Chirangaridzo nephropathy

Membranous nephropathy chirwere cheitsvo chinotungamira mukuchinja uye kuzvimba kwezvivakwa mukati meitsvo zvinobatsira kusefa marara uye mvura. Iko kuzvimba kunogona kutungamira kumatambudziko neitsvo basa.

Membranous nephropathy inokonzerwa nekukora kwechikamu cheiyo glomerular yepasi membrane. Iyo glomerular yepasi membrane inhengo yeitsvo iyo inobatsira kusefa marara uye nekuwedzera mvura kubva muropa. Chikonzero chaicho chekuwedzera uku hachizivikanwe.

Iyo yakakora glomerular membrane haishande zvakajairika. Nekuda kweizvozvo, yakawanda mapuroteni anorasika mumuti weti.

Aya mamiriro ndeimwe yezvakanyanya kukonzera nephrotic syndrome. Iri iboka rezviratidzo zvinosanganisira mapuroteni mumuguta, yakaderera ropa protein protein, yakakwira cholesterol mazinga, akakwira triglyceride mazinga, uye kuzvimba. Membranous nephropathy inogona kunge iri hosha yepfungwa yeitsvo, kana inogona kunge ichibatana nemamwe mamiriro.

Izvi zvinotevera zvinowedzera njodzi yako kune ino mamiriro:

• Cancers, kunyanya kenza yemapapu neyekoloni
• Kuratidzirwa kune chepfu, kusanganisira goridhe uye mercury
• Zvirwere, zvinosanganisira hepatitis B, malaria, syphilis, uye endocarditis
• Mishonga, kusanganisira penicillamine, trimethadione, uye mafuta-anovhenekera ganda
• Systemic lupus erythematosus, rheumatoid arthritis, Graves chirwere, uye zvimwe autoimmune kusagadzikana

Dambudziko racho rinoitika chero pazera, asi rinowanzoitika mushure memakore makumi mana.

Zviratidzo zvinowanzotanga zvishoma nezvishoma nekufamba kwenguva, uye zvinogona kusanganisira:

• Edema (kuzvimba) mune chero nzvimbo yemuviri
• Kuneta
• Kupenga kwehuputi weti (nekuda kweakawanda mapuroteni)
• Chido chisina kunaka
• Weti, yakanyanyisa usiku
• Kurera huremu

Kuongorora kwepanyama kunogona kuratidza kuzvimba (edema).

Kuongorora urinal kunogona kuratidza huwandu hwakawanda hweprotein mumugini. Panogona zvakare kuve nerimwe ropa mumurini.Iyo glomerular filtration rate (iyo "inomhanya" iyo itsvo inonatsa ropa) kazhinji inenge yakajairika.

Dzimwe bvunzo dzinogona kuitwa kuti vaone kuti itsvo dziri kushanda zvakadii uye nemuviri uri kugadzirisa chinetso cheitsvo. Izvi zvinosanganisira:

• Albumin - ropa uye weti
• Ropa urea nitrogen (BUN)
• Creatinine - ropa
• Chibvumirano cheCreatinine
• Lipid pani
• Mapuroteni - ropa uye weti

Itsvo biopsy inosimbisa kuongororwa.

Iyi inotevera bvunzo inogona kubatsira kuona chinokonzera membranous nephropathy:

• Antinuclear antibodies bvunzo
• Anti-double-strand DNA, kana iyo antinuclear antibodies bvunzo iri yakanaka
• Kuongororwa kweropa kutarisa hepatitis B, hepatitis C, uye syphilis
• Zadzisa mazinga
• Cryoglobulin bvunzo

Chinangwa chekurapa ndechekuderedza zviratidzo uye kunonoka kufambira mberi kwechirwere.

Kudzora BP ndiyo yakanyanya kukosha nzira yekunonoka kukuvara kweitsvo. Chinangwa ndechekuchengetedza BP kana kana pazasi pe 130/80 mm Hg.

Yakakwira ropa cholesterol uye triglyceride mazinga anofanirwa kurapwa kudzikisa njodzi ye atherosclerosis. Nekudaro, yakaderera-mafuta, yakaderera-cholesterol chikafu kazhinji haigone kubatsira kune vanhu vane membranous nephropathy.

Mishonga inoshandiswa kurapa membranous nephropathy inosanganisira:

• Angiotensin-inoshandura enzyme (ACE) inhibitors uye angiotensin receptor blockers (ARBs) kudzikisa BP.
• Corticosteroids nemimwe mishonga inodzvinyirira immune system
• Mishonga (kazhinji statins) yekudzora cholesterol uye triglyceride mazinga
• Mapiritsi emvura (diuretics) ekuderedza kuzvimba
• Ropa rakapfava kudzikisa njodzi yekuvhara ropa mumapapu nemakumbo

Zvikafu zvine mapuroteni mashoma zvinogona kubatsira. Kudya zvine mwero-mapuroteni (1 gramu (gm) yeprotini pa kilogiramu (kg) yehuremu hwemuviri pazuva) kunogona kutaurwa.

Vitamin D ingangoda kutsiviwa kana nephrotic syndrome iri kwenguva refu (isingagumi) uye isingapindure pakurapwa.

Ichi chirwere chinowedzera mukana wekuvhara ropa mumapapu nemakumbo. Ropa rakapfava rinogona kupihwa kudzivirira izvi zvinetso.

Maonero anosiyana, zvinoenderana neuwandu hwepuroteni kurasikirwa. Panogona kunge paine nguva dzisina zviratidzo uye dzimwe nguva kuputika. Dzimwe nguva, mamiriro acho anoenda, uine kana usina kurapwa.

Vazhinji vanhu vane chirwere ichi vanozokuvara neitsvo uye vamwe vanhu vanozoita yekupedzisira-nhanho renal chirwere.

Matambudziko anogona kukonzerwa nechirwere ichi anosanganisira:

• Kukundikana kusingaperi kwechirwere
• Yakadzika venous thrombosis
• End-nhanho renal chirwere
• Nephrotic chirwere
• Pulmonary embolism
• Renal vein thrombosis

Dana kuti usangane nemupi wako wezvehutano kana:

• Iwe une zviratidzo zve membranous nephropathy
• Zviratidzo zvako zvinowedzera kana kuti hazvipere
• Unovandudza zviratidzo zvitsva
• Wadzikisa weti kubuda

Kurumidza kurapa kusagadzikana uye kudzivirira zvinhu zvinogona kukonzera membranous nephropathy kunogona kudzikisa njodzi yako.

Chokumusoro glomerulonephritis; Chirangaridzo GN; Extramembranous glomerulonephritis; Glomerulonephritis - membranous; MGN

• Itsvo anatomi

Radhakrishnan J, Appel GB. Glomerular kusagadzikana uye nephrotic syndromes. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Chirwere chepakutanga chinoratidzira. 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. 31.

Salant DJ, Cattran DC. Chirangaridzo nephropathy. Muna: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Yakakwana Kliniki Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 20.