Wake waphawula ukuthi imilenze namaqakala akho ayavuvukala nje? Noma wake waphawula ukuthi uma uchama, kuba namagwebu? Lezi akuzona izimpawu okufanele uzishaye indiva nje. Zingaba izimpawu zokuthi kukhona okungahambi kahle ngezinso zakho. Namuhla sizokhuluma ngesimo esingavamile kodwa esibalulekile esithinta izinso zakho. Lokho kubizwa ngokuthi i-Membranous Nephropathy (MN).
Kuyini i-Membranous Nephropathy (MN)?
Kalula nje, i-Membranous Nephropathy (MN) yisimo lapho amasosha omzimba wakho, uhlelo olukuvikela ezifweni, luhlasela izinso zakho. Akumangalisi yini? Amasosha ethu okuzivikela ayasihlasela.
Manje bheka, ngaphakathi kwezinso zethu, kunezigidi zezihlungi ezincane ezihlanza igazi. Lezi sizibiza ngokuthi ama-glomeruli . Njengesihlungi setiye, lezi zihlungi zihlunga imfucuza engafuneki egazini bese ziyikhipha emzimbeni njengomchamo. Omunye umsebenzi walezi zihlungi ukugcina izinto ezibalulekile ezifana namaprotheni umzimba owadingayo egazini.
Okwenzekayo kumuntu one-MN ukuthi amasosha omzimba, njengoba ngishilo, ahlasela futhi alimaze lawa ma-filter abizwa ngokuthi ama-glomeruli. Uma kwenzeka lo monakalo, izimbobo ezihlungini ziba zinkulu. Ngemuva kwalokho amaprotheni adingwa ngumzimba aqala ukuhlunga ngesihlungi bese ephuma nomchamo. Lena yinkinga eyisisekelo yalesi sifo.
Lesi simo singavela ngokuzumayo, noma singakhula kancane kancane ngokuhamba kwesikhathi. Ngezinye izikhathi, abantu bangase bangazi nokuthi banalesi simo iminyaka eminingi.
Kunezinhlobo ezimbili eziyinhloko zalesi sifo.
Sihlukanisa lesi simo se-Membranous Nephropathy (MN) ngezigaba ezimbili eziyinhloko. Lokhu kuhlukaniswa kwenziwa ngokusekelwe esibangweni.
| Uhlobo lwesifo | Incazelo |
|---|---|
| I-Primary Membranous Nephropathy (Idiopathic) | Lolu uhlobo oluvame kakhulu (cishe ama-75% eziguli). Okwenzekayo lapha ukuthi amasosha omzimba ahlasela izinso ngqo, ngaphandle kwanoma yisiphi esinye isifo. Lokhu kubhekwa njengesimo sokuzivikela komzimba. |
| I-Secondary Membranous Nephropathy | Lokhu kwenzeka lapho izinso zonakaliswa esinye isimo sezokwelapha, ukutheleleka, noma imithi. Lokhu kusho ukuthi izinso zonakaliswa njengomphumela wesinye isizathu. Cishe ama-25% eziguli analolu hlobo. |
Ingabe nawe unalezi zimpawu?
Izimpawu eziyinhloko zesifo se-MN zibangelwa inani elikhulu lamaprotheni akhishwa emchameni, njengoba ngishilo ekuqaleni. Kwezokwelapha, sibiza iqoqo lezimpawu ezibangelwa yilesi simo i-Nephrotic Syndrome .
Izimpawu eziyinhloko yilezi:
- Ukuvuvukala: Ukuvuvukala, ikakhulukazi emilenzeni, emaqakaleni, ezinyaweni, futhi ngezinye izikhathi ebusweni nasezizandleni. Lokhu kuvuvukala kwenzeka lapho kunokwehla kweprotheni egazini, okubangela amanzi emithanjeni yegazi ukuba angene ezicutshini.
- Umchamo onamagwebu amaningi (i-Proteinuria): Ngenxa yokuqukethwe okuphezulu kwamaprotheni emchameni, ungase ubonakale unegwebu, njengamanzi anensipho.
- Ukukhathala okukhulu nokukhathala: Ungase uzizwe ukhathele ngaso sonke isikhathi ngoba umzimba wakho ulahlekelwa amandla nezakhamzimba ozidingayo.
- Ukukhuluphala okungazelelwe: Lokhu akukhuli ngempela, kodwa kukhuluphala ngenxa yokugcinwa kwamanzi.
- I-cholesterol ephezulu: Lapho amazinga eprotheni egazini ehla, isibindi sethu sikhiqiza amafutha amaningi kanye ne-cholesterol ukuze sibuyisele.
