Ingabe futhi uhlala womile futhi ukhipha umchamo omningi? Ake sixoxe nge-Nephrogen Diabetes Insipidus.

Ingabe nawe uzizwa womile usuku lonke? Kungakhathaliseki ukuthi uphuza amanzi angakanani, usazizwa sengathi awunawo anele? Ingabe udinga futhi ukuchama njalo futhi ngobuningi? Ungase ucabange ukuthi lokhu kuyinto evamile, noma ungase ucabange ukuthi yisifo sikashukela. Kodwa-ke, lokhu kungaba uphawu lwesifo esingavamile esibizwa ngokuthi 'i-Nephrogen Diabetes Insipidus'. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Kuyini i-Nephrogen Diabetes Insipidus?

Kalula nje, i-nephrogenic diabetes insipidus yisimo lapho izinso zakho zingakwazi ukulawula kahle inani loketshezi emzimbeni wakho. Imizimba yethu ikhiqiza i-hormone ebizwa ngokuthi i-Antidiuretic Hormone, noma i-ADH ngamafuphi. Abanye abantu bayibiza nangokuthi i-Vasopressin. Le hormone, i-ADH, "itshela" izinso zethu ukuthi mangakanani amanzi okufanele akhishwe emchameni nokuthi mangakanani okufanele agcinwe emzimbeni.

Izinso zomuntu onesifo sikashukela se-nephrogenic insipidus aziphenduli kahle kule hormone ye-ADH. Okusho ukuthi, yize i-hormone ye-ADH inikeza isignali "yokugcina amanzi nokunciphisa umchamo," izinso azilaleli. Okwenzekayo-ke ukuthi izinso zikhiqiza umchamo omningi kunokudingekile. Lokhu kungaholela ngokushesha, ngezinye izikhathi ngendlela eyingozi, ekuphelelweni amanzi emzimbeni, okungukuthi, ukuntuleka kwamanzi.

Sivame kangakanani lesi simo?

Ososayensi abaqiniseki kahle ukuthi bangaki abantu abane-nephrogenic diabetes insipidus, kodwa bakholelwa ukuthi yisimo esingavamile kakhulu . Lokho kusho ukuthi akusona isifo esitholwa yiwo wonke umuntu.

Ingabe kunezinhlobo ezahlukene ze-Diabetes Insipidus?

Yebo, kunezinhlobo ezine zesifo sikashukela insipidus. Ake sibone ukuthi ziyini:

• I-Central Diabetes Insipidus: Lokhu kwenzeka uma kukhona umonakalo ku-pituitary gland noma i-hypothalamus ebuchosheni bakho. Lezi yizingxenye zobuchopho bakho ezikhiqiza, zigcine, futhi zikhulule i-hormone i-ADH. Lo monakalo uvimbela umzimba wakho ekulawuleni i-ADH ngendlela evamile.
• I-Nephrogen Diabetes Insipidus: Kulolu hlobo lwesifo sikashukela esikhuluma ngalo namuhla, izinso azikwazi ukusabela kahle ku-hormone ye-ADH. Ngisho noma i-hormone ye-ADH ikhona, izinso zibonakala zingayinaki.
• I-Dipsogenic Diabetes Insipidus: Ebizwa nangokuthi 'i-Primary Polydipsia', lokhu kubangelwa ukungasebenzi kahle kwendlela yokulawula ukoma ku-hypothalamus yakho. Lokhu kukwenza uzizwe womile kakhulu, uzizwe unesidingo sokuphuza amanzi njalo , futhi uchame ngokweqile.
• Isifo Sikashukela Sokukhulelwa I-Insipidus: Lokhu kwenzeka kuphela ngesikhathi sokukhulelwa. Ngezinye izikhathi i-enzyme ekhiqizwa yi-placenta iphula i-hormone ye-ADH. Lokhu kuyaphela ngemva kokuzalwa komntwana.

Uyini umehluko phakathi kwe-Nephrogen Diabetes Insipidus kanye ne-Diabetes Mellitus?

Lena indaba ebaluleke kakhulu abantu abaningi abadidekile ngayo. Uma sizwa igama elithi "isifo sikashukela," sicabanga ngoshukela, okusho ukuthi isifo sikashukela. Kodwa-ke, yize ezinye zezimpawu zesifo sikashukela insipidus kanye nesifo sikashukela (njengokuchama ngokweqile kanye nokoma ngokweqile) zifana, lezi zifo ezimbili zihlukile ngokuphelele.

