lokhu, indawo iyavaleka ukuze ungezwa ubuhlungu. Uzokunikeza nomuthi wokudambisa okhanyayo ukuze akusize uphumule. Ngemuva kwalokho, kufakwa inaliti esikhumbeni iye ezinso bese kuthathwa isampula yezicubu.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kuncike esigabeni sesifo sakho, iminyaka yakho, kanye nempilo yakho iyonke. Ukulawula isifo sakho sikashukela kuyisinyathelo sokuqala ekwelapheni lesi sifo sezinso. Izinto ezilandelayo zingakusiza ukuphatha isifo sakho sikashukela:

• Faka ukudla okwengeziwe okune-fiber eningi, amafutha aphansi kanye nama-calories ekudleni kwakho.
• Ukuzivocavoca njalo.
• Ukulawula isisindo somzimba.
• Yeka ukubhema noma ukusebenzisa eminye imikhiqizo kagwayi.

Uma unomfutho wegazi ophakeme, kubalulekile ukuwelapha nawo. Udokotela wakho angase akunike imithi yomfutho wegazi ophakeme.

Ingabe umonakalo wezinso ungalungiswa?

Cha, umonakalo wezinso obangelwa isifo sikashukela awunakuguqulwa ngokuphelele. Kodwa-ke, ungalawula, wehlise ijubane, futhi mhlawumbe umise nomonakalo owengeziwe wezinso ngokuthatha imithi yakho njengoba uyalelwe udokotela wakho, ngokulandela ukudla okunempilo, nangokuhlala usebenza ngokomzimba.

Yimiphi imithi enikezwayo ngalokhu?

Ukuze ulawule isifo sezinso esinesifo sikashukela, kubalulekile ukulawula isifo sakho sikashukela, ukwehlisa umfutho wegazi, kanye nokwehlisa amazinga akho e-cholesterol. Udokotela wakho angase akunike imithi elandelayo yokwelapha lezi zimo:

• Ngesifo sikashukela:
• Ama-Biguanides (isib. i-metformin): Lawa anciphisa inani le-glucose elenziwa yisibindi sakho. Aphinde athuthukise indlela i-insulin esebenza ngayo emzimbeni, ehlisa izinga lokuguqulwa kwama-carbohydrate abe ushukela.
• Izithibi ze-Sodium-glucose cotransporter 2 (SGLT2): Lezi zisiza izinso ukukhipha ushukela emzimbeni ngezinso nomchamo.
• Ama-agonist afana ne-glucagon peptide 1 (GLP-1): Lawa andisa ukukhishwa kwe-insulin, anciphisa ukukhishwa kwe-glucose esibindini ngemva kokudla, futhi abambezele ukukhishwa kwesisu. Lokhu kungasiza futhi ekunciphiseni isisindo.

• Ngomfutho wegazi ophakeme:
• Izithibi ze-Angiotensin-converting enzyme (ACE): Lezi zivimba ukukhiqizwa kwe-hormone ebizwa ngokuthi i-angiotensin II. Umzimba usebenzisa le hormone ngokwemvelo ukulawula umfutho wegazi. Ngemva kokwelashwa nge-ACE inhibitors, umfutho wegazi kufanele wehle.
• Ama-Angiotensin II receptor blockers (ARBs): Lawa avimba i-hormone angiotensin II ukuthi ingakwazi ukubopha kuma-receptor emithanjeni yegazi. Ama-ARB asebenza ngendlela efanayo nama-ACE inhibitors, ehlisa umfutho wegazi.

Okubalulekile: Ngaphezu kokwehlisa umfutho wegazi, ama-ACE inhibitors nama-ARB nawo asiza ekunciphiseni ukuqhubeka kwesifo sezinso esihlobene nesifo sikashukela.

• Nge-cholesterol ephezulu:
• Ama-statin: Lawa anciphisa i-cholesterol embi futhi akhuphula i-cholesterol enhle. Angaba usizo kwabanye abantu abanesifo sezinso esihlobene nesifo sikashukela.

Iyiphi indlela yokwelapha uma lesi sifo siba sibi kakhulu?

Uma isifo sezinso sesifo sikashukela siba sibi kakhulu, izinketho zokwelapha zifaka:

• I-Dialysis: Uma izinso zakho zingasebenzi kahle, i-dialysis ingasebenza ezinso zakho. Kulokhu, umshini uthatha igazi lakho, uhlunge udoti kanye noketshezi olwengeziwe, bese ubuyisela igazi elihlanziwe emzimbeni wakho.
• Ukufakelwa kwezinso: Kulokhu, uthola izinso ezinempilo komunye umuntu (onikela ngezinso).

Ungasigwema kanjani lesi sifo?

Indlela engcono kakhulu yokuvimbela isifo sezinso esinesifo sikashukela ukuphatha kahle isifo sakho sikashukela kanye nomfutho wegazi. Kubalulekile ukulandela uhlelo lokwelashwa olunqunywe udokotela wakho ngqo.

Yini umuntu onalesi sifo angayilindela?