- Umfutho Wegazi Ophakeme: Umfutho wegazi ungakhuphuka uma izinso zingasebenzi kahle.
- Ubunzima bokuphefumula: Lesi simo singaba khona uma uketshezi luqoqana emaphashini.
Kungani lokhu kwenzeka? Yiziphi izizathu?
Izizathu ziyahlukahluka kuye ngezinhlobo ezimbili esixoxe ngazo ekuqaleni.
Imbangela ye-MN eyinhloko
Ngithe i-MN eyinhloko iyisimo sokuzivikela komzimba. Okwenzekayo lapha ukuthi amasosha ethu omzimba ahlonza ngephutha iphrotheni ekhethekile ebizwa ngokuthi i-phospholipase A2 receptor (PLA2R) ezihlungini zezinso (glomeruli) "njengesitha." Bese, yenza ama-antibodies okubhubhisa le phrotheni ye-PLA2R bese iyihlasela. Lokhu kulwa yikho okubangela ukuthi lezo zihlungi zonakale futhi iphrotheni iphume.
Izinto ezingabangela i-MN yesibili
I-MN yesibili ingumphumela wento ethile. Nazi ezinye izinto ezingayithinta:
- Ezinye izifo ezithinta amasosha omzimba: Izifo ezifana ne-Lupus kanye ne-Rheumatoid Arthritis.
- Izifo: Izifo ezifana ne-Hepatitis B, i-Hepatitis C, i-Malaria, kanye ne-Syphilis.
- Umdlavuza: Ikakhulukazi umdlavuza wamaphaphu nowe-colon.
- Imithi:Ukusetshenziswa isikhathi eside kwemithi efana nemithi ethile yokudambisa izinhlungu (ama-NSAID) kanye ne-penicillamine.
- Ubuthi: Ukuchayeka ezinsimbini ezisindayo njenge-mercury.
Khumbula, uma unalezi zimpawu, into ebaluleke kakhulu ukubona udokotela wakho ngokushesha okukhulu bese ucela iseluleko, kunokuqagela imbangela.
Yiziphi izinkinga ezingabangelwa yilokhu?
Uma i-MN ingelashwa kahle, izinkinga ezinkulu zingavela ngokuhamba kwesikhathi.
- Ingozi ephezulu ye-cholesterol kanye nesifo senhliziyo: Ukwanda kwamafutha egazini kwandisa ingozi yezimo ezifana nesifo senhliziyo kanye nesifo sohlangothi.
- Amahlule egazi: Uma iphrotheni ikhishwa emchameni, amaprotheni avimbela ukujiya kwegazi nawo akhishwa emzimbeni. Lokhu kungaholela ekuqhekekeni kwegazi emithanjeni yemilenze. Lokhu sikubiza ngokuthi i -Deep Vein Thrombosis (DVT) . Uma leli hlule legazi liqhuma futhi libhajwe emthanjeni emaphashini, kuyisimo esibi nesisongela ukuphila esibizwa ngokuthi i-Pulmonary Embolism (PE) .
- Ukwehluleka Kwezinso: Uma lesi sifo singalawulwa, umonakalo wezinso uyanda kancane kancane, futhi ekugcineni izinso zingase zingasebenzi ngokuphelele.
Udokotela ukuthola kanjani lokhu?
Uma unezimpawu ezingenhla, udokotela womndeni wakho uzokudlulisela kuchwepheshe wezinso (i-Nephrologist). Uzokwenza izivivinyo eziningana ukuze ahlole lesi sifo ngokunembile.
| Ukuhlolwa | Uhlola ini? |
|---|---|
| Ukuhlolwa Komchamo | Bahlola ukuthi kungakanani amaprotheni negazi elisemchameni. |
| Ukuhlolwa Kwegazi | Izinto ezifana ne -creatinine, i-blood urea nitrogen (BUN) , ezilinganisa ukusebenza kwezinso, kanye namazinga amaprotheni egazini (i-albumin) ziyahlolwa. |
| Izinga Lokuhlunga le-Glomerular (GFR) | Lokhu kwenziwa nangokuhlolwa kwegazi. Kukala ukuthi izinso zakho zishesha kangakanani ukuhlunga imfucuza. |
| Ukuhlolwa Kwezinso | Lena yindlela engcono kakhulu yokuqinisekisa lesi sifo isikhathi esingu-100%. Kusetshenziswa inalithi encane, kuthathwa ingcezu encane kakhulu yezicubu ezinso bese ihlolwa ngaphansi kwe-microscope. Lokhu kunganquma ngokunembile ukuthi izinguquko kanye nama-antibodies ahlobene nesifo se-MN zikhona yini. |
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa kuncike ekutheni uhlobo luni lwe-MN onalo nokuthi izimpawu zakho zimbi kangakanani. Umgomo oyinhloko wokwelashwa ukunciphisa izimpawu nokuvimbela lesi sifo ukuthi singabi sibi kakhulu.
