Ingabe udokotela wakho wake wakutshela noma othile emndenini wakho ukuthi unesifo esibangela ukwakheka kwama-cyst agcwele uketshezi ezinso zakho? Lokhu kwaziwa ngokwezokwelapha ngokuthi 'i-Autosomal Dominant Polycystic
kidney disease ', noma
i-ADPKD ngamafuphi. Kujwayelekile ukuzizwa wesaba kancane uma uzwa lokhu, ngoba ngokuhamba kwesikhathi, lokhu kungaholela ekuhlulekeni kwezinso. Kodwa ungakhathazeki. Kunezindlela zokwelapha ezinganciphisa inkambo yalesi sifo futhi zisize ekuvikeleni izinso zakho. Namuhla sikhuluma nge
-Jynarque , umuthi okuwukuphela kwawo ovunyelwe lesi simo.
Lo muthi i-Jynarque ubasiza kanjani iziguli ze-ADPKD?
Kalula nje, i-ADPKD
yisifo sofuzo esidluliselwa kusuka esizukulwaneni kuya kwesinye . Lesi yisimo lapho ama-cyst amaningi agcwele uketshezi (ama-cyst) akheka khona ezinso. Ngokuhamba kwesikhathi, la ma-cyst akhula, ashintshe isimo sezinso futhi abe makhulu kakhulu kunokujwayelekile. Ekugcineni, izinso azisakwazi ukwenza umsebenzi wazo wokuhlunga igazi kahle. Ngokuvamile, lezi zimpawu azibonakali kubantu abasha, kodwa zibonakala phakathi kweminyaka engama-30 no-50. Uphawu oluvamile
umfutho wegazi ophezulu . Ubuhlungu ezinso bungavela futhi. Lokhu kungabangelwa ukutheleleka ezinso noma emgudwini womchamo, ama-cyst aqhekekile, noma amatshe ezinso. Cishe wonke umuntu one-ADPKD ekugcineni uba nesifo sezinso esingamahlalakhona (CKD). Lesi yisimo esiba sibi kancane kancane. Ake sibone ukuthi yiziphi izigaba zaso.
| Isigaba se-CKD | Isimo silula. |
|---|
| Izigaba 1 no-2 | Lesi yisikhathi sokuqala. Izinso zisasebenza kahle, ngakho-ke ngokuvamile azikho izimpawu. |
| Izigaba 3 no-4 | Okwamanje, ukusebenza kwezinso sekwehle kakhulu. Izimpawu ziqala ukuvela ngoba azikwazi ukuhlunga igazi kahle. |
| Isigaba 5 | Lesi yisigaba sokugcina. Izinso azikwazi ukusebenza nhlobo (Ukwehluleka Kwezinso). Ngaphandle kwe-dialysis noma ukufakelwa kwezinso, kungaba yingozi empilweni. |
Umgomo oyinhloko wokwelashwa kwe-ADPKD
ukunciphisa umonakalo wezinso ngangokunokwenzeka. Enye indlela yokwenza lokhu ukulawula umfutho wegazi ophezulu. Enye ukuphuza amanzi amaningi usuku lonke nokunciphisa ukudla kwakho i-caffeine (itiye, ikhofi). Ngaphezu kwalokho, udokotela wakho angase ancome izinguquko zendlela yokuphila njengokuzivocavoca umzimba, ukunciphisa usawoti ekudleni kwakho, nokuyeka ukubhema.
I-Jynarque isebenza ngendlela eyingqayizivele kakhulu. Imizimba yethu ine-hormone ebizwa ngokuthi `(vasopressin)`. Ezigulini ze-ADPKD , le hormone ithumela izimpawu ezinso ukuze zenze ama-cyst amaningi. Isithako esisebenzayo ku-Jynarque, `(tolvaptan),` sivimba leso sibonakaliso ukuthi singafiki ezinso. Lokhu kunciphisa ukwakheka kwama-cyst amasha kanye nokukhula kwama-cyst amadala. Lokhu kuvumela izinso ukuthi zisebenze kahle isikhathi eside.
Ingabe lo muthi awufanele wonke umuntu?
Yebo, iJynarque ayifaneleki kubo bonke iziguli.
Kubalulekile ukutshela udokotela wakho ngazo zonke izimo zakho zezokwelapha zangaphambili nezamanje , ikakhulukazi:
- Uma unezinkinga zesibindi.
