Chirwere chetsvo chisingaperi

Chirwere chetsvo chisingaperi ndiko kunonoka kurasikirwa kweitsvo kushanda nekufamba kwenguva. Basa guru reitsvo kubvisa marara nemvura yakawandisa kubva mumuviri.

Chirwere chetsvo chisingaperi (CKD) chinowedzera kuwedzera pamwedzi kana makore. Iwe haugone kuona chero zviratidzo kwenguva yakati. Kurasikirwa kwebasa kunogona kunonoka zvekuti hauna zviratidzo kusvikira itsvo dzako dzave kutomira kushanda.

Chikamu chekupedzisira cheCKD chinonzi end-stage renal chirwere (ESRD). Panguva ino, itsvo hadzichakwanise kubvisa marara akakwana uye zvinwiwa zvakawandisa kubva mumuviri. Panguva ino, iwe waizoda dialysis kana yeitsvo kuisirwa.

Chirwere cheshuga uye kuwedzerwa kweropa ndizvo zvikonzero zviviri zvinowanzoitika uye account yezvakawanda zviitiko.

Zvimwe zvakawanda zvirwere uye mamiriro anogona kukuvadza itsvo, kusanganisira:

• Autoimmune kusagadzikana (senge systemic lupus erythematosus uye scleroderma)
• Kuremara kwekuzvarwa kweitsvo (senge polycystic chirwere cheitsvo)
• Mamwe makemikari ane chepfu
• Kukuvadza kune itsvo
• Itsvo matombo uye hutachiona
• Matambudziko ane tsinga dzinopa itsvo
• Mimwe mishonga, senge kurwadziwa uye gomarara zvinodhaka
• Kudzokera kumashure kwerini mukati meitsvo (Reflux nephropathy)

CKD inotungamira kune kuwanda kwemvura uye marara zvigadzirwa mumuviri. Aya mamiriro anokanganisa masisitimu mazhinji emuviri nemabasa, kusanganisira:

• Kuwedzera kweropa
• Yakaderera masero eropa kuverenga
• Vitamin D uye hutano hwepfupa

Zviratidzo zvekutanga zveCKD zvakafanana nezvezvimwe zvirwere zvakawanda. Zviratidzo izvi zvinogona kunge zviri izvo chete chiratidzo chedambudziko mumatanho ekutanga.

Zviratidzo zvinogona kusanganisira:

• Nzara kurasikirwa
• Kazhinji kurwara kunzwa uye kuneta
• Kutemwa nemusoro
• Itching (pruritus) uye yakaoma ganda
• Nausea
• Kurera huremu pasina kuyedza kudzikisa huremu

Zviratidzo zvinogona kuitika kana basa reitsvo ranyanya kuwedzera zvinosanganisira:

• Ganda risina kujairika kana rakapfava
• Kurwadziwa kwepfupa
• Kukotsira kana matambudziko ekuisa pfungwa kana kufunga
• Unhu kana kuzvimba mumaoko nemakumbo
• Tsvina kubvunda kana kurwadza
• Kufema kunhuwa
• Kupwanya kuri nyore, kana ropa muchitsiko
• Nyota yakanyanya
• Kakawanda hiccups
• Matambudziko nebasa repabonde
• Nguva yekuenda kumwedzi inomira (amenorrhea)
• Kufema kwekufema
• Zvinetso zvekurara
• Kusvipa

Vanhu vazhinji vanozove neBP yakakwira pamatanho ese eCKD. Munguva yebvunzo, wako mupi wezvehutano anogona kunzwa zvakare zvisina kujairika moyo kana mapapu kurira muchipfuva chako. Iwe unogona kunge uine zviratidzo zvekukuvara kwetsinga panguva yetsinga system bvunzo.

Kuongorora urinalysis kunogona kuratidza mapuroteni kana zvimwe shanduko mumuti wako. Shanduko idzi dzinogona kuoneka 6 kusvika 10 mwedzi kana kupfuura zviratidzo zvisati zvaonekwa.

Kuyedza kunoongorora mashandiro ari kuita itsvo kunosanganisira:

• Chibvumirano cheCreatinine
• Zvisikwa zveCreatinine
• Ropa urea nitrogen (BUN)

CKD inoshandura mhedzisiro yemamwe bvunzo. Iwe unozofanirwa kuve neiyi inotevera bvunzo nguva zhinji semwedzi miviri kusvika mitatu yega apo chirwere cheitsvo chiri kuwedzera kuipa:

• Albumin
• Calcium
• Cholesterol
• Yakazara kuverenga ropa (CBC)
• Electrolyte
• Magnesium
• Phosphorus
• Potassium
• Sodium

Mimwe miedzo inogona kuitwa kutsvaga chikonzero kana rudzi rwechirwere cheitsvo dzinosanganisira:

• CT scan yemudumbu
• MRI yemudumbu
• Ultrasound yemudumbu
• Itsvo biopsy
• Itsvo kuongorora
• Itsvo Ultrasound

Chirwere ichi chinogona zvakare kuchinja mhedzisiro yemiedzo inotevera:

• Erythropoietin
• Parathyroid hormone (PTH)
• Bone density bvunzo
• Vitamin D mwero

Ropa kumanikidza kudzora kunononoka kumwe kukuvara kweitsvo.