Okukodwa noma ngaphezulu kwalokhu okulandelayo kungasetshenziswa njengokwelashwa:
- Imithi yokucindezeleka kwegazi: Imithi efana ne-ACE inhibitors kanye ne-ARBs ilawula ukucindezeleka kwegazi futhi inciphisa nokukhishwa kwamaprotheni emchameni.
- Ama-Diuretics: Lawa abizwa nangokuthi "amaphilisi amanzi." Asiza ekunciphiseni ukuvuvukala ngokukhipha uketshezi oluningi emzimbeni njengomchamo.
- Imithi yokwehlisa i-cholesterol (ama-Statins): Le mithi inikezwa ukulawula amazinga aphezulu e-cholesterol egazini.
- Izinto zokunciphisa igazi: Lezi zisetshenziselwa ukunciphisa ingozi yezinkinga ezifana ne-DVT.
- Ama-Immunosuppressants: Imithi efana nama -corticosteroids inikezwa ukucindezela umsebenzi wesimiso somzimba sokuzivikela futhi sizame ukusivimba ekuhlaseleni izinso.
- Izinguquko ekudleni: Kubaluleke kakhulu ukunciphisa ukudla okunosawoti omningi namafutha amaningi . Udokotela wakho uzokweluleka ngokudla okufanele.
Uma lezi zindlela zokwelapha ezijwayelekile zinganele ukulawula lesi sifo, udokotela angase aqhubekele ekwelashweni okunamandla kakhulu okubizwa ngokuthi i-immunotherapy . Izidakamizwa ezifana ne -Rituximab ne -Cyclophosphamide zisetshenziselwa ukubhubhisa amaseli akhiqiza ama-antibodies ahlasela izinso.
Kumuntu one-MN yesibili, ukwelapha imbangela eyinhloko (isib. ukutheleleka kwe-hepatitis, i-lupus) kungamisa noma kunciphise ukulimala kwezinso.
Uma lesi sifo siqhubekela esigabeni esibi kakhulu futhi sibangela ukwehluleka kwezinso, kungadingeka ukuthi kukhishwe i-dialysis noma kufakwe ukufakelwa kwezinso.
Impilo injani ngalesi sifo?
Indlela lesi sifo esiqhubeka ngayo iyahlukahluka kuye ngomuntu nomuntu. Kwabanye abantu, lesi sifo siphela ngokuphelele ngokwelashwa okuncane noma ngaphandle kokwelashwa nhlobo. Kwabanye, lesi sifo siqhubeka iminyaka eminingi.
Ingxenye engcono kakhulu ukuthi abantu abangaphansi kuka-15% abane-MN bayaqhubeka nokwehluleka kwezinso, okusho ukuthi iningi labo lingaphila impilo evamile ngokwelashwa.
Kodwa into ebaluleke kakhulu okufanele uyikhumbule ukuthi lesi sifo singaphinde sibuye ngisho nangemva kokwelashwa. Ngakho-ke, kubalulekile ukuvakashela imitholampilo bese uhlolwa ngezikhathi ezihleliwe njengoba kunqunywe udokotela wakho wezinzwa. Ngemuva kwalokho, uma kunezimpawu zokuthi lesi sifo siphinde sibuye, ukwelashwa kungaqalwa ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- Uma uvuvukele ngendlela engachazeki emilenzeni, ezinyaweni, noma ebusweni, noma ubona igwebu eliningi emchameni wakho, ungakushayi indiva lokho. Bonana nodokotela wakho ngokushesha.
- I-Membranous Nephropathy (MN) yisimo sokuzivikela komzimba lapho amasosha omzimba wakho ehlasela khona izinso zakho.
- Ukuhlolwa kwezinso kubaluleke kakhulu ukuze kutholakale lesi sifo ngokunembile.
- Nakuba lesi sifo singelapheki ngokuphelele, kunezindlela zokwelapha ezisebenza kahle kakhulu zokulawula izimpawu, ukunciphisa umonakalo ezinso, nokuvimbela izinkinga.
- Ukulandela imiyalelo kadokotela wakho ngqo nokuya emitholampilo ngesikhathi kubalulekile ekugcineni impilo yezinso zakho.
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