Ingabe kukhona amaprotheni amaningi kakhulu emchameni wakho? (I-Proteinuria) - Ake sithole ukuthi iyini ngempela le nto!

Wake waphawula ukuthi umchamo wakho, noma umchamo, unegwebu kancane? Noma mhlawumbe udokotela uke wenza ukuhlolwa komchamo wathi, "Uneprotheni eningi kakhulu emchameni wakho." Yilokho esikubiza ngokwezokwelapha ngokuthi i-proteinuria . Kalula nje, lokhu kusho ukuthi umchamo wakho uneprotheni eningi kunalokho okufanele. Lokhu ngezinye izikhathi kungaba uphawu lokuqala lokwehluleka kwezinso.

Iyini iphrotheni futhi kungani ibaluleke kangaka emizimbeni yethu?

Cabanga ngakho, amaprotheni afana nezisebenzi emizimbeni yethu. Enza umsebenzi omningi obalulekile.

• Kuyasiza ekwakheni imisipha namathambo . Uma sigijima futhi sigxuma, uma siphakamisa izinsimbi, sidinga imisipha eqinile.
• Ilawula inani loketshezi egazini lethu .
• Zisiza imizimba yethu ukulwa nezifo . Zifana namasosha amancane emizimbeni yethu.
• Futhi banesibopho sokulungisa izicubu ezonakele .

Lawa maprotheni kufanele abe segazini lethu. Yilapho enza khona umsebenzi wawo obalulekile. Kodwa, uma ngesizathu esithile lawa maprotheni ephuma egazini bese ephelela emchameni, lokho kusho ukuthi ayakhishwa emzimbeni. Uma lokho kwenzeka, kungathinta impilo yomzimba wethu wonke.

Ingabe iphrotheni emchameni iyingozi kakhulu?

Yebo, amaprotheni emchameni ayinkinga ngempela, njengoba ezinye izifundo zikhombisile ukuthi lesi simo sandisa ingozi yokufa ngenxa yesifo senhliziyo nesifo senhliziyo.

Ngezinye izikhathi, lesi simo, esibizwa ngokuthi i-proteinuria, singaba uphawu lokuqala lwesifo sezinso esingamahlalakhona (CKD) . Kodwa-ke, abanye abantu bangase babe namazinga ajwayelekile eprotheyini emchameni wabo yize bene-CKD. I-CKD iwukulahlekelwa kancane kancane kokusebenza kwezinso. Uma lokhu kuqhubeka, ungadinga ukufakelwa izinso noma i-dialysis. Isifo sikashukela kanye nomfutho wegazi ophezulu yizimbangela ezimbili eziyinhloko zokulimala kwezinso. Lezi yizimbangela ezivame kakhulu zesifo sezinso.

Ubani osengozini enkulu yalesi simo?

Noma ubani angaba ne-proteinuria. Kodwa-ke, kungenzeka kakhulu ukuthi ube nalesi simo uma:

• Uma uneminyaka engaphezu kwengu-65 ubudala .
• Uma kukhona emndenini wakho oke waba nesifo sezinso noma okwamanje .
• Uma unesinye isimo sezokwelapha esithinta izinso zakho, njengesifo sikashukela .
• Le ngozi itholakale iphezulu emaqenjini athile ezinhlanga (isibonelo, abamnyama, amaHispanic, amaNdiya aseMelika, noma amaPacific Islander).

Sivame kangakanani lesi simo?

I-proteinuria yisimo esivame kakhulu. Isibonelo, kubikwa ukuthi cishe abantu abangu-6.7% e-United States banalesi simo.

Iprotheni ingena kanjani emchameni? Kwenzekani ngaphakathi kwezinso?

Cabanga ngezinso zethu njengesihlungi esikhulu. Umsebenzi wazo oyinhloko ukuhlunga imfucuza kanye namanzi angaphezulu egazini lethu. Le mfucuza ehlungiwe kanye namanzi yikona okuphuma emzimbeni njengomchamo.

Ngaphakathi kwezinso kunemithambo yegazi eminingi emincane ebizwa ngokuthi i-glomeruli . Lezi yisigaba sokuqala sokuhluzwa kwegazi. Ngokuvamile, la ma-glomeruli awavumeli izinhlayiya ezinkulu zamaprotheni noma amaseli egazi ukuba adlulele emchameni. Kufana nesihlungo esine-mesh esibamba izingcezu ezinkulu. Kodwa-ke, uma ezinye izinhlayiya ezincane zamaprotheni zidlula kula ma-glomeruli, amashubhu amade, amancane (ama-tubules) ezinso aphinde amunce lawo maprotheni abuyele emzimbeni.

