End-danho chirwere cheitsvo

End-stage chirwere cheitsvo (ESKD) ndiyo yekupedzisira nhanho yenguva refu (chisingaperi) chirwere cheitsvo. Apa ndipo apo itsvo dzako dzisingachagone kutsigira zvido zvemuviri wako.

End-stage chirwere cheitsvo chinonziwo end-stage renal chirwere (ESRD).

Itsvo dzinobvisa marara uye zvakawandisa mvura kubva mumuviri. ESRD inoitika apo itsvo dzisisakwanise kushanda padanho rinodiwa rehupenyu hwezuva nezuva.

Zvinonyanya kukonzera ESRD muUnited States chirwere cheshuga uye kuwedzerwa kweropa. Aya mamiriro anogona kukanganisa itsvo dzako.

ESRD inenge ichiuya nguva dzose mushure mechirwere chetsvo chisingaperi. Itsvo dzinogona kumira zvishoma nezvishoma kushanda mukati memakore gumi kusvika makumi maviri makore ekupedzisira asati abuda chirwere.

Zviratidzo zvakajairika zvinogona kusanganisira:

• Kazhinji kurwara kunzwa uye kuneta
• Itching (pruritus) uye yakaoma ganda
• Kutemwa nemusoro
• Kurera huremu pasina kuyedza
• Kupererwa nechido
• Nausea

Zvimwe zviratidzo zvinogona kusanganisira:

• Ganda risina kujairika kana rakapfava
• Chipikiri shanduko
• Kurwadziwa kwepfupa
• Kukotsira uye kuvhiringidzika
• Matambudziko ekuisa pfungwa kana kufunga
• Unhu mumaoko, tsoka, kana dzimwe nzvimbo
• Tsvina kubvunda kana kurwadza
• Kufema kunhuwa
• Kupwanya kuri nyore, kubuda ropa mumhino, kana ropa muriseini
• Nyota yakanyanya
• Kakawanda hiccups
• Matambudziko nebasa repabonde
• Nguva yekuenda kumwedzi inomira (amenorrhea)
• Zvinetso zvekurara
• Kuzvimba kwetsoka nemaoko (edema)
• Kurutsa, kazhinji mangwanani

Anokuchengetedza hutano achaita bvunzo dzepanyama uye odza bvunzo dzeropa. Vanhu vazhinji vane chirwere ichi vane BP yakakwira.

Vanhu vane ESRD vanozoita shoma weti, kana itsvo hadzichagadzi weti.

ESRD inoshandura mhedzisiro yemiedzo yakawanda. Vanhu vanogamuchira dialysis vachada izvi nemimwe bvunzo inoitwa kazhinji:

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

Chirwere ichi chinogona zvakare kuchinja mhedzisiro yemiedzo inotevera:

• Vhitamini D
• Parathyroid kemikari
• Bone density bvunzo

ESRD ingangoda kurapwa ne dialysis kana itsvo kuisazve. Ungangoda kugara pachikafu chakakosha kana kutora mishonga yekubatsira muviri wako kushanda zvakanaka.

ZVINODZIDZISWA

Dialysis rinoita rimwe rebasa reitsvo pavanomira kushanda zvakanaka.

Dialysis inogona:

• Bvisa imwe munyu, mvura, uye marara zvigadzirwa kuti zvirege kuvaka mumuviri wako
• Chengetedza zvikamu zvakachengeteka zvemaminerari uye mavitamini mumuviri wako
• Batsira kudzora BP
• Batsira muviri kugadzira masero matsvuku eropa

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

• Kazhinji, iwe uchaenda pane dialysis kana uchingova ne10% kusvika 15% yebasa rako reitsvo rakasara.
• Kunyangwe vanhu vakamirira itsvo kuisirwa vangangoda dialysis pavakamirira.

Nzira mbiri dzakasiyana dzinoshandiswa kuita dialysis:

• Munguva yehemodialysis, ropa rako rinopfuura nepachubhu kupinda muitsvo, kana firita. Iyi nzira inogona kuitwa pamba kana kune dialysis centre.
• Munguva yeparitoneal dialysis, yakakosha mhinduro inopinda mudumbu rako kunyangwe catheter chubhu. Mhinduro yacho inoramba iri mudumbu mako kwenguva yakati ozobviswa. Iyi nzira inogona kuitwa pamba, kubasa, kana mukufamba.

KUSHANDISA KIDHINI

Kuisa itsvo kuvhiya kuisa itsvo ine hutano mukati memunhu ane itsvo kutadza. Chiremba wako anozokuendesa kune inoiswa nzvimbo. Ikoko, iwe uchaonekwa uye kuongororwa nechikwata chekudyara. Ivo vanozoda kuve nechokwadi chekuti iwe uri mukwikwidzi akanaka weitsvo kuisazve.

KUKOSHA KUKOSHA

Iwe ungangoda kuramba uchitevera yakakosha kudya kwechirwere chisingaperi cheitsvo. Kudya kwacho kunogona kusanganisira:

• Kudya chikafu chakaderera mumapuroteni
• Kuwana macalorie akakwana kana uri kurasikirwa uremu
• Kugumira mvura
• Kukanganisa munyu, potasium, phosphorus, uye mamwe maelectrolyte

Kumwe Kurapwa

Kumwe kurapwa kunoenderana nezviratidzo zvako, asi zvinogona kusanganisira:

• Yakawedzera calcium uye vhitamini D. (Gara uchitaura nemupi wako usati watora zvinowedzera.)
• Mishonga inonzi phosphate binders, kubatsira kudzivirira phosphorus mazinga kubva pakureba zvakanyanya.
• Kurapa kweanemia, senge yakawedzera iron mukudya, mapiritsi esimbi kana kupfura, kupfura mushonga unonzi erythropoietin, uye kuwedzerