Amaqiniso Abalulekile Okufanele Uwazi Ngokuhluleka Kwezinso | Nirogi Lanka

Wake wake wema ukucabanga ukuthi izinso zakho ezimbili ezincane zisebenza kangakanani kuwe nsuku zonke? Nokho, ngezinye izikhathi, izinso zakho zingase zibe nzima ukusebenza ngendlela efanele. Yilokhu esikubiza ngokuthi ukwehluleka kwezinso. Nakuba lokhu kungase kuzwakale kungaphezu kwamandla, eNirogi Lanka , sikholelwa ukuthi ukuqonda impilo yakho kuyithuluzi elinamandla kakhulu onalo. Ukuhlala unolwazi kuyisinyathelo sokuqala sokulawula inhlalakahle yakho.

Kuyini Ukwehluleka Kwezinso?

Kalula nje, ukwehluleka kwezinso kwenzeka lapho eyodwa noma zombili izinso zakho zingasasebenzi kahle. Zingakwazi ukwenza imisebenzi yazo ebalulekile zodwa. Lokhu kungenzeka ngezindlela ezimbili eziyinhloko: Ukwehluleka Kwezinso Okukhulu , okwenzeka ngokuzumayo nangokushesha—nakuba kwezinye izimo, kungaba okwesikhashana futhi kuguqulwe ngokwelashwa—kanye Nesifo Sezinso Esingamahlalakhona (CKD) , okubhekisela ekuwohlokeni kancane kancane kokusebenza kwezinso ngokuhamba kwesikhathi. I-CKD iyindlela evame kakhulu yenkinga yezinso.

Uma ukusebenza kwezinso kuqhubeka nokwehla, kungafinyelela esigabeni sokugcina esaziwa ngokuthi yi -End-Stage Kidney Disease (ESKD) . Ngaphandle kokungenelela kwezokwelapha, i-ESKD isongela impilo; isiguli singaphila izinsuku noma amasonto ambalwa kuphela ngaphandle kokwelashwa. Kodwa-ke, ungesabi—ngokuphathwa nokunakekelwa okufanele eNirogi Lanka, ungalondoloza izinga elihle lempilo ngisho noma uphila nesifo sezinso.

Zenzani Izinso Zakho?

Ake sibheke ukuthi lezi zitho zomzimba zisebenza kanjani emzimbeni wakho. Izinso zakho ezimbili zibunjwe njengobhontshisi futhi zilingana nenqindi yakho. Unesinye ohlangothini ngalunye lomgogodla wakho, ngaphansi nje kwesikhala sezimbambo zakho. Nakuba abantu abaningi benazo ezimbili, kungenzeka ngokuphelele ukuphila impilo enempilo ngenso eyodwa esebenzayo.

Indima eyinhloko yezinso zakho ukuhlunga ubuthi emzimbeni wakho . Zicabange njengohlelo lokuhlunga oluyinkimbinkimbi: zihlunga igazi lakho futhi zisuse imfucuza, bese ikhishwa njengomchamo.

Uma izinso zakho zingasebenzi kahle, le mfucuza iqala ukunqwabelana emzimbeni wakho. Lokhu kukwenza uzizwe ungaphilile kahle, futhi uma ingelashwa, ingagcina ibulale. Kodwa-ke, njengoba kushiwo, ngokunakekelwa nokuqapha okufanele, lesi simo singaphathwa ngempumelelo.

Kuvame Kangakanani Ukwehluleka Kwezinso?

Ukwehluleka kwezinso kuvame kakhulu. Emazweni afana ne-United States, abantu ababalelwa ku-750,000 bayathinteka minyaka yonke, futhi emhlabeni wonke, izigidi ziphila nalesi simo. NaseSri Lanka, abantu abaningi babhekene nale nkinga, ikakhulukazi ngenxa yokusabalala kwezifo ezihambisana nesifo sikashukela kanye nomfutho wegazi ophakeme.

Yiziphi Izigaba Ezinhlanu Zesifo Sezinso?

Ukuze sithole isigaba sesifo sezinso, sibheka i-eGFR yakho (Isilinganiso Sokuhlunga Esilinganiselwe Se-Glomerular) , esilinganiswa ngokuhlolwa kwegazi.

Kalula nje, i-eGFR ilinganisa ukuthi izinso zakho zihlunga kahle kangakanani imfucuza. Umuntu ophilile ngokuvamile uba ne-eGFR engaphezu kuka-90. Uma i-eGFR yakho yehla iye ku-0, kusho ukuthi izinso azinawo amandla okusebenza asele.

Kunezigaba ezinhlanu eziyinhloko zesifo sezinso:

• Isigaba I: I-GFR yakho ingu-90 noma ngaphezulu. Kungase kube nomonakalo omncane wezinso, kodwa izinso zisasebenza kahle.
• Isigaba II: I-GFR yakho iphakathi kuka-60 no-89. Umonakalo ubaluleke kakhulu kuneSigaba I, kodwa ziyaqhubeka nokusebenza kahle.
• Isigaba III: I-GFR yakho iphakathi kuka-30 no-59. Lapha, ukusebenza kwezinso kuncishiswe ngokulinganisela kuya kakhulu.
• Isigaba IV: I-GFR yakho iphakathi kuka-15 no-29. Ukusebenza kwezinso kuyaphazamiseka kakhulu kulesi sigaba.
• Isigaba V: I-GFR yakho ingaphansi kuka-15. Lokhu kubonisa ukwehluleka kwezinso okuseduze noma okuphelele, futhi izimpawu zivame ukugqama kulesi sigaba.

Yiziphi Izimpawu Zokuqala Zokwehluleka Kwezinso?

Ngokuvamile, ezigabeni zokuqala, ungase ungabi nazimpawu nhlobo noma ezingabonakali kakhulu. Ngisho noma uzizwa uphilile, i-Chronic Kidney Disease (CKD) ingadala umonakalo wangaphakathi.

Izimpawu ziyahlukahluka kumuntu nomuntu. Uma izinso zakho zinenkinga, ungase uqaphele okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ukukhathala okuqhubekayo. Lokhu kungaphezu nje kokuzizwa ukhathele; kuwukukhathala okujulile okungaxazululwa ukuphumula.
• Ukucanuzela kwenhliziyo nokuhlanza, okuvame ukuhambisana nokulahlekelwa yisifiso sokudla.
• Ubunzima bokugxilisa ingqondo noma inkungu yobuchopho. Ukuzizwa udidekile engqondweni noma ungakwazi ukugxila emisebenzini.
• Ukuvuvukala (ukuvuvukala). Ikakhulukazi ezandleni zakho, emaqakaleni, noma eduze kwamehlo, ikakhulukazi lapho uvuka ekuseni.
• Izinguquko ekuchameni. Kungase kudingeke ukuthi uchame kaningi, kancane kancane, noma uqaphele ukuthi umchamo wakho ubonakala unegwebu.
• Ukuqaqamba kwemisipha noma ukuqaqamba kwemisipha.
• Isikhumba esomile noma esilumayo.
• Ukunambitheka kwensimbi emlonyeni wakho noma ukuphelelwa yisifiso sokudla.

Ungesabi uma unesinye noma ezimbili zalezi zimpawu, kodwa uma ziqhubeka, kufanele ubonane nodokotela ngokushesha . Uma ubhekene nesimo esiphuthumayo, shayela u-911 noma uvakashele umnyango wezimo eziphuthumayo oseduze nawe.

Yiziphi Izimbangela Eziyinhloko Zokwehluleka Kwezinso?

Izimbangela eziyinhloko zeSifo Sezinso Esingapheli kanye nokwehluleka kwezinso okulandelayo yilezi:Isifo Sikashukela kanye Nomfutho Wegazi Ophakeme . Zombili ziyizimo ezivamile nezilawulekayo esizibona njalo eNirogi Lanka.

Uma unesifo sikashukela futhi singaphathwa kahle, amazinga kashukela egazini lakho azokhuphuka njalo, okuholela ku-hyperglycemia. Uma la mazinga ehlala ephezulu njalo, angabangela umonakalo omkhulu ezinso zakho nakwezinye izitho ezibalulekile ngokuhamba kwesikhathi.

Umfutho wegazi ophakeme, noma umfutho wegazi ophakeme, kwenzeka lapho igazi liphoqeleka ukungena emithanjeni yakho ngomfutho omkhulu. Ngaphandle kokwelashwa isikhathi eside, lokhu kucindezeleka okwengeziwe kungabangela umonakalo omkhulu ezicutshini ezibuthakathaka ezinso zakho.

Ukwehluleka kwezinso akwenzeki ngobusuku obubodwa. Kunezinye izinto eziningana ezibangela lokhu:

• Isifo Sezinso Esibizwa Nge-Polycystic (PKD): Lesi yisifo sofuzo esizuzwe kubazali. Sibangela ukuba amasaka agcwele uketshezi, aziwa ngokuthi ama-cyst, akhule ngaphakathi kwezinso.
• Izifo ze-Glomerular: Lezi zimo zithinta ikhono lezinso lokuhlunga imfucuza egazini lakho ngempumelelo.
• Izifo zezinso ezizivikela ngokuzenzakalelayo: Isibonelo, i-Lupus . Lesi yisifo esizivikela ngokuzenzakalelayo lapho amasosha omzimba wakho ehlasela khona amaseli akho aphilile ngephutha. Lokhu kungaholela ekulimaleni kwezitho zomzimba, ubuhlungu bamalunga, umkhuhlane kanye nokuqubuka kwesikhumba.

Ngezinye izikhathi, ukwehluleka kwezinso kungakhula ngokushesha ngenxa yezimbangela ezingalindelekile. Lokhu kwaziwa ngokuthi i-Acute Kidney Injury (AKI) . Kulesi simo, ukusebenza kwezinso kwehla ngokuzumayo, ngokuvamile ezinsukwini ezimbalwa. Ngenhlanhla, lesi simo sivame ukuguqulwa.

Izimbangela ezivamile zokulimala kwezinso okukhulu zifaka:

• Imithi ethile: Ngokukhethekile, ukusetshenziswa kwesikhathi eside kwemithi ethile yokudambisa izinhlungu.
• Ukuphelelwa amanzi emzimbeni okukhulu: Uma umzimba wakho untula uketshezi olwanele.
• Ukuvaleka komgudu womchamo: Lokhu kungabangelwa yizimo ezinjengamatshe ezinso.
• Izifo zomzimba ezingelashwanga: Isibonelo, isifo senhliziyo noma isifo sesibindi.

Yiziphi izici eziyingozi zokwehluleka kwezinso?

Ukwehluleka kwezinso kungathinta noma ubani. Kodwa-ke, ungase ube sengozini enkulu uma unezici ezilandelayo:

• Unesifo sikashukela .
• Une -hypertension (umfutho wegazi ophakeme) .
• Unesifo senhliziyo .
• Kukhona umlando womndeni wesifo sezinso (uhlobo lofuzo).
• Unezinkinga zesakhiwo ezinso zakho.
• Ungowozalo lwabantu abamnyama noma abansundu baseMelika (ngenxa yezici ezithile zofuzo).
• Uneminyaka engaphezu kwengu-60 ubudala .
• Unomlando omude wokusebenzisa ama-painkiller, ikakhulukazi ama- NSAID athengiswa ngaphandle kwemithi kadokotela (Nonsteroidal Anti-inflammatory Drugs) .

Yiziphi izinkinga zokwehluleka kwezinso?

Izinso zakho zenza imisebenzi ebalulekile. Uma zehluleka, kungaholela ezinkingeni ezahlukahlukene, njenge:

• Umfutho wegazi ophezulu.
• I-anemia: Izinso zikhiqiza i-hormone esiza ekwakheni amangqamuzana abomvu egazi. Uma onakele, lokhu kukhiqizwa kuyehla.
• Isifo samathambo.
• Uketshezi oluzungeze amaphaphu akho.
• Ukulimala kwemizwa.
• Ukungalingani kwama-electrolyte: Ushintsho emazingeni amaminerali afana ne-sodium ne-potassium egazini lakho.

Sicela ungacabangi ukuthi ukuxilongwa kokwehluleka kwezinso kusho ukuphela. Uma ulandela ngokuqinile uhlelo lokwelashwa lukadokotela wakho—olungafaka phakathi imithi, ukulungiswa kwendlela yokuphila, kanye nemikhawulo yokudla ngosawoti kanye nezakhamzimba ezithile—ungasiphatha lesi simo ngempumelelo. Kodwa-ke, ukunganaki iseluleko sezokwelapha kungaholela ekuwohlokeni okuqhubekayo kanye nemiphumela engaba yingozi empilweni. KwaNirogi Lanka, silapha ukusekela uhambo lwakho lokuphathwa okungcono.

Ingabe ukwehluleka kwezinso esigabeni sokugcina kungaholela ekufeni?

Yebo, Isifo Sezinso Esisesigabeni Sokugcina (i-ESKD) singasongela impilo. Kodwa-ke, njengoba kushiwo, ngokwelashwa okufanele, abantu abaningi bangaphila impilo ephelele. Kubalulekile ukukhumbula ukuthi okwamanje akukho ikhambi eliphelele lokwehluleka kwezinso. Ukwelashwa kugxile ekulondolozeni ukusebenza kwezinso zakho okusele isikhathi eside ngangokunokwenzeka kanye nokulibazisa ukwehla okuqhubekayo.

Kuhlonzwa kanjani ukwehluleka kwezinso?

Udokotela wakho uzosebenzisa izivivinyo ezahlukahlukene ukuhlola ukuthi izinso zakho zisebenza kahle kangakanani. Uma udokotela wakho esola ukuthi usengozini yokwehluleka kwezinso, ngokuvamile uzoyala okulandelayo:

• Ukuhlolwa kwegazi: Lokhu kulinganisa ukuthi izinso zakho zihlunga kanjani imfucuza egazini lakho ngempumelelo. Isampula ithathwa emthanjeni osengalweni yakho bese ihlaziywa elebhu. I-eGFR yakho inqunywa ngalolu vivinyo.
• Ukuhlolwa komchamo: Lokhu kuhlola umchamo wakho ukuthi awunazo yini izinto ezifana neprotheni noma igazi. Uzocelwa ukuthi unikeze isampula esitsheni esihlanzekile ukuze kuhlaziywe elebhu.
• Ukuhlolwa kwezithombe: Lokhu kuvumela udokotela wakho ukuthi abone izinso zakho ukuthi zihlole ukukhubazeka noma ukuvinjelwa. Ukuhlolwa okuvamile kwezithombe kuhlanganisa i-Kidney Ultrasound , i-CT Urogram , kanye ne -MRI .

Kulashwa kanjani ukwehluleka kwezinso?

Indlela yokwelapha ukwehluleka kwezinso incike embangela eyinhloko kanye nobunzima besimo sakho. Nakuba ukwehluleka kwezinso kuyisimo esibucayi, esisongela impilo esingenakwelashwa ngokuphelele, uhlelo lokwelashwa olufanele eNirogi Lanka lungakusiza uphile impilo ende nekhululekile ngenkathi uphatha izimpawu nezinkinga ngempumelelo.

Uma ukusebenza kwezinso zakho kwehla kancane kancane, ithimba lakho lezokunakekelwa kwempilo lizoqapha impilo yakho eduze futhi lisebenzise amasu okulondoloza ukusebenza okusele isikhathi eside ngangokunokwenzeka. Lokhu kungafaka:

• Ukuhlolwa kwegazi njalo.
• Ukuqapha njalo umfutho wegazi lakho.
• Imithi kadokotela elungiselelwe izidingo zakho.

Uma usesimeni sokwehluleka kwezinso esisesigabeni sokugcina , ukwelashwa okusebenzayo kubalulekile ukuze uphile. Kunezindlela ezimbili zokwelapha eziyinhloko: i-Dialysis kanye ne -Kidney Transplantation .

Imithi Yokwehluleka Kwezinso

Kuye ngokuthi yini ebangele isifo sakho sezinso, udokotela wakho angase akunike okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ama-Angiotensin-converting enzyme (ACE) inhibitors noma ama-Angiotensin II receptor blockers (ARBs): Lawa asiza ekuphatheni nasekunciphiseni umfutho wegazi lakho.
• Ama-diuretics: Ngokuvamile abizwa ngokuthi “amaphilisi amanzi,” lawa asiza umzimba wakho ukuqeda uketshezi oluningi.
• Ama-statin: Lawa asetshenziselwa ukwehlisa amazinga akho e-cholesterol.
• Ama-Erythropoietin-stimulating agents: Uma unesifo sokuntuleka kwegazi, lawa asiza umzimba wakho ukukhiqiza amangqamuzana abomvu egazi.
• I-Vitamin D ne-Calcitriol: Lokhu kusiza ukuvikela impilo yamathambo akho nokuvimbela ukuwohloka.
• Izihlanganisi ze-phosphate: Lezi zisiza ukususa i-phosphorus eningi egazini lakho.

I-Dialysis

I-Dialysis isebenza njengesihlungi sangaphandle segazi lakho, inikeza izinso zakho ukwesekwa ezikudingayo lapho zingasakwazi ukusebenza zodwa. Kunezinhlobo ezimbili eziyinhloko:

• I-Hemodialysis: Kule nqubo, umshini uhlunga igazi lakho. Iningi leziguli lithola lolu hlobo lokwelashwa esibhedlela noma esikhungweni se-dialysis esikhethekile kathathu kuya kane ngesonto. Kungaba nzima ngokomzimba, njengoba kuzodingeka uhlale uxhumene nomshini amahora amaningana ngeseshini ngayinye.
• I-Peritoneal dialysis: I-catheter ifakwa esiswini sakho, okuvumela isisombululo se-dialysis esikhethekile ukuba sigeleze singene emgodini wakho wesisu. Lolu ketshezi lumunca imfucuza kanye noketshezi oluningi, bese lukhishwa luphume. Ezimweni eziningi, lolu hlobo lwe-dialysis lungenziwa ukhululekile ekhaya lakho.

Ukufakelwa Kwezinso

Ekufakweni Kwezinso , udokotela ohlinzayo ushintsha izinso zakho ezonakele ngezomnikeli eziphilile. Lesi sitho somnikeli singavela kumnikeli oshonile noma kumnikeli ophilayo. Ungaphila impilo egcwele nenempilo ngenso eyodwa esebenzayo. Ngemva kokufakelwa, kuzodingeka uthathe imithi impilo yakho yonke ukuvimbela umzimba wakho ekwenqabeni isitho esisha.

Ingabe ukwehluleka kwezinso esigabeni sokugcina kungelapheka?

Ukubikezela kwakho kuncike ezintweni ezahlukahlukene. Ngokunakekelwa kwezokwelapha okuzinikele, ungaphila impilo eyanelisayo nejabulisayo. Kodwa-ke, kufanele ulungiselele iqiniso lokuthi ukwelashwa kuzodingeka impilo yakho yonke. Sicela ukhumbule, isifo sezinso kanye nokwehluleka akunakuguqulwa ; ukwelashwa kugxile ekunciphiseni ukuqhubeka kwesifo kanye nokulawula lesi simo.

Ukwehluleka kwezinso kungavinjelwa kanjani?

Nakuba isifo sezinso esingamahlalakhona (i-CKD) kanye nokwehluleka kwezinso kungenakukwazi ukuguqulwa njalo, ungathatha izinyathelo ezisebenzayo ukuvikela ukusebenza kwezinso zakho okusele. Ukwamukela imikhuba enempilo kanye nemikhuba kunganciphisa kakhulu ukuqhubeka kwesifo.

Uma une-CKD noma usengozini yokwehluleka kwezinso, cabanga ngalokhu okulandelayo:

• Qapha ukusebenza kwezinso zakho njalo (njengoba udokotela wakho ekweluleke).
• Uma unesifo sikashukela, gcina amazinga kashukela egazini lakho esezingeni elifanele .
• Gcina umfutho wegazi lakho usezingeni elijwayelekile nelinempilo .
• Gwema yonke imikhiqizo kagwayi , okuhlanganisa nokubhema.
• Nciphisa ukudla okune-potassium eningi kanye ne-sodium (usawoti) . Xhumana nodokotela wakho noma isazi sokudla okunempilo, njengoba ezinye izithelo nemifino zino-potassium eningi ngokwemvelo.
• Yiba khona kuzo zonke izikhathi zokubonana nodokotela wakho ezihleliwe .

Yini ongayilindela uma unesifo sezinso?

Akukho ukwelashwa okuphelele kokwehluleka kwezinso. Kodwa-ke, ngokuxilongwa okunembile nokwelashwa okuqhubekayo, ungaphila impilo ende nenenjongo ngaphandle kokubeka engcupheni izinga lempilo yakho.

Kufanele ubonane nini nodokotela?

