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Yini i-nephrotic syndrome? Izimbangela, izimpawu, kanye nokwelashwa

Yini i-nephrotic syndrome? Izimbangela, izimpawu, kanye nokwelashwaImfundo Yezempilo

Ziningi izifo ezihambisana nokusebenza kwezinso okungekuhle. Uma uqala ukuqaphela ukuthi amaqakala akho ayavuvukala, uyaxakeka, noma unenkinga yokulala — kungaba nzima ukukhomba ukuthi kungani umzimba wakho ungasebenzi kungcono kakhulu. Lezi yizimpawu ezimbalwa nje zokulimala kwezinso, futhi kunezimbangela eziningi ezingaba khona. I-Nephrotic syndrome ingenye yazo. Yini i-nephrotic syndrome? Funda ukuze ufunde izimbangela, izimpawu, nokwelashwa.

Yini i-nephrotic syndrome?

I-Nephrotic syndrome yenzeka lapho uhlelo lokuhlunga izinso lwakho lungasebenzi ngendlela efanele. Lokhu kulimala kwezinso kuvumela amaprotheni ajwayelekile atholakala kwi-plasma yakho yegazi ukuthi achitheke emchameni. Umphumela uba amaprotheni amaningi emchameni wakho (proteinuria) kanye namaprotheni amancane egazini lakho. Ukulahleka kwamaprotheni okuvela egazini kuvumela uketshezi ovame ukulubamba endaweni olungamukeleki ukuze luvuze emzimbeni, kubangele ukuvuvukala (okwaziwa nangokuthi i-edema).



Kuyisimo esingajwayelekile neze esithinta nje 5 kubantu abayi-100,000 , kodwa uma ingalawulwa, ingadala umonakalo kwezinye izinhlelo zomzimba. Izinkinga ze-nephrotic syndrome zibandakanya ukwanda kwengozi yamahlule egazi, i-cholesterol ephezulu, umfutho wegazi ophakeme, i-anemia, kanye nokutholakala kokutheleleka. I-Nephrotic syndrome isuselwa ku-autoimmune-based in zimo ezithile, kepha hhayi konke. Ngokulashwa okufanele, ukubikezelwa kuhle. Uma ishiywe ingalashwa, ingaba nzima futhi idale ukwehluleka kwezinso noma ukufa.



uyini umuthi ojwayelekile we-invokana

Izimbangela

Kunamaqoqo emithambo yegazi emincane (okuthiwa i-glomeruli) ezinso zakho ehlunga igazi lakho njengoba lidlula kulesi sitho. Ukulimala kwe-glomeruli kuyimbangela ejwayelekile kakhulu ye-nephrotic syndrome. Kodwa-ke, kunezimo eziningi ezingadala ukulimala kwe-glomerular, kufaka phakathi:

  • Isifo sezinso sikashukela yaziwa ngenye indlela njenge-nephropathy yesifo sikashukela. Mayelana ikota yabo bonke abanesifo sikashukela (kokubili Uhlobo 1 noHlelo 2) ekugcineni baba nesifo sezinso esingalimaza i-glomeruli.
  • Isifo sokushintsha okuncane i-idiopathic syndrome, okusho ukuthi imbangela yokusebenza okungavamile ayikwazi ukunqunywa. Ithola igama layo ngoba ushintsho ezinso lincane kakhulu alutholakali ku-biopsy yezinso. Yimbangela ejwayelekile kakhulu ye-nephrotic syndrome ezinganeni, ebhekele ngaphezu kwezingu-90% zezingane ezitholakele. Izingane eziningi zidlula ukugula okuncane kakhulu, kepha ezinye zisiletha ebudaleni. Akuvamile kakhulu kubantu abadala, okubandakanya kuphela i-10% -15% yamacala we-nephrotic syndrome. Yize imbangela ivame ukungaziwa, ingabangelwa ukutheleleka ngegciwane, izidakamizwa ezingezona ukuvuvukala (ama-NSAID), izicubu nokunye ukuphendula okweqile.
  • I-Focal segmental glomerulosclerosis (FSGS) yisifo esiqhubekela phambili esihlose izingxenye ezithile zezinso. Kubo bonke abantu abadala abane-nephrotic syndrome, ama-akhawunti e-FSGS U-40% wabo . Ezinganeni, ama-FSGS enza ama-20% wamacala. I-FSGS ingabangelwa yisifo se-sickle cell, izifo, ukuhlangana kwezidakamizwa, ukukhuluphala, izinto ezinobuthi, kanye (nezingajwayelekile) zofuzo olungajwayelekile. Umdlali we-NBA u-Alonzo Mourning udume ngokufakelwa izinso i-FSGS, nokuholele ekutheni athathe umhlalaphansi kuligi ngo-2003.
  • I-nephropathy eyinhloko ye-membranous (PMN) kuthinta ngokukhethekile i-glomeruli yezinso. Lapho amaprotheni anele ehlunga emchameni, iziguli zithola ukuxilongwa kwe-nephrotic syndrome. Singavela kuyo yonke iminyaka, kepha lesi sifo sigxile kakhulu kubantu abaneminyaka yobudala engama-50-60. Okuqinile Iziguli ezingama-30% nge-PMN bayakwazi ukuthuthukisa isimo sabo ngaphandle kokwelapha konke. Kodwa-ke, amanye ama-30% anesimo esiqhubekayo esizogcina sidinga i-dialysis noma ukufakelwa izinso. Kulabo abangenaso isifo sikashukela, i-PMN ingumthombo ovame kakhulu we-nephrotic syndrome kubantu abadala. Akuvamile ezinganeni. I-PMN ingabangelwa izifo ezizimele, izifo ezithathelwanayo, imishanguzo nezicubu.
  • Uhlelo lupus erythematosus (SLE) uhlobo oluvame kakhulu lwe-lupus. Yisifo esingapheli sokuvuvukala esingaholela ekulimaleni kwezinso. Ezinye izinhlobo ze-lupus nazo zingaba yi-etiological ye-nephrotic syndrome, njenge-lupus podocytopathy kanye ne-lupus nephritis.
  • I-Amyloidosis kwenzeka lapho kune-amyloid protein buildup ezithweni zesiguli. Kuyiprotheni engajwayelekile futhi kungakhiwa ngezinhlanganisela ezahlukahlukene zamaprotheni.

I-Nephrotic syndrome ivela ezinganeni nakubantu abadala, kepha imvamisa ngezizathu ezahlukahlukene. Izingane zivame ukutholakala zinezifo ezincane zokushintsha. Abantu abadala kaningi bane-nephrotic syndrome diagnostic ebangelwa yisifo sikashukela.



Izici zobungozi

Zonke lezi zifo zilimaza uhlelo lokuhlunga ezinso zomzimba. Ngokwengeziwe, kunezici ezandisa ubungozi bokuthola i-nephrotic syndrome:

  • Ukuxilongwa kwezokwelapha: Isifo se-Sickle cell, isifo sikashukela, umdlavuza kanye ne-lupus konke kwenza kube nokwenzeka ukuthi ube nephrotic syndrome.
  • Imithi: Ama-NSAID, ama-antibiotic amaningana, neminye imithi yandisa ingozi yokulimala kwezinso. Ukufaka ezinye izinto ezinobuthi nakho kungaholela ekulimaleni kwezinso.
  • Izifo: I-HIV, i-hepatitis B, i-hepatitis C, ne-malarial konke kwandisa ingozi ye-nephrotic syndrome.

Ukuhlola isimo sakho esivele sikhona kungakusiza ukuthi unqume kangcono ukuthi ngabe usengozini ye-nephrotic syndrome. Ngokwengeziwe, ukunquma ukuthi yini edala umonakalo kungasiza abahlinzeki bezokunakekelwa kwezempilo kangcono ukuphatha iziguli zabo.

Izimpawu

Ngaphandle kwezimbangela ezahlukahlukene, kunezimpawu ezimbalwa ezingakuqondisa ekuxilongweni kwesifo se-nephrotic. Uma unamagremu amathathu wamaprotheni emchameni, kanye ne-cholesterol ephezulu, kanye nokuvuvukala noma i-edema, yilokho-ke i-nephrotic syndrome, kuchaza U-Ahmad Oussama Rifai, MD , i-nephrologist kanye nochwepheshe be-hypertension kanye nomsunguli we-The Virtual Nephrologist.



Izimpawu ezisemqoka zifaka:

  • I-Edema, noma ukuvuvukala, ikakhulukazi amaqakala, izinyawo, ubuso, nesisu — kepha kungenzeka kwenye indawo emzimbeni
  • Umchamo wegwebu obangelwa inani elingeqile lamaprotheni emchameni
  • Ukugcinwa kwamanzi okwenza ukwanda kwesisindo
  • Ukukhathala
  • Ukuphelelwa isifiso sokudla
  • I-cholesterol ephezulu ebangelwa umzimba wakho uzama ukugcwalisa amaprotheni alahlekile (njengama-lipids noma ama-anti-clotting protein)
  • Ukutheleleka njalo
  • Ukungondleki

Lapho lezi zimpawu zihlanganiswa nezinga eliphansi le-serum protein elibizwa nge-albumin, singesinye isibonakaliso esiyinhloko se-nephrotic syndrome, ngokusho UBarry Gorlitsky, MD , i-nephrologist eCarolina Nephrology kanye ne-CEO ye-KidneyAide.

Ungashayela nini umhlinzeki wakho wezokunakekelwa kwempilo

Uma uqaphela umchamo obandayo, njengogwebu othela ubhiya, noma ukuvuvukala okwandayo, sekuyisikhathi sokubona udokotela, kusho uDkt. Gorlitsky. Uma uvakashela umhlinzeki wezokunakekelwa kwempilo, udokotela wakho kungenzeka ahlole ukuhlolwa kwegazi nokuhlolwa komchamo (noma i-urinalysis).



izindlela ezinhle zokudlula ku-hangover

UDkt Rifai uchaza ngokuhlolwa: I-Urinalysis isivivinyo esishibhile kwezokwelapha emlandweni wesintu nenani lemininingwane ekunika lona. Ngempela ukuhlolwa okungu- $ 0.07 okunikeza izingcezu zolwazi eziyi-10, kufaka phakathi isifo sikashukela, amaprotheni emchameni, igazi emchameni, i-bilirubin, isifo sesibindi, i-jaundice, ubuthakathaka bemisipha. I-Nephrotic syndrome yisifo esisodwa nje esivivinywa ukuhlolwa umchamo. Lokhu kuhlolwa kungenziwa ekhaya noma ehhovisi likadokotela.

I-biopsy yezinso ingasiza ekutholeni imbangela yezimpawu zakho. Ukuxilongwa kungaba inqubo eyinkimbinkimbi lapho i-biopsy yezinso inganikezi ulwazi olwanele, noma iholela ekukhanyeni kwemicroscopy (lapho ungaboni lutho oluphawulayo ku-biopsy ejwayelekile). Ngemuva kwalokho, uDkt Rafai uchaza ukuthi udokotela angenza amabala akhethekile, i-electron microscopy, noma i-immune microscopy. Ngokuya ngalokho, sizonquma ukuthi iyiphi i-etiology nokuthi singakuphatha kanjani lokhu, kusho uDkt Rifai.

Uma uthola ukuxilongwa kwesifo sokushintsha okuncane kusuka ku-biopsy eyodwa, ungahle ufune ukucela i-biopsy yesibili engxenyeni ehlukile yezinso. Lokhu kungenxa yokuthi i-FSGS (egxile futhi ihlukaniswe ngokwengxenye, njengoba igama liphakamisa) ivela kwezinye izingxenye zezinso, kepha hhayi ezinye.



UDkt Rifai ufanisa izinso nensimu, engaba nezingxenye ezihlukene zezihlahla, izimbali, nezihlahla. Uyanezela, Uma unebhadi ngokwanele ukuthatha i-biopsy engxenyeni ejwayelekile yezinso, khona-ke uzoyibiza njengesifo sokushintsha okuncane kepha empeleni i-FSGS. Ngoba i-FSGS iyathuthuka, lokhu kungabonakala kuyingozi.

OKUSHIWO: Ukuhlolwa kwe-Creatinine, amabanga ajwayelekile, nokuthi ungawehlisa kanjani amazinga

ungasho kanjani ukuthi inhliziyo yami iphilile

Ungayiphatha kanjani i-nephrotic syndrome

Wonke umuntu one-nephrotic syndrome uhlukile, kepha njengoba kunezimbangela eziningi, ziningi izindlela zokwelashwa ezingaba khona.



  1. Uvithamini D: Lesi sithako sisiza ukulawula ukusebenza kwezinso. Iziguli ze-Nephrotic syndrome zivame ukusebenzisa izengezo zikaVitamin D, ngaphezu kwemithombo yemvelo, ukuzisiza ekwelashweni kwazo.
  2. Izinguquko zokudla: Odokotela bavame ukuncoma ukulungiswa kokudla okunomsoco ukunciphisa amaprotheni emchameni nasekugcinweni oketshezi okwengeziwe. Ikakhulu, iziguli zingaya ekudleni okunesodium ephansi (imvamisa engaphansi kuka-1,000 mg we-sodium ngosuku) kanye nokwehliswa kokudla kwamaprotheni. Kuwumqondo omuhle futhi ukunciphisa ukusetshenziswa kwamafutha agcwele.