Isifo sikashukela i-Mellitus sisifo esivame kakhulu. Sibangelwa ukuntuleka kwe-hormone i-insulin noma ukungasebenzisi kahle i-insulin emzimbeni, okubangela amazinga aphezulu kashukela egazini. Kodwa-ke, i-nephrogenic diabetes insipidus iyinkinga eyenzeka lapho izinso zingasabeli ku-hormone i-ADH futhi ingahlobene namazinga kashukela egazini . Ngakho-ke, kungcono ukungadidanisi lokhu kokubili, akunjalo?

Yiziphi izimbangela ze-Nephrogen Diabetes Insipidus?

Izinso zethu zinomthwalo wokuhlunga igazi nokususa ukungcola kanye noketshezi oluthe xaxa emzimbeni njengomchamo. I-hormone i-ADH (vasopressin) isiza ukugcina ibhalansi phakathi kwenani lamanzi esiwaphuzayo kanye nenani lomchamo esiwukhiphayo.

Cabanga nje, lapho umuntu ophilile ejuluka kakhulu noma ephuza amanzi amancane, amazinga e-ADH ayanda, etshela izinso ukuthi 'zenze umchamo omncane, zonge amanzi emzimbeni.' Ngokufanayo, uma kunamanzi anele emzimbeni, amazinga e-ADH ayancipha, etshela izinso ukuthi 'kulungile, vele wenze umchamo manje.'

Kodwa-ke, uma umzimba wakho ungaphenduli kahle ku-ADH, izinso zakho zikhiqiza umchamo omningi kakhulu. Yilokhu okwenzekayo ku-nephrogenic diabetes insipidus. Lesi simo singaba yifa (eliyifa) noma singavela nganoma yisiphi isikhathi empilweni yakho (esitholakalayo) .

I-insipidus yesifo sikashukela esitholakale sinesifo sikashukela

Lolu uhlobo oluvame kakhulu. Kwenzeka lapho okuthile kuphazamisa ikhono lomzimba lokuphendula ku-ADH. Isibonelo, kungabangelwa izimo ezithile ezithinta izinso zakho. Lezi zimo zifaka:

• I-Amyloidosis - Lokhu kwenzeka lapho iphrotheni engajwayelekile ifakwa ezithweni zomzimba okuhlanganisa nezinso.
• Izinhlobo ezithile zomdlavuza
• Isifo sezinso esingamahlalakhona
• Ukutheleleka kwezinso, isibonelo, i-pyelonephritis
• Isifo sezinso esine-polycystic – Lokhu kwenzeka lapho kwakheka ama-cyst agcwele uketshezi ezinso.
• Izinso zesiponji ze-Medullary

Kunezinye izizathu ezithinta lokhu:

• Imithi ethile: Ikakhulukazi i-lithium (esetshenziselwa ezinye izifo zengqondo) uma isetshenziswa isikhathi eside.
• Amazinga aphansi e-potassium egazini (i-hypokalemia)
• Ukwanda kwamazinga e-calcium egazini (i-hypercalcemia)
• I-anemia yamaseli esikele
• I-Sjögren's syndrome – Lesi yisifo esithinta amasosha omzimba.
• Ukuvaleka komgudu womchamo – isibonelo, into efana netshe lomchamo.

Isifo sikashukela se-nephrogenic insipidus esidluliselwa ngefa

Lokhu kubangelwa ukuguquka kwezakhi zofuzo i-AVPR2 noma i-AQP2. Lawa ma-gene atshela umzimba ukuthi kufanele afake amanzi angakanani emchameni. Uma lawa ma-gene enenkinga, izinso azikwazi ukuphendula ku-ADH. Izimpawu zesifo sikashukela se-nephrogenic insipidus, esizalwa naso, zivame ukuvela ezinyangeni ezimbalwa zokuqala zokuphila .

Yiziphi izimpawu ze-Nephrogen Diabetes Insipidus?

Cabanga nje, uyazi othile, ake sithi uSumana. USumana womile kakhulu usuku lonke. Usebenza nebhodlela elikhulu lamanzi eduze. Kodwa kungakapheli nehora elilodwa ephuzile, womile futhi, futhi kufanele aye endlini yangasese njalo, futhi uchama kakhulu. Ngezinye izikhathi uvuka kabili noma kathathu ebusuku ukuze achame. Wacabanga, 'Mhlawumbe kungenxa yokuthi ngiphuza amanzi amaningi kakhulu.' Kodwa lezi yizimpawu eziyinhloko ze-nephrogenic diabetes insipidus.

Umuntu onesifo sikashukela se-nephrogenic insipidus angaba nezimpawu ezifana nalezi:

• Izimpawu zokuphelelwa ngamanzi emzimbeni: Umlomo owomile, izindebe eziqhekekile, ukukhathala okukhulu, ukuzizwa unesizungu, futhi ngezinye izikhathi unamehlo aluhlaza okwesibhakabhaka uma umi. Cabanga ngakho njengokuhlala elangeni isikhathi eside ngaphandle kwamanzi.
• I-Polydipsia: Ukuzizwa sengathi awutholi amanzi anele kungakhathaliseki ukuthi uphuza kangakanani.
• Ukuchama ngokweqile (i-Polyuria): Uma umuntu omdala echama ngaphezu kwamalitha amathathu ngosuku (ngokuvamile phakathi kwamalitha angu-5-20!), kanti uma ingane ichama ngaphezu kwamalitha amabili ngosuku, kuyasolisa. Umchamo nawo unombala okhanyayo kakhulu, njengamanzi.

Uma umntwana omncane enalesi simo, angase abonise izimpawu ezinjengalezi ngoba akaqondi ukuthi kufanele akhulume kanjani:

• Uhudo
• Ukwehluleka ukukhula nokukhula kwesisindo – Akukhuluphali noma kukhule kube kukhulu kunezinye izingane.
• Umkhuhlane ovamile
• Ukungahlaliseki nokukhala njalo (Ukucasuka) - umntwana ubonakala ecindezelekile.
• Ukulahlekelwa yisifiso sokudla, ukuncipha kokudla ubisi
• Ukuquleka - Lesi yisibonakaliso esiyingozi.
• Ukuhlanza
• Ukushintsha amanabukeni amanzi njalo.

Isifo sikashukela i-Insipidus se-Nephrogen sitholakala kanjani?

Uma unalezi zimpawu, into yokuqala okufanele uyenze ukubona udokotela. Uzokubuza imibuzo, akuhlole, futhi, uma kudingeka, acele ukuhlolwa okufana nalokhu:

• Ukuhlolwa kwegazi: Hlola izinga lama-electrolyte, njenge-sodium, emzimbeni, kanye nokusebenza kwezinso.
• Ukuhlolwa komchamo:Bheka ukuthi umchamo ungakanani (ungakanani uncibilika), nokuthi yini esemchameni.
• Ukuhlolwa kokuntuleka kwamanzi: Lokhu kuhilela ukungaphuzi lutho oluwuketshezi amahora amaningana, bese uqapha isisindo sakho, ukuphuma komchamo, kanye nokugcwala kwegazi nomchamo ngehora. Lokhu kuhlolwa okunzima, kodwa kubaluleke kakhulu ekuxilongweni. Lena ukuphela kwendlela yokunquma ngokunembile ukuthi izinso ziyasabela yini ku-ADH. Lokhu kuhlolwa kwenziwa ngaphansi kokuqashwa kwezokwelapha esibhedlela.
• Ukuhlolwa nge-hormone ye-ADH: Ngezinye izikhathi, i-hormone ye-ADH inikezwa njengomjovo kanye nokuhlolwa kokuntuleka kwamanzi, bese kuhlolwa ukuthi ingabe ukugcwala komchamo kuyashintsha yini. Ku-nephrogenic diabetes insipidus, noma ngabe i-ADH inikezwa, ukugcwala komchamo akushintshi kakhulu.
• Ukuskena kwe-MRI ye-pituitary gland yakho (i-Magnetic resonance imaging): Uma usola isimo esifana nesifo sikashukela esiphakathi, bheka noma yikuphi ukukhubazeka ebuchosheni.
• Ukuhlolwa kofuzo: Uma othile emndenini wakho enesifo sikashukela insipidus, noma uma usola ukuthi kuyisimo esizuzwe njengefa.