- Uma unezinga eliphansi noma eliphezulu le-sodium egazini lakho.
- Uma unenkinga yokuchama (isib. amatshe ezinso , ukuvaleka komgudu womchamo).
- Uma ungezwa ukoma noma unenkinga yokuphuza amanzi usuku lonke.
Ukukhuluma nodokotela wakho ngezinto ezinjengalezi kubaluleke kakhulu ukuze uphephe.
Ungayisebenzisa kanjani imithi?
I-Jynarque iyiphilisi elithathwa kabili ngosuku. Lingathathwa ngaphambi noma ngemva kokudla. Isikhathi sokuthatha lokhu sibaluleke kakhulu.
| Umthamo | Isikhathi esithathiwe |
|---|
| Umthamo wokuqala (ekuseni) | Yithathe ngokushesha nje lapho uvuka ekuseni. Lona umthamo ophezulu kakhulu. |
| Umthamo wesibili (ntambama) | Thatha umthamo wokuqala emahoreni angu-8 ngemuva komthamo wokugcina. (Isibonelo, uma uwuthatha ngo-8 ekuseni, thatha olandelayo ngo-4 ntambama). Lona umthamo ophansi. |
Uma uqala ukuthatha umuthi, udokotela wakho uzokunika umthamo ophansi. Uma ungenazo izinkinga ezinkulu amasonto angu-1-2, bazokwandisa umthamo kancane. Ngemva kwalokho, uma ungenazo izinkinga, ungandisa umthamo futhi.
Kubaluleke kakhulu: Ngesikhathi uthatha lo muthi, udokotela wakho uzokucela ukuthi uhlolwe igazi (ukuhlolwa kokusebenza kwesibindi) ngezikhathi ezithile ukuze uhlole ukusebenza kwesibindi sakho . Kubalulekile ukuthi uye kulezi zivivinyo ngezinsuku ezihleliwe. Kuye ngemiphumela, umthamo wakho kungadingeka wehliswe, umiswe izinsuku ezimbalwa, noma umiswe ngokuphelele.
Uma uphuthelwe umthamo, ungawuthathi.
Yeqa umthamo ophuthelwe bese uthatha umthamo wakho olandelayo ngesikhathi esibekiwe. Kubalulekile ukulandela uhlelo ngqo, ngokushesha nje lapho uvuka ekuseni kanye namahora angu-8 kamuva. Kungumqondo omuhle ukusetha i-alamu efonini yakho ukuze ukhumbule umthamo wesibili.
Izivivinyo zithini ngempumelelo yalo muthi?
Kuye kwenziwa izifundo ezimbili ezinkulu ukuhlola ukuphepha nokusebenza kahle komuthi i-Jynarque.
Iziguli ze-CKD ezisezingeni lokuqala (isigaba 1 noma 2)
Kulolu cwaningo, izinga lokukhula kwezinso kulabo abathathe i-Jynarque lehle kakhulu uma liqhathaniswa nalabo abathathe i-placebo. Uma sikhuluma iqiniso, izinga lokukhula kwezinso kulabo abathathe i-Jynarque
lehle cishe ngo-49% uma liqhathaniswa nalabo abathathe i-placebo. Lokhu kusho ukuthi umonakalo wezinso wawulawulwa kakhulu. Ngaphezu kwalokho, labo abathathe i-Jynarque nabo babe nobuhlungu obuncane obuhlobene nezinso.
Iziguli ze-CKD ezisesigabeni sokugcina (isigaba sesi-3 noma sesi-4)
Kuleli qembu leziguli, izinga lokuwohloka kokusebenza kwezinso kulabo abathathe i-Jynarque lalihamba kancane kunakwabanye. Lokhu kusho ukuthi lo muthi ungasiza ekulondolozeni ukusebenza kwezinso zabo isikhathi eside, ngisho nakulabo abanesifo esibi kakhulu.
Imiphumela emibi nokuthi ungayiphatha kanjani?
Kunemiphumela emibi engaba khona uma usebenzisa i-Jynarque, futhi kubalulekile ukuyiqaphela.
- Ukuchama njalo: Lona umphumela ovame kakhulu. Lokhu kungabangela ukuthi udinge ukuya endlini yangasese kaningi, kokubili emini nasebusuku. Ukuze unciphise ukungakhululeki ebusuku, thatha umthamo wesibili ngesikhathi esifanayo, hhayi kamuva kusihlwa.