OKUSHIWO: Izinketho zokwelashwa okuphezulu kwe-triglyceride

  1. Imithi: Kunezinhlobo eziningana zemithi umhlinzeki wakho wezokunakekelwa kwempilo angakunquma, kuya ngezimbangela eziyinhloko zezimpawu zakho.
  • Ama-steroid ukusiza ukunciphisa ukuvuvukala kwezinso 'glomeruli
  • Ama-modulators wesistimu yomzimba ukusiza ukulungisa izinkinga eziyimisipha ezingaphansi, njenge-lupus noma imishanguzo yesifo sikashukela
  • I-Angiotensin-converting enzyme (ACE) inhibitors yokwehlisa umfutho wegazi ophezulu
  • Izidakamizwa, noma amaphilisi amanzi, ukunciphisa ukugcinwa kwamanzi nokuvuvukala
  • Ama-thinner egazi, noma ama-anticoagulants, ukunciphisa ubungozi bokuqina

Kunezidakamizwa ezimbalwa kuphela ezenzelwe i-nephrotic syndrome. Iningi lalemithi lisetshenziswa ngaphandle kwelebula ukunciphisa izimpawu zalesi simo.

Imithi elapha i-nephrotic syndrome
Igama lomuthi Isigaba sezidakamizwa Isebenza kanjani Thola isigqebhezana
I-Prinivil, Qbrelis, Zestril (lisinopril) Ama-ACE inhibitors Yehlisa umfutho wegazi Thola isigqebhezana
I-Lotensin (benazepril) Ama-ACE inhibitors Yehlisa umfutho wegazi Thola isigqebhezana
IVasotec (i-captopril / enalapril) Ama-ACE inhibitors Yehlisa umfutho wegazi Thola isigqebhezana
I-Lasix (furosemide) Izidakamizwa Kunciphisa ukugcinwa koketshezi ukunciphisa ukuvuvukala Thola isigqebhezana
I-Aldactone, iCarospir (i-spironolactone) Abamelene nabamukeli Kunciphisa ukugcinwa koketshezi ukunciphisa ukuvuvukala Thola isigqebhezana
I-Zaroxolyn (i-hydrochlorothiazide noma i-metolazone) AmaThiyazide Kunciphisa ukugcinwa koketshezi ukunciphisa ukuvuvukala Thola isigqebhezana
I-Lipitor (atorvastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
I-Lescol XL (i-fluvastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
I-Altoprev (lovastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
I-Pravachol(pravastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
I-Crestor(rosuvastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
Zocor(simvastatin) I-HMG-CoA reductase inhibitors (ama-statins) Yehlisa i-cholesterol Thola isigqebhezana
UJantoven(i-warfarin) Ama-anticoagulants Inciphisa ingozi yegazi Thola isigqebhezana
Pradaxa(dabigatran) I-thrombin inhibitors eqondile Inciphisa ingozi yegazi Thola isigqebhezana
U-Eliquis(apixaban) I-Factor Xa inhibitors Inciphisa ingozi yegazi Thola isigqebhezana
Xarelto(i-Rivaroxaban powder) I-Factor Xa inhibitors Inciphisa ingozi yegazi Thola isigqebhezana
I-Rituxan(rituximab) Amasosha omzimba angama-monoclonal Yehlisa amasosha omzimba ayingozi abangela ukuvuvukala Thola isigqebhezana
I-Prednisolone(i-prednisone) Ama-Corticosteroids Kubanga ukuthethelelwa ngokuxazulula i-proteinuria Thola isigqebhezana

Noma izimpawu zakho zilawulwa kahle ngokudla, izithasiselo, kanye nemithi, kufanele uhlale uziphaphamele izimpawu ngokuzayo. UDkt. Gorlitsky uthi, Kaningi sizoqhubeka nokuqapha ngezikhathi ezithile ukuze siqiniseke ukuthi akukho okuqubukayo. Lokhu kunikeza iziguli nethimba lazo lezokwelapha ithuba lokuphatha lawo ma-flare-ups njengoba eza.