Uma unezici eziyingozi zokwehluleka kwezinso, sicela uhlele ukubonisana nodokotela wakho. Lokhu kufaka phakathi:

• Une- high blood pressure (umfutho wegazi ophakeme) .
• Ubona izinguquko emaphethini akho omchamo (njengokuchama njalo, ukwehla kokukhishwa komchamo, umchamo onegwebu, noma igazi emchameni wakho).
• Uba nobunzima bokugxilisa ingqondo noma ukugxila ezintweni ezikukhathazayo.
• Uhlushwa isicanucanu noma ukuhlanza okuqhubekayo.
• Uxilongwe ukuthi unesifo sikashukela .
• Unomlando womndeni wesifo sezinso.
• Unomlando wangaphambilini wokulimala kwezinso (isb., ukwehluleka kwezinso okukhulu).
• Uvame ukusebenzisa imithi yokubulala izinhlungu yohlobo lwe-NSAID .

Uma ubhekene nanoma yiziphi zalezi zimpawu, ungazinaki. Isinyathelo esihlakaniphile kakhulu ukubonana nodokotela ngokushesha ukuze uthole iseluleko sochwepheshe bezokwelapha.

Imibuzo Okufanele Uyibuze Udokotela Wakho

Cabanga ngokuxoxa ngale mibuzo mayelana nokwehluleka kwezinso nomhlinzeki wakho wezempilo:

• Kutholakale kanjani ukuthi nginesifo sezinso?
• Uma kungekona ukwehluleka kwezinso, yiziphi ezinye izimo ezingachaza lezi zimpawu?
• Iyini imbangela eyinhloko yokukhubazeka kwezinso zami?
• Ingabe ngidinga i-dialysis?
• Iyiphi indlela ye-dialysis ongincomayo kimi?
• Ingabe ngingumuntu ofanelekela ukufakelwa izinso?
• Yimiphi imithi oyincomayo?
• Ingabe kufanele ngenze izinguquko ezithile ekudleni kwami ​​noma ekuphuzeni uketshezi?
• Kudingeka ngibe khona kangaki emihlanganweni yokulandelela?

Kunini Lapho Kufanele Ucabangele Ukunakekelwa Kwe-Hospice Uma Uhluleka Izinso?

Ukunquma ukuthi uzoshintshela nini ekunakekelweni kwe-hospice wena noma othandekayo wakho kuyisinqumo sakho siqu. Ithimba lakho lezokwelapha lingakusiza ukuthi uqonde endleleni engcono kakhulu yesimo sakho. Umgomo oyinhloko wokunakekelwa kwe-hospice ukukunikeza induduzo, isithunzi, kanye nokusekelwa phakathi nezigaba ezithuthukile zokwehluleka kwezinso. Uma kukhulunywa ngokwehluleka kwezinso, i-hospice ivame ukubhekwa lapho ukwelashwa okufana ne-dialysis noma ukufakelwa kwezicubu kungasasebenzi noma kungasasebenzi kahle esigulini.

Izinto Ezibalulekile Ezithathwayo ezivela eNirogi Lanka

Izinso zakho ziyizitho ezibalulekile ezibangela ukuhlunga imfucuza kanye noketshezi oluningi emzimbeni wakho. Ukwehluleka kwezinso kusho ukuthi lezi zitho azisawenzi imisebenzi yazo ebalulekile, okungaba yingozi empilweni ngaphandle kokungenelela okufanele. Kodwa-ke, ungalahli ithemba; izinketho ezifana ne -dialysis noma ukufakelwa kwezinso zingakusiza ukuthi ugcine impilo yakho isezingeni elihle. Uhlelo lwakho lokunakekelwa lungafaka imithi kanye nokulungiswa kokudla okuthile. Hlala uya emihlanganweni yakho yezokwelapha njalo. Uma unemibuzo noma ukukhathazeka mayelana nokwelashwa kwakho, imithi, izinguquko zendlela yokuphila, noma yisiphi isici sohlelo lwakho lokunakekelwa, khuluma ngokukhululekile nodokotela wakho.

Amagama angukhiye: Ukwehluleka kwezinso, Isifo sezinso, Isifo sikashukela, Umfutho wegazi ophakeme, I-Dialysis, Ukufakelwa kwezinso