Ngakho-ke, amaprotheni aqala ukungena emchameni uma kukhona okungahambi kahle ngale nqubo:

• Uma kukhona umonakalo ku-glomeruli noma kuma-tubules.
• Uma kunenkinga ngenqubo yokumuncwa kabusha kwamaprotheni.

Ziyini izimpawu zalokhu? Sikubona kanjani?

I-proteinuria ivame ukungabi nazimpawu ezigabeni zokuqala . Yingakho ingaba yingozi kancane. Kodwa-ke, njengoba isimo siqhubeka, izimpawu ezifana nalezi:

• Ukuvuvukala kobuso, isisu, imilenze, noma amaqakala (i-edema) . Abanye abantu babika ukuthi ubuso babo buzizwa bukhukhumele lapho bevuka ekuseni, noma ukuthi imilenze yabo iyavuvuka kusihlwa.
• Ukudinga ukuchama njalo.
• Ubunzima bokuphefumula.
• Ukukhathala okukhulu, ukukhathala.
• Isicanucanu nokuhlanza.
• Ukudla akunambitheki.
• Ukuqaqamba kwemisipha ebusuku.
• Ukuvuvukala eduze kwamehlo, ikakhulukazi ekuseni.
• Umchamo onegwebu noma onamagwebu. Lolu uphawu lokuqala abantu abaningi abaluqaphelayo. Uma luphuma njengamanzi anensipho, kufanele ukhathazeke.

Okubalulekile: Lezi zimpawu zingaba izimpawu zesifo sezinso esingamahlalakhona. Uma uhlangabezana nalezi zimpawu, ikakhulukazi umchamo onegwebu kanye nokuvuvukala, bona udokotela ngokushesha.

Ziyini izimbangela ze-proteinuria?

Ezimweni eziningi, i-proteinuria ingabangelwa yizimo zezokwelapha ezingenangozi (ezingezona umdlavuza) noma zesikhashana. Izibonelo zalezi zifaka:

• Ukuphelelwa amanzi emzimbeni - Lokhu kusho ukungabi namanzi anele emzimbeni.
• Ukuvuvukala- Ukuvuvukala okwenzeka endaweni ethile emzimbeni.
• Umfutho wegazi ophansi (i-Hypotension).
• Amatshe ezinso.

Futhi, izinto ezifana nokuzivocavoca okunzima, ukucindezeleka, ukuphuza imithi efana ne-aspirin nsuku zonke, kanye nokuchayeka emakhazeni amakhulu kungakhuphula okwesikhashana amazinga amaprotheni emchameni.

Kodwa-ke, izimo zezokwelapha ezingathi sína kakhulu zingalimaza izinso futhi zibangele i-proteinuria. Lezi zimo zifaka:

• Ezinye izifo zokuzivikela komzimba , njenge-lupus kanye ne-Goodpasture's syndrome.
• Ukuvuvukala kwezinso okubukhali , okwaziwa nangokuthi i-glomerulonephritis.
• Umdlavuza wamaseli e-plasma , owaziwa nangokuthi i-multiple myeloma.
• Ukubhujiswa kwamangqamuzana abomvu egazi kubangela ukuthi i-hemoglobin iqoqeke egazini (i-intravascular hemolysis).
• Isifo senhliziyo.
• I-proteinuria kanye nomfutho wegazi ophezulu kowesifazane okhulelwe ngesikhathi esisodwa - lokhu kubizwa ngokuthi i-preeclampsia.
• Ubuthi.
• Izingozi/ukulimala ngokomzimba (`Ukuhlukumezeka`).
• Umdlavuza wezinso.
• Izimo zenhliziyo (`Ukwehluleka kwenhliziyo okubangelwa ukuminyana`).

Kufanele sikhathazeke ngamaprotheni amangaki emchameni wethu?

Ngokuvamile, inani lamaprotheni emchameni wethu kufanele libe ngaphansi kwama-milligram angu-150 ngosuku. Uma umchamo wakho uqukethe ama-milligram angu-150 ephrotheni ngosuku, lokho kubizwa ngokuthi i-proteinuria. Umkhawulo ophezulu waleli zinga elijwayelekile ungahluka kancane kuye ngelabhorethri.

Uma une -protein ephakathi kuka-3 no-3.5 amagremu emchameni wakho ngosuku, ibizwa ngokuthi i-nephrotic-range proteinuria . I-Nephrotic syndrome yisimo esingavamile lapho izinso zikhipha amaprotheni amaningi kakhulu emchameni.

Ingabe lesi yisifo esithathelwanayo?

Cha, i-proteinuria ayisona isifo esithathelwanayo . Kodwa-ke, uma abanye abantu emndenini wakho benalesi simo, kungenzeka kakhulu ukuthi ube naso. Lokhu kusho ukuthi kungase kube nokuthambekela kofuzo.

Ukuthola kanjani lokhu ngqo? Yiziphi izivivinyo ezenziwayo?

Udokotela wakho uzoqala ngokukwenza ukuhlolwa kwe-dipstick ukuze ahlole i-proteinuria.Kulesi sivivinyo, uchamela esitsheni esikhethekile ehhovisi likadokotela wakho noma esibhedlela. Ngemuva kwalokho, udokotela ucwilisa induku encane yepulasitiki (i-dipstick) ehlanganiswe nekhemikhali ekhethekile kusampula yomchamo. Uma kukhona amaprotheni amaningi emchameni, induku izoshintsha umbala.

Ngemuva kwalokho, udokotela wakho uzokwenza ukuhlolwa komchamo kusampula yomchamo esele. Lokhu kuzobheka ukubukeka, ukwakheka kwamakhemikhali, kanye nezakhiwo zangaphakathi zomchamo ngaphansi kwe-microscope. Udokotela uzobheka izinto ezingavamile ukutholakala emchameni. Isibonelo, amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, amabhaktheriya, kanye namakristalu kasawoti noma amaprotheni angakha amatshe ezinso.

Yini okufanele uyenze uma usola ukuthi unesifo sezinso?

Uma udokotela wakho esola ukuthi unesifo sezinso, uzokucela ukuthi uphinde uhlole umchamo kathathu esikhathini esiyizinyanga ezintathu. Uma kutholakala iphrotheni kusampula ngayinye yomchamo, kungenzeka ukuthi unesimo esingamahlalakhona (sesikhathi eside). Uma lokhu kutholakala ngokushesha, amathuba okulawula nokuvimba ukuqhubeka kwesifo sezinso aba maningi.

Ngaphezu kwalokho, kungenziwa izivivinyo ezilandelayo:

• Ukuhlolwa kokuhlanzwa kwe-Creatinine: I-Creatinine iwumkhiqizo wamakhemikhali ongcolile. Lokhu kuhlolwa kulinganisa inani le-creatinine emchameni wakho nasegazini. Uma izinso zakho ziphilile, zisusa i-creatinine egazini lakho bese ziyidlulisela emchameni wakho. Kodwa uma izinso zakho zingasebenzi kahle, i-creatinine ihlala egazini lakho.
• Ukuhlolwa kwegazi kwe-Glomerular filtration rate (GFR): I-GFR iqhathanisa amazinga amaprotheni abizwa ngokuthi i-creatinine ne-albumin egazini lakho, ngokusekelwe kusayizi womzimba wakho, iminyaka, ubulili begazi, kanye nohlanga. I-GFR ingatshela udokotela wakho ukuthi izinso zakho zisebenza kahle kangakanani nokuthi isifo sakho sezinso sithuthuke kangakanani. Lolu lwazi lungakusiza ukuthi wakhe uhlelo lokwelapha olungcono kakhulu.
• Ukuhlolwa kwegazi okulinganisa inani eliphelele leprotheyini esegazini: I-Serum yingxenye yegazi equkethe amaprotheni.
• Ukuhlolwa kwezithombe: Ukuhlolwa okufana nokuskena kwe-CT kanye ne-ultrasound kungabona izinkinga ezifana namatshe ezinso, izimila, noma ukuvinjelwa komgudu womchamo.
• I-electrophoresis yamaprotheni omchamo (i-UPEP): I-UPEP ivumela udokotela wakho ukuthi afune izinhlobo ezithile zamaprotheni. Isampula yomchamo wakho ithunyelwa elabhorethri. Lapho, uchwepheshe welabhorethri usebenzisa ugesi kusampula yomchamo wakho. Lokhu kungaveza inani lamaprotheni emchameni wakho.
• Ukuhlolwa kwegazi lokuqinisa amasosha omzimba (IFE):Udokotela usebenzisa inalithi encane kanye nepayipi ukuze athathe isampula yegazi emthanjeni osesandleni sakho noma esandleni sakho. Isampula yegazi ithunyelwa elabhorethri ukuze ihlolwe amaprotheni athile egazini.
• Ukuhlolwa kwezinso: Kulokhu kuhlolwa, udokotela wakho ususa ingxenye encane kakhulu yezinso zakho. Isampula ithunyelwa elabhorethri. Uchwepheshe welabhorethri uhlola isampula yezinso ngaphansi kwe-microscope ukuze abone ukuthi yini ebangela isifo sezinso zakho nokuthi umonakalo owenzekile ungakanani.

Kuphathwa kanjani lokhu?

Ukwelashwa kwe-proteinuria kuncike esibangweni . Imbangela ngayinye inokwelashwa kwayo.

Uma i-proteinuria ibangelwa yisifo sezinso , uhlelo lwakho lokwelashwa lungafaka imithi, izinguquko ekudleni, kanye nokuzivocavoca . Uma unomfutho wegazi ophezulu, udokotela wakho uzokunikeza imithi. Uma unomfutho wegazi ophansi, kuwumqondo omuhle ukuthi uhlolwe umchamo futhi uhlolwe umfutho wegazi njalo ngonyaka.

Uma unesifo sikashukela , udinga ukulawula amazinga kashukela egazini lakho . Udinga futhi ukuhlolwa kwegazi lakho le-GFR njalo ngonyaka.

Abesifazane abakhulelwe abanomlando we-preeclampsia kufanele babone udokotela wabo njalo ukuze bahlolwe. Nakuba i-preeclampsia iyisimo esibucayi, ivame ukuba ngcono ezinsukwini noma emavikini ambalwa ngemva kokubeletha.

Uma une-proteinuria kodwa ungenaso isifo sikashukela, umfutho wegazi ophakeme, noma ezinye izimo zezokwelapha, udokotela wakho angase akunike imithi yokucindezela kwegazi ukusiza ukuvimbela ukulimala kwezinso. Kungumqondo omuhle ukuthi uhlolwe umfutho wegazi lakho futhi umchamo wakho uhlolwe njalo ezinyangeni eziyisithupha ukuqinisekisa ukuthi awunaso isifo sezinso.

Uma une-proteinuria encane noma yesikhashana, ungase ungadingi ukwelashwa.

Ingabe ukuphuza amanzi kunciphisa amaprotheni emchameni?

Cha, ukuphuza amanzi amaningi ngeke kwelaphe i-proteinuria. Ukuphuza amanzi amaningi kuzokwenza uchame kakhulu, okungase kunciphise inani le-protein emchameni wakho ngesikhathi esisodwa. Kodwa-ke, ngeke kuvimbele izinso ekuvuzeni i-protein.

Ngizinakekela kanjani? Yiziphi izinto okudingeka ngizenze?

Indlela engcono kakhulu yokuzinakekela ukuphuza imithi yakho njengoba nje udokotela wakho ekuyalele.

Ngaphezu kwalokho, nazi ezinye izindlela ongasiza ngazo:

• Ukunciphisa ukudla okucebile ngamaprotheni.
• Ukunciphisa usawoti odliwayo. Lokhu kuzosiza ukwehlisa umfutho wegazi.
• Ukudla ukudla okune-fiber eningi kungasiza ekwehliseni i-cholesterol futhi kulawule amazinga kashukela egazini.
• Ukuzivocavoca noma ukuhlala umatasa njalo.Zama ukwenza okungenani amahora amabili omsebenzi ngesonto.
• Hlola amazinga kashukela egazini lakho njalo.
• Ukuyeka ukubhema nokusebenzisa ugwayi.
• Gwema ukuthatha imithi engeyona eye-steroidal elwa nokuvuvukala (ama-NSAID) ngaphandle kokuthi unikezwe udokotela. Ama-NSAID asetshenziswa kakhulu yi-aspirin (Bayer®), ibuprofen (Advil®), kanye ne-naproxen (Aleve®).

Ingabe ikhona indlela yokuvimbela lokhu?

I-proteinuria ayinakuvinjelwa ngokuphelele . Kodwa-ke, ungayilawula . Izimo eziningi ezibangela i-proteinuria zingalawulwa ngemithi kanye nokushintsha indlela yokuphila.