Isifo sezinso esinesifo sikashukela siyisimo esiqhubeka kancane kancane . Uma unalesi sifo, umonakalo ezinso zakho awunakuguqulwa. Kodwa-ke, uma ubamba lesi sifo kusenesikhathi futhi ulandela uhlelo lokwelashwa olufanele, unganciphisa noma umise ukuqhubeka kwalesi sifo.

Uma lesi sifo siba sibi kakhulu, singaholela ekuhlulekeni kwezinso, okusongela impilo. Izindlela zokwelapha ukwehluleka kwezinso yi-dialysis noma ukufakelwa izinso.

Kufanele ngizinakekele kanjani?

Udokotela wakho uzokusiza ukuthi wakhe uhlelo lokwelashwa olukufanele. Lungafaka imithi kanye nezinguquko endleleni yokuphila. Uhlelo lwakho lokwelashwa lungafaka:

• Ukuthatha imithi yesifo sikashukela kanye nomfutho wegazi enikezwe udokotela ngqo.
• Hlola amazinga kashukela egazini lakho kanye nomfutho wegazi njalo.
• Ukulandela ukudla okunempilo (njengokudla kwaseMedithera noma ukudla kwe-DASH).
• Vivinya umzimba okungenani imizuzu engama-30 ngosuku izinsuku eziningi zesonto. Zama ukuthola okungenani imizuzu eyi-150 yokuzivocavoca ngesonto. Ungahamba, ugijime, ugibele ibhayisikili, ubhukude, noma wenze noma yimuphi omunye umsebenzi wenhliziyo owuthandayo.
• Ukugwema imithi engalimaza izinso. Lokhu kungafaka phakathi imithi ethile yokudambisa izinhlungu (imithi engeyona eye-steroidal yokulwa nokuvuvukala - ama-NSAID).
• Ukugcina ama-aphoyintimenti kadokotela kanye nokwenza zonke izivivinyo zelebhu.
• Yeka ukubhema noma ukusebenzisa eminye imikhiqizo kagwayi.
• Ukunciphisa inani lotshwala obuphuzayo.
• Lala amahora aphakathi kwayisikhombisa nayisishiyagalolunye njalo ebusuku.

Kufanele ngimbone nini udokotela?

Uma unesifo sikashukela, kufanele ubonane nodokotela wakho njalo njalo ezinyangeni ezintathu kuya kweziyisithupha, njengoba kunconywa udokotela wakho.

Uma unesifo sikashukela, udokotela wakho uzoncoma ukuhlolwa kwaminyaka yonke kwesifo sezinso sesifo sikashukela , okuzoqala eminyakeni emihlanu ngemva kokuxilongwa kwakho. Ukulimala kwezinso ngokuvamile akubonakali eminyakeni eyi-10 yokuqala ngemva kokuxilongwa kwakho. Uma usuneminyaka engaphezu kwengu-25 unesifo sikashukela futhi izinso zakho zingakalimalanga, mancane amathuba okuba nesifo sezinso sesifo sikashukela.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Kubaluleke kakhulu ukubuza imibuzo efana nale uma ubona udokotela wakho:

• Wazi kanjani ukuthi nginesifo sezinso ngenxa yesifo sikashukela?
• Ingabe kufanele ngibone udokotela wezinzwa noma omunye uchwepheshe?
• Yiziphi izivivinyo ozenzayo ukuze uxilonge isifo sezinso esihlobene nesifo sikashukela?
• Isifo sami sezinso esinesifo sikashukela sibi kangakanani?
• Yiziphi izinguquko zendlela yokuphila engingayenza ukuze nginciphise noma ngimise ukuqhubeka kwesifo sami sezinso esihlobene nesifo sikashukela?
• Yimiphi imithi oyincomayo?
• Yikuphi ukwelashwa okuncomayo?
• Kukangaki ngidinga ukuza ngezikhathi ezithile?
• Ungancoma amaqembu okusekela abantu abanesifo sezinso esihlobene nesifo sikashukela?

Lona umyalezo obaluleke kakhulu engikunike wona...

Ukulimala kwezinso okubangelwa isifo sikashukela kuyisimo esibi kakhulu. Kungaqhubekela phambili ekuhlulekeni kwezinso, okusongela impilo. Uma udokotela wakho ekuxilonga ukuthi unesifo sezinso esihlobene nesifo sikashukela, kuvamile ukuzizwa wesaba futhi udangele. Kodwa-ke, uma ubamba lesi sifo kusenesikhathi futhi ulandela uhlelo lwakho lokwelashwa ngokucophelela, unganciphisa noma umise ukuqhubeka kwesifo sezinso esihlobene nesifo sikashukela.

Ukuthola ukwelashwa kwesimo esinjengalesi kungaba yinto ekucindezelayo ngokomzwelo. Kodwa khumbula, udokotela wakho ukhona ukuzokusiza. Uzibophezele ekuphenduleni yonke imibuzo yakho nasekukusizeni ugcine izinga lempilo yakho. Ngakho-ke ungesabi ukukhuluma nodokotela wakho ngakho konke okusengqondweni yakho.

Isifo Sikashukela , Isifo Sezinso, Isifo Sezinso Esinesifo Sikashukela, I-DKD, I-Nephropathy, i-eGFR, Ukuhlolwa Komchamo, I-Dialysis