Ake sazi konke ngeTarpeyo, umuthi wesifo sezinso obizwa ngokuthi i-IgA Nephropathy.

Izinso zingenye yezitho ezibaluleke kakhulu emzimbeni wethu. Kodwa ngezinye izikhathi, izinguquko ohlelweni lwethu lokuzivikela komzimba zingalimaza izinso. Esinye sezimo ezinjalo yi-primary immunoglobulin A nephropathy, noma i- IgA nephropathy. Kulokhu, i-antibody ebizwa ngokuthi i-IgA iqoqana ezinso, okubangela ukuba zivuvuke futhi zingasebenzi kahle. Namuhla, sizokhuluma ngalesi sifo kanye nomuthi okhethekile obizwa ngokuthi i-Tarpeyo onikezwa wona.

Isebenza kanjani isidakamizwa iTarpeyo?

Kalula nje, i-IgA Nephropathy iqala lapho umzimba wethu uqala ukukhiqiza ama-antibodies angavamile e-IgA (IgA1). Ngokuvamile, ama-antibodies afana nabalindi besimiso sethu somzimba. Asivikela ezintweni ezifana namagciwane namagciwane. Kodwa kulesi sifo, kukhona iphutha elincane kuma-antibodies e-IgA akhiqizwayo. Lawa ma-antibodies anephutha ayanamathelana futhi akhe amaqoqo amakhulu. Isimiso sethu somzimba sibheka la maqoqo njengokungathi ayisitha. Ngakho-ke, isimiso somzimba siqala ukulwa nala maqoqo. Le mpi yenzeka ngaphakathi kwezinso. Lokhu kubangela ukuvuvukala kumayunithi okuhlunga athambile ngaphakathi kwezinso, abizwa ngokuthi i-glomeruli. Ngokuhamba kwesikhathi, lokhu kuvuvukala kubangela izibazi kulezo zindawo futhi kulimaze izinso. Umuntu onalesi sifo angase angazizwa ekhululekile ekuqaleni. Kodwa-ke, ngokuhamba kwesikhathi, lezi zimpawu zingase zivele ngenxa yokulimala kwezinso. Odokotela bavame ukwelapha lesi sifo ngokulawula izimpawu ezifana nomfutho wegazi ophakeme kanye nokunikeza imithi elawula amasosha omzimba. Lokhu kufaka phakathi imithi efana nemithi yokucindezela amasosha omzimba kanye nemithi yokwelapha i-corticosteroids. Kodwa-ke, le mithi evamile ingaba nemiphumela emibi eminingi engafuneki uma ithathwa isikhathi eside. Yilapho umuthi i-Tarpeyo ungena khona. I-Tarpeyo nayo iyi-corticosteroid, kodwa okukhethekile kwayo ukuthi iya endaweni lapho kukhiqizwa khona ama-antibodies e-IgA ayinkinga. Ama-antibodies akhiqizwa engxenyeni ethile yamathumbu ethu ebizwa ngokuthi i-ileum. I-Tarpeyo iya ngqo lapho futhi inciphisa ukukhiqizwa kwale IgA1 engalungile. Ngakho-ke, ukuvuvukala kanye nomonakalo wezinso kuyancishiswa, futhi imiphumela emibi yesikhathi eside yemithi ejwayelekile ye-steroid nayo iyancishiswa.

Ngingawusebenzisa kanjani lo muthi?

I-Tarpeyo umuthi oza ngesimo se-capsule. Kufanele uthathwe njalo ekuseni, okungenani ihora ngaphambi kokudla .

• Ungawuphuli, ungawuhlafuni, noma uwuchoboze umuthi. Kufanele ugwinywe wonke.
• Ungadli i-grapefruit noma uphuze ijusi ye-grapefruit ngenkathi uthatha lo muthi. Sizoxoxa ngesizathu kamuva.

Kubaluleke kakhulu: Ungayeki ukuthatha lo muthi ngaphandle kokukhuluma nodokotela wakho. Uma uqhubeka nokuthatha ama-corticosteroids njengeTarpeyo, umzimba wakho uyayeka ukukhiqiza ama-hormone e-steroid akhiqizwa ngokwemvelo. Uma uyeka ukuthatha umuthi ngokuzumayo, umzimba wakho uzolahlekelwa inani lama-steroid olidingayo futhi ungase ube nezimpawu zokuhoxa. Isibonelo, ungase uzwe ukukhathala okukhulu, izinhlungu zomzimba, isicanucanu, umfutho wegazi ophansi, kanye nekhanda elibuhlungu. Ngakho-ke, uma uyeka ukuthatha umuthi, kufanele ukwenze kancane kancane ngokunciphisa umthamo (ukunciphisa umthamo) . Udokotela wakho uzokutshela indlela efanele yokwenza lokhu.

Kuye kwafundwa kanjani izinzuzo zalo muthi?

Esifundweni esikhulu sokubona ukuphepha nokusebenza kahle kweTarpeyo, kwaqhathaniswa ne-placebo. I-placebo iyiphilisi eliyimbumbulu elingenawo umuthi. Lokhu kwenzelwa ukubona ukuthi umehluko uyini phakathi kwabantu abathathe umuthi wangempela nalabo abathathe iphilisi eliyimbumbulu. Bonke abahlanganyeli ocwaningweni babene-IgA nephropathy futhi babeneprotheyini eyengeziwe emchameni wabo. Bonke babethatha nemithi yokucindezela kwegazi, njenge-ACE inhibitors noma ama-ARB, anciphisa ingcindezi ezinso. Abahlanganyeli bakhethwa ngokusekelwe ezicini ezimbili:

• Isilinganiso se-Urine protein-to-creatinine (UPCR): Lokhu kulinganisa ukuthi ingakanani iprotheni ekhishwa emchameni zingakapheli amahora angama-24.
• Izinga lokuhlunga le-glomerular elilinganiselwe (i-eGFR): Lokhu kulinganisa ukuthi izinso zakho zisebenza kahle kangakanani nokuthi zihlunga kahle kangakanani imfucuza. Abantu abacwaningweni babenokwehla kokusebenza kwezinso okuncane kuya kokuphakathi.

Kulolu cwaningo, iqembu elilodwa lanikezwa iTarpeyo izinyanga ezingu-9, kanti elinye lanikwa i-placebo. Ngemva kwezinyanga ezingu-9, ukwelashwa kwamiswa futhi baqashwa ezinye izinyanga ezingu-15.

Yiziphi izinzuzo eziye zaboniswa ezifundweni?

Ucwaningo lubonise ukuthi abantu abathatha iTarpeyo babenomonakalo omncane kakhulu wezinso kunalabo abathatha i-placebo. Le nzuzo yaqhubeka ngemva kwezinyanga ezingu-9 bethatha umuthi.

Amazinga amaprotheni anciphile emchameni

Ekupheleni kwezinyanga ezingu-9, amazinga amaprotheni emchameni walabo abathatha iTarpeyo ehle ngo-35%, uma kuqhathaniswa no-5% kuphela kulabo abathatha i-placebo. Lokhu kwehla kwaqhubeka izinyanga ezingu-24.

Umsebenzi wezinso (eGFR)

Ekupheleni kwezinyanga ezingu-24, labo abathatha iTarpeyo babe nokwehla okuncane kakhulu ekusebenzeni kwezinso kunalabo abathatha i-placebo. Inani elihle (+) lisho ukuthi ukusebenza kwezinso kuthuthukile, kanti inani elibi (-) lisho ukuthi kubi kakhulu. Lolu cwaningo lukhombisile ukuthi ukuthatha iTarpeyo izinyanga ezingu-9 kunganciphisa umonakalo wezinso. Lokhu kungasiza ekulawuleni izimpawu futhi kulibazise ukwehluleka kwezinso. Kodwa khumbula ukuthi le miphumela ingahluka kuye ngomuntu nomuntu.

Ungayivimbela kanjani futhi uyiphathe kanjani imiphumela emibi?

I-Tarpeyo umuthi ocindezela amasosha omzimba, ngakho-ke unamathuba amaningi okuthola izifo. Ungase uthole umkhuhlane, umkhuhlane, kanye nezifo zomgudu womchamo kaningi. Hlala kude nabantu abanezifo ezithelelanayo njenge-chickenpox kanye ne-measles. Indlela engcono kakhulu yokuvimbela izifo ukugeza izandla zakho njalo futhi uhlale kude nabantu abagulayo. Khuluma nodokotela wakho mayelana nokuthola imijovo. Shayela udokotela wakho ngokushesha uma unezinye zalezi zimpawu zokutheleleka:

• Umkhuhlane noma ukubanda
• Ubuhlungu bomzimba
• Ukukhwehlela
• Ukukhathala okukhulu
• Ikhanda elibuhlungu eliqhubekayo
• Izinguquko zombono noma ukulahlekelwa yinkumbulo
• Ukushaya okubuhlungu

I-Tarpeyo ingabangela ukuvuvukala noma umfutho wegazi ophakeme . Khuluma nodokotela wakho ngendlela yokuphila enempilo, okuhlanganisa ukudla nokuzivocavoca. Ukunciphisa usawoti ekudleni kwakho, ukuphuza amanzi amaningi, nokwenza ukuzivocavoca okulula njengokuhamba kungasiza ekunciphiseni ukuvuvukala nokulawula umfutho wegazi. Eminye imiphumela emibi evamile ihlanganisa isicanucanu, ukuphatheka kabi kwesisu, ukuqaqamba kwemisipha, induna, kanye nekhanda elibuhlungu . Uma unenduna, landela inqubo enhle yokunakekela isikhumba, njengezihlanzi ezithambile kanye nezimonyo ezingenawo amafutha. Lena akuyona yonke imiphumela emibi engaba khona. Uma unezimpawu ezikukhathazayo, khuluma nodokotela wakho ngazo.

Yiziphi izivivinyo okufanele zenziwe ngenkathi uthatha umuthi?

Udokotela wakho uzoyala ukuhlolwa okuhlukahlukene ukuze abone ukuthi umzimba wakho usabela kanjani emithini. Nansi eyinhloko:

• Ukulinganisa umfutho wegazi
• Ukuhlolwa komchamo ukuhlola inani leprotheni emchameni
• Ukuhlolwa kwegazi ukuhlola ukusebenza kwezinso
• Ukuhlolwa kwegazi kwegciwane le-hepatitis B

Yiziphi ezinye izinto ezingasebenzisana nalo muthi?

Eminye imithi nokudla kungathinta indlela iTarpeyo esebenza ngayo. Ngakho-ke, kubaluleke kakhulu ukutshela udokotela wakho ngayo yonke imithi oyithathayo (kufaka phakathi amavithamini nemikhiqizo yamakhambi) . Qaphela kakhulu ngalokhu okulandelayo:

• Eminye imithi yokulwa namagciwane kanye nemithi elwa namagciwane (isb., i-clarithromycin (Biaxin), i-itraconazole (Sporanox), i-ketoconazole (Nizoral))
• Eminye imithi esetshenziswa ekwelapheni i-HIV
• Ijusi le-Grapefruit noma i-grapefruit

Lolu akulona uhlu oluphelele, ngakho qiniseka ukuthi utshela udokotela wakho ngakho konke okuthathayo.

Thola ukuthi ungawuthola kanjani lo muthi.

I-Tarpeyo umuthi okhethekile. Lokhu kusho ukuthi uyabiza futhi usetshenziselwa izimo ezithile zezokwelapha. Ngakho-ke, kungenzeka ukuthi awutholakali kuwo wonke amakhemisi. Ngokuvamile, lolu hlobo lomuthi luyatholakala emakhemisi asesibhedlela noma emakhemisi akhethekile. Udokotela wakho uzokuqondisa ngenqubo yokuthola lo muthi nokuthi ungawuthola kuphi. I-IgA nephropathy, i-Tarpeyo, isifo sezinso, iphrotheni emchameni, i-eGFR, i-corticosteroid, isimiso somzimba sokuzivikela