• Angiotensin-inoshandura enzyme (ACE) inhibitors kana angiotensin receptor blockers (ARBs) anoshandiswa kazhinji.
• Chinangwa ndechekuchengetedza BP kana kana pazasi pe 130/80 mm Hg.

Kuita shanduko yemararamiro kunogona kubatsira kudzivirira itsvo, uye kudzivirira chirwere chemwoyo uye sitiroko, senge:

• USASVIRA.
• Idya chikafu chakaderera mumafuta uye cholesterol.
• Gara uchirovedza muviri (taura nachiremba wako kana mukoti usati watanga kuita maekisesaizi).
• Tora zvinodhaka kudzikisa cholesterol yako, kana zvichidikanwa.
• Chengetedza shuga yako yeropa ichidzora.
• Dzivisa kudya munyu wakawanda kana potasium.

Gara uchitaura neitsvo yenyanzvi usati watora chero mushonga wepamusoro. Izvi zvinosanganisira mavitamini, mahebhu uye zvinowedzera. Ita shuwa kuti vese vanopa iwe vaunoshanyira vanoziva kuti une CKD. Mimwe mishonga inogona kusanganisira:

• Mishonga inonzi phosphate binders, kubatsira kudzivirira yakakwira phosphorus mazinga
• Yakawedzera iron mukudya, mapiritsi esimbi, iron inopihwa kuburikidza netsinga (intravenous iron) kupfura kwakakosha kwemushonga unonzi erythropoietin, uye kuwedzerwa ropa kurapa kupererwa
• Yakawedzera calcium uye vhitamini D (gara uchitaura nemupi wako usati watora)

Wako mupi anogona kunge iwe uchitevera chakakosha chikafu cheCKD.

• Kugumira mvura
• Kudya zvishoma mapuroteni
• Kurambidza phosphorus uye mamwe maelektrolyte
• Kuwana macalorie akakwana kudzivirira kuonda

Vanhu vese vane CKD vanofanirwa kunge vachifambirana nemajekiseni anotevera:

• Hepatitis A jekiseni
• Hepatitis B yekudzivirira
• Mushonga wefuru
• Pneumonia jekiseni (PPV)

Vamwe vanhu vanobatsirwa nekutora chikamu muboka rekutsigira chirwere cheitsvo.

Vanhu vazhinji havana kuongororwa kuti vane CKD kudzamara varasikirwa neakawanda epfungwa yavo.

Iko hakuna mushonga weCKD. Kana ichikura kuna ESRD, uye nekukurumidza sei, zvinoenderana ne:

• Chikonzero chekukuvara kweitsvo
• Unonyatsozvitarisira sei

Itsvo kutadza idanho rekupedzisira reCKD. Apa ndipo apo itsvo dzako dzisingachagone kutsigira zvinodiwa nemuviri wedu.

Wako mupi achakurukura dialysis newe usati waida. Dialysis inobvisa tsvina kubva muropa rako apo itsvo dzako dzisingakwanise kuita basa radzo.

Muzviitiko zvakawanda, iwe uchaenda kune dialysis kana uchingova negumi kusvika gumi neshanu muzana pabasa rako reitsvo rasara.

Kunyangwe vanhu vakamirira itsvo kuisirwa vangangoda dialysis pavakamirira.

Zvinetso zvinogona kusanganisira:

• Anemia
• Kubuda ropa mudumbu kana ura
• Bone, kubatana, uye kurwadziwa kwemhasuru
• Shanduko muropa shuga
• Kukuvadza kune tsinga dzemakumbo nemaoko (peripheral neuropathy)
• Dementia
• Fluid buildup yakatenderedza mapapu (pleural effusion)
• Mwoyo uye neropa mudziyo zvinetswa
• Yakakwira phosphorus mazinga
• High potassium mazinga
• Hyperparathyroidism
• Kuwedzera kwengozi yezvirwere
• Kukuvara kwechiropa kana kukundikana
• Kushaya zvokudya zvinovaka muviri
• Miscarriage uye kushaya mbereko
• Kufenda
• Kuzvimba (edema)
• Kushaya simba kwemapfupa uye kuwedzera njodzi yekutyoka

Kurapa iyo mamiriro ari kukonzera dambudziko kunogona kubatsira kudzivirira kana kunonoka CKD. Vanhu vane chirwere cheshuga vanofanirwa kudzora shuga yavo yeropa uye kuwanda kweropa uye havafanirwe kuputa.

Itsvo kutadza - chisingaperi; Renal kutadza - kusingaperi; Chisingaperi itsvo insufficiency; Kusingaperi itsvo kutadza; Kukundikana kusingaperi kwechirwere

• Itsvo anatomi
• Itsvo - kuyerera kweropa uye weti
• Glomerulus uye nephron

Christov M, Sprague SM. Chirwere chetsvo chisingaperi - chicherwa pfupa kusagadzikana. Mune: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner uye Rector Iyo Itsvo. 11th ed. Philadelphia, PA: Elsevier; 2020: chits. 53.

Grams INE, McDonald SP. Epidemiology yechirwere chetsvo chisingaperi uye dialysis. Muna: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Yakakwana Kliniki Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019: chits. 77.

Taal MW. Kurongwa uye manejimendi yechirwere cheitsvo chisingaperi. Mune: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner uye Rector Iyo Itsvo. 11th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 59.