Proximal renal tubular acidosis

Proximal renal tubular acidosis chirwere chinoitika kana itsvo dzikasabvisa zvakanaka acids kubva muropa kuenda mumurini. Nekuda kweizvozvo, acid yakawandisa inoramba iri muropa (inonzi acidosis).

Kana muviri ukaita mashandiro awo akajairika, unoburitsa acid. Kana iyi acid ikasabviswa kana kurerutswa, ropa rinozoita kuva acidic. Izvi zvinogona kutungamira mukusaenzana kwe electrolyte muropa. Inogona zvakare kukonzera matambudziko neyakajairika mashandiro emamwe maseru.

Itsvo dzinobatsira kudzora mwero weasidhi yemuviri nekubvisa asidhi muropa uye nekuiburitsa mukati merini. Acidic zvinhu mumuviri zvakasarudzika nealkaline zvinhu, zvakanyanya bicarbonate.

Proximal renal tubular acidosis (mhando II RTA) inoitika kana bicarbonate isina kunyatso kudzoreredzwa neiyo itsvo yekusefa system.

Rudzi rwechipiri RTA haruna kujairika kupfuura mhando I RTA. Type I inonziwo distal renal tubular acidosis. Rudzi rwechipiri runowanzoitika panguva yehucheche uye runogona kuenda rwoga.

Zvinokonzera mhando II RTA zvinosanganisira:

• Cystinosis (muviri haugone kuputsa chinhu cysteine)
• Zvinodhaka zvakadai ifosfamide (chemotherapy mushonga), mamwe maantibhakitiriya ayo asisashandiswe zvakanyanya (tetracycline), kana acetazolamide
• Fanconi syndrome, kusagadzikana kweiyo itsvo machubhu umo zvimwe zvinhu zvinowanzo nyudzwa muropa neitsvo zvinosunungurwa mumuti weti
• Yakagara nhaka fructose kusagadzikana, kusagadzikana uko kune kushomeka kweprotein inodiwa kuputsa muchero shuga fructose
• Multiple myeloma, rudzi rwekenza yeropa
• Primary hyperparathyroidism, kusagadzikana uko maronda eparathyroid mumutsipa anogadzira yakawandisa parathyroid hormone
• Sjögren syndrome, autoimmune kusagadzikana umo maronda anounza misodzi uye mate anoparadzwa
• Chirwere cheWilson, chirwere chinogarwa nhaka umo mune mhangura yakawandisa mumatumbu emuviri
• Vitamin D kushomeka

Zviratidzo zvekuwedzera renal tubular acidosis zvinosanganisira chero cheanotevera:

• Kuvhiringidzika kana kudzikira kwekusvinura
• Kupera mvura mumuviri
• Kuneta
• Kuwedzera mweya wekufema
• Osteomalacia (kupfavisa kwemapfupa)
• Kutambudzika kwemhasuru
• Kushaya simba

Zvimwe zviratidzo zvinogona kusanganisira:

• Yakaderera weti kubuda
• Yakawedzera kurova kwemoyo kana kusagadzikana kwemoyo
• Tsandanyama tsandanyama
• Marwadzo mumapfupa, musana, parutivi, kana mudumbu
• Mafupa akaremara

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezvezviratidzo.

Miedzo inogona kurairwa inosanganisira:

• Arterial ropa gasi
• Ropa kemisitiri
• Ropa pH nhanho
• Weti pH uye acid-kurodha bvunzo
• Kuongorora urinal

Icho chinangwa ndechekudzosera zvakajairwa acid nhanho uye muyero we electrolyte mumuviri. Izvi zvinobatsira kugadzirisa kusagadzikana kwemapfupa uye kudzora njodzi ye osteomalacia uye osteopenia muvakuru.

Vamwe vanhu vakuru vangangoda kurapwa. Vese vana vanoda alkaline mushonga senge potassium citrate uye sodium bicarbonate. Uyu ndiwo mushonga unobatsira kugadzirisa acidic mamiriro emuviri. Mushonga unobatsira kudzivirira chirwere chemapfupa chinokonzerwa neyakawandisa acid, senge rickets, uye kubvumidza kukura kwakajairika.

Thiazide diuretics zvakare inowanzo shandiswa kuchengetedza bicarbonate mumuviri.

Icho chinokonzeresa chinokonzera proximal renal tubular necrosis inofanirwa kugadziriswa kana ichigona kuwanikwa.

Vitamin D uye calcium zvinowedzera zvinogona kudikanwa kubatsira kudzikamisa maronda akaremara anokonzerwa neosteomalacia.

Kunyangwe hazvo chikonzero chekukonzera renal tubular acidosis chichienda choga, mhedzisiro nematambudziko zvinogona kuve zvechigarire kana kutyisidzira hupenyu. Kurapa kunowanzo kubudirira.

Fonera mupiki wako kana iwe uine zviratidzo zveproimal renal tubular acidosis.

Tora rubatsiro rwechiremba ipapo kana paine anotevera echiratidzo echimbichimbi anokura:

• Kupera kwekusvinura kana kusagadzikana
• Kuderera kwekuziva
• Kufenda

Mazhinji ezvinetso zvinokonzeresa renal tubular acidosis hazvidziviririke.

Renal tubular acidosis - proximal; Rudzi rwechipiri RTA; RTA - proximal; Renal tubular acidosis mhando II

• Itsvo anatomi
• Itsvo - kuyerera kweropa uye weti

Bushinsky DA. Itsvo matombo. Mune: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Chinyorwa cheEndocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: chits. 32.

Dixon BP. Renal tubular acidosis. Mune: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 547.

Seifter JL. Acid-base kusagadzikana. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 110.