Uyini umbono womuntu one-proteinuria?

Uma kutholakale ukuthi une-proteinuria futhi welashwa ngendlela efanele, isimo sengqondo sabantu abane-proteinuria sihle.

Kodwa-ke, uma ingelashwa, i-proteinuria ingaholela ngisho nasekufeni. Izifundo zikhombisile ukuthi abantu abangenayo i-proteinuria baphila isikhathi eside kunalabo abane-proteinuria encane noma enzima.

Kufanele ngimbone nini udokotela?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu, xhumana nodokotela ngokushesha:

• Uma udinga ukuchama kaningi kunokujwayelekile, noma uma uzwa ubuhlungu lapho uchama.
• Uma umchamo wakho unegwebu noma unamabhamuza.
• Uma uzizwa unesicanucanu noma uhlanza.
• Uma uzizwa unesiyezi, ubuthakathaka, noma unekhanda elibuhlungu.
• Uma uvuvukele noma uvuvukele ebusweni bakho, esiswini, noma emzimbeni ongezansi.
• Uma izimpawu zakho zingathuthuki ngemva kokwelashwa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uya kudokotela, ungabuza imibuzo efana nale:

• Udokotela wazi kanjani ukuthi ngine-proteinuria?
• Yisiphi isimo esangenza ngaba ne-proteinuria?
• Yiziphi izivivinyo ozincomayo?
• Ingabe ngine-proteinuria encane noma yesikhashana?
• Yimiphi imithi noma izindlela zokwelapha ozincomayo?
• Ingabe kudingeka ngenze noma yiziphi izinguquko ekudleni kwami ​​noma endleleni yami yokuphila?
• Uma ngingenayo i-proteinuria, yisiphi esinye isimo engingaba naso?

Uyini umehluko phakathi kwe-Proteinuria ne-Orthostatic Proteinuria?

I-Orthostatic proteinuria ( ebizwa nangokuthi i-postural proteinuria) isho ukuthi wenaLokhu kusho ukuthi kuneprotheni eningi emchameni wakho uma uchama umi, kodwa iprotheni emchameni wakho ijwayelekile uma uchama ulele phansi. Lesi yisimo esivame ukubonakala kubantu abasha, ikakhulukazi abantu abade nabancane, futhi asiyona ingozi kakhulu.

Uyini umehluko phakathi kwe-Proteinuria ne-Transient Proteinuria?

I-proteinuria yesikhashana yisimo sesikhashana . Ngokuvamile ibangelwa izinto ezifana nokuzivocavoca okunzima, ukucindezeleka, umkhuhlane, kanye nokuchayeka isikhathi eside emakhazeni amakhulu. I-proteinuria yesikhashana ivame ukuphelela yodwa ngaphandle kokwelashwa.

I-Proteinuria iyizinga eliphakeme le-protein emchameni wakho. Uma une-proteinuria, kungadingeka ukuthi uchame njalo, futhi umchamo wakho ungase ube namagwebu noma ube nama-bubble. Ungase futhi ube nezimpawu ezivamile zokugula, njengesicanucanu, ukuhlanza, ukukhathala, nokuvuvukala. Uma unalezi zimpawu izinsuku ezingaphezu kwezimbalwa, kungcono ukubona udokotela. Angahlonza isimo esibangela i-proteinuria yakho futhi anikeze ukwelashwa ukuze kugcinwe izinso zakho ziphilile.

Okokugcina, izinto okufanele uzikhumbule

Kulungile, ngakho-ke kulokho esikuxoxile, ngithemba ukuthi uthole umbono omuhle mayelana ne-proteinuria. Into ebaluleke kakhulu ukubona udokotela uma ubona noma yiziphi izinguquko emchameni wakho (ikakhulukazi umchamo onegwebu) noma ukuvuvukala emzimbeni wakho. Uma ukuqaphela kusenesikhathi, ungavimbela izinkinga eziningi. Izinso zifana nezisebenzi zomzimba wethu ezithule. Kungumsebenzi wethu ukuzinakekela kahle. Ungakhathazeki, lezi zimo zingalawulwa ngeseluleko sezokwelapha esifanele kanye nokwelashwa.

i- proteinuria, iphrotheni emchameni, isifo sezinso, umchamo onegwebu, impilo yezinso, ukulimala kwezinso, i-CKD