- Ukuphelelwa amanzi emzimbeni: Kukhona ingozi yokuphelelwa amanzi emzimbeni ngoba umzimba ulahlekelwa uketshezi oluningi kakhulu. Ukuze uvimbele lokhu, phuza amanzi amaningi usuku lonke, ngaphandle kokulinda uze uzizwe womile . Phuza amanzi ngokushesha uma uzizwa womile. Ukuphelelwa amanzi emzimbeni kungabangela amazinga aphezulu e-sodium egazini. Uma uzwa izimpawu ezifana nokuzungeza, ubuthakathaka , ukukhathala okukhulu, ukuquleka, noma ukushaya kwenhliziyo okungajwayelekile , yazisa udokotela wakho ngokushesha.
Akuzona lezi kuphela, kodwa neminye imiphumela emibi ingase ivele. Khuluma nodokotela wakho nganoma yiziphi izimpawu ezikukhathazayo.
Ingabe kungaba nezinkinga ngeminye imithi noma ukudla?
Yebo, lokhu futhi kuyindaba ebaluleke kakhulu.
- Eminye imithi: I-Jynarque ingase ihlangane neminye imithi. Eminye imithi ingandisa imiphumela emibi ye-Jynarque, kanti eminye inganciphisa ukusebenza kahle kwe-Jynarque. Ngakho-ke, qiniseka ukuthi utshela udokotela wakho ngayo yonke imithi oyithathayo (kufaka phakathi amavithamini kanye nemithi yamakhambi).
- Ukudla: Ungadli i-grapefruit noma uphuze ijusi le-grapefruit ngenkathi uthatha lo muthi. I-Grapefruit ikhulisa izinga le-Jynarque emzimbeni, okwandisa ingozi yemiphumela emibi. Lo mphumela ungenzeka noma ngabe udla i-grapefruit nganoma yisiphi isikhathi sosuku, hhayi lapho uthatha umuthi, ngakho-ke gwema i-grapefruit ngokuphelele.
Ingabe ikhona indlela ekhethekile yokuthola lo muthi?
I-Jynarque umuthi onamandla angavamile kakhulu okubangela ukulimala kwesibindi. Ngenxa yale ngozi, lo muthi utholakala kuphela ngaphansi
kohlelo olukhethekile olubizwa ngokuthi i-REMS Program . Kumelwe ubhalise kulolu hlelo ngaphambi kokuba uqale ukuthatha umuthi. Kuzodingeka futhi ukuthi uhlolwe igazi ukuze uhlole ukusebenza kwesibindi sakho. Kuzodingeka uqhubeke nokwenza lokhu kuhlolwa kwegazi ngezikhathi ezithile ngemva kokuqala ukuthatha umuthi. Kubalulekile ukuthi uqhubeke nokwenza lokhu kuhlolwa uma ufuna ukuqhubeka nokuthatha umuthi. Udokotela wakho uzochaza kabanzi ngalokhu.
Umlayezo Wokuya Nawe Ekhaya
- I-ADPKD yisifo esidluliselwa ngofuzo esibangela ukwakheka kwamatshe ezinso, okungagcina kuholele ekuhlulekeni kwezinso.
- I-Jynarque (i-Tolvaptan) umuthi okhethekile osiza ekunciphiseni ukukhula kwalezi zimila zezinso.
- Lo muthi awufanele wonke umuntu. Tshela udokotela wakho ngazo zonke izimo zakho zezokwelapha.
- Thatha umuthi ngesikhathi esifanele, ngesilinganiso esifanele. Ungayeki ukuhlolwa kwegazi ukuze uhlole ukusebenza kwesibindi sakho.
- Phuza amanzi amaningi usuku lonke. Gwema ukudla nokuphuza i-grapefruit ngokuphelele.
- Ngisho noma ungezwa mehluko, gwema ukuyeka lo muthi noma omunye umuthi ngaphandle kweseluleko sikadokotela wakho.
I-Jynarque, i-Tolvaptan, i-ADPKD, Isifo Sezinso Esiyi-Polycystic, Isifo Sezinso, Ama-cyst Ezinso, i-CKD, Ukwehluleka Kwezinso, Isifo Sezinso Esingapheli, i-Jambola
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