Ingabe ikhona ikhambi eliphelele le-Nephrogen Diabetes Insipidus?

Uma ngikhuluma iqiniso, okwamanje alikho ikhambi eliphelele lesifo sikashukela se-nephrogenic insipidus.

Kodwa ungakhathazeki. Kungaphathwa. Udokotela wakho angase akwazi ukushintsha imithi oyithathayo ebangela inkinga (njenge-lithium). Futhi, uma kukhona esinye isimo esiyisisekelo (njengesifo sezinso noma ukungalingani kwe-calcium/potassium), ukukwelapha ngendlela efanele ngezinye izikhathi kungaguqula noma kulawule i-nephrogenic diabetes insipidus.

Ngakho-ke uphatha kanjani lokhu?

Ezimweni lapho kungenakulungiseka khona (isibonelo, ukuzalwa), ukwelashwa kuhloselwe kakhulu ukuvimbela ukuphelelwa amanzi emzimbeni kanye nokugcina izinga lempilo elihle. Lokhu kungafaka:

• Phuza amanzi njalo: Lena yinto ebaluleke kakhulu. Kufanele uphuze amanzi usuku lonke, noma nini lapho uzizwa womile. Qiniseka ukuthi uphuza amanzi amaningi, ikakhulukazi ngezinsuku ezishisayo, lapho uzivocavoca, noma lapho ujuluka. Gcina ibhodlela lamanzi eduze nasebusuku.
• Izinguquko ekudleni:
• Ukudla okungenasawoti omningi: Ukudla usawoti omningi kwandisa ukoma kanye nokuchama.
• Ukudla okungenamaprotheni amaningi: Ngezinye izikhathi ungase utshelwe ukuthi unciphise amaprotheni, ngoba amanzi nawo ayadingeka ukuze kukhishwe imfucuza ekhiqizwa ngesikhathi sokugaya amaprotheni.
• Imithi enciphisa ukuphuma komchamo:
• I-Thiazide diuretics:Ngokumangalisayo, lawa ma-diuretic, uma enikezwa abantu abanesifo sikashukela se-nephrogenic insipidus, empeleni anciphisa inani lomchamo abawukhiqizayo. Kuyinkimbinkimbi kancane, kodwa ayasiza.
• I-Amiloride: Inganikezwa kanye ne-thiazides, ikakhulukazi i-NDI ebangelwa yi-lithium.
• Imithi Engavimbi Ukuvuvukala Engavunyelwe Ngodokotela (ama-NSAID): Isibonelo, i-indomethacin. Lokhu kusiza ukwenza izinso zizwele kancane ku-ADH.

Yikuphi ukudla neziphuzo okufanele umuntu onalesi simo akugweme?

Udokotela wakho angase akutshele ukuthi unciphise utshwala, iziphuzo ezine-caffeine (njengekhofi, itiye, neziphuzo ezibandayo), ukudla okunosawoti (njenge-pickle, inyama eyomisiwe, amasoseji, nama-chips), kanye nokudla okunamaprotheni amaningi, njengoba lokhu kungabangela ukuthi umzimba wakho ulahlekelwe amanzi amaningi futhi kwandise ukudla kwakho okusamanzi.

Ingabe zikhona izindlela zokuvimbela i-Nephrogen Diabetes Insipidus?

Awekho amasu aqinisekisiwe okuvimbela lokhu. Ikakhulukazi uhlobo lokuzalwa alunakuvinjelwa. Kodwa-ke, ngohlobo olutholiwe:

• Uma uthatha imithi engabangela i-NDI, njenge-lithium, kubalulekile ukukhuluma nodokotela wakho ngayo futhi uhlolwe njalo ukusebenza kwezinso zakho.
• Ingozi ingancishiswa ngokwelapha ngokushesha nangokufanele izinkinga zempilo eziyisisekelo (isifo sezinso, ukungalingani kwama-electrolyte).

Uma nginalesi simo, yini okufanele ngiyilindele?

Lezi yizindaba ezinhle kakhulu. Ngokwelashwa okufanele kanye nendlela yokuphila enempilo , abantu abanesifo sikashukela se-nephrogenic insipidus bavame ukuba nezinkinga ezimbalwa ezinkulu futhi bangaphila impilo evamile. Ungasebenza futhi ujabulele impilo evamile.

Kodwa-ke, uma kungaphathwa kahle, lokhu kungaholela ezinkingeni ezinkulu. Ake sibheke ukuthi ziyini:

• Ukuphelelwa amanzi emzimbeni: Lena inkinga evame kakhulu futhi ebucayi kakhulu. Ukuphelelwa amanzi emzimbeni kakhulu kungaholela ekulahlekelweni yingqondo, ekuqulekeni, nasekuhlulekeni kwezinso.
• Ukuphazamiseka kwe-electrolyte: Lokhu kungukushintsha kwenani lama-electrolyte (njenge-sodium ne-potassium) emzimbeni. Lokhu kungathinta izinga lokushaya kwenhliziyo kanye nokusebenza kwezinzwa.
• Ukutheleleka: Izinto ezifana nokutheleleka kwe-Urinary Tract (UTI) kanye nokutheleleka kwezinso.
• Ukulibaziseka kokukhula, ukulimala kobuchopho kanye nokukhubazeka kwengqondo ezinganeni. Lokhu kuyingozi kakhulu ezinganeni ezincane. Ngakho-ke, uma ingane inalezi zimpawu, ukwelashwa kufanele kuqalwe ngokushesha.
• Ukwehluleka kwezinso: Kungenzeka esikhathini eside uma kungalawulwa kahle.
• I-Hydronephrosis: Ngenxa yokuthi isinyi sihlala sigcwele, umchamo uyabuya futhi izinso ziyavuvukala.

Kufanele ufune nini iseluleko sezokwelapha?

Uma unokungabaza noma ukukhathazeka mayelana nenani lomchamo owukhiphayo, ikakhulukazi uma ukhipha umchamo omningi ngenxa yokuchama ngokweqile, qiniseka ukuthi ubonana nodokotela.

Inani lomchamo umuntu omdala adlula kuwo ngosuku lingahluka kuye ngomuntu, ikakhulukazi kuye ngokuthi baphuza amanzi angakanani. Kodwa uma uchama ngaphezu kwamalitha angu-2-3 ngosuku (ezinye izincazelo zithi ngaphezu kwamalitha angu-3), noma uma uchama njalo (ngaphezu kwezikhathi eziyisikhombisa noma eziyisishiyagalombili ngosuku) , kungaba uphawu lwenkinga.

Ngaphambi kokuya kudokotela, kuyasiza kakhulu ukugcina idayari yokuthi uphuza amanzi angakanani nokuthi ukhiqiza umchamo ongakanani (kulinganiswe uma kungenzeka). Lokhu kuzokwenza kube lula ngodokotela ukuqonda isimo sakho.

Ngakho-ke, yiziphi izinto okufanele sizikhumbule kule ndaba? (Umyalezo Ofanele Uwuthathe Ekhaya)

Isifo Sikashukela Esibangelwa Yi-Nephrogenic I-insipidus yisimo esingavamile lapho izinso zakho zingasabeli kahle ku-hormone i-ADH emzimbeni wakho, okubangela ukuthi ukhiqize umchamo omningi kakhulu. Lokhu kungaholela ekuphelelweni amanzi emzimbeni ngokushesha.

• Izimpawu eziyinhloko ukoma ngokweqile kanye nokuchama ngokweqile, okunamanzi .
• Lokhu akufanele kudidaniswe nesifo sikashukela; kulokhu, izinga likashukela egazini livamile.
• Lesi simo singaba khona ekuzalweni noma sikhule kamuva ekuphileni.
• Nakuba kungekho ikhambi eliphelele, ngokwelashwa okufanele kanye nokushintsha indlela yokuphila (ikakhulukazi ukuphuza amanzi anele nokulawula ukudla kwakho), ungaphila impilo evamile nenempilo.
• Uma usola ukuthi wena noma ingane yakho inanoma yiziphi zalezi zimpawu, funa iseluleko sezokwelapha ngokushesha. Ungesabi, kodwa into ebaluleke kakhulu ukwaziswa nokuthatha izinyathelo ezidingekayo. Awuwedwa, futhi odokotela bangakusiza.

Isifo sikashukela se- Nephrogenic insipidus, isifo sezinso, ukuchama ngokweqile, ukoma ngokweqile, i-ADH, i-vasopressin, ukuphelelwa amanzi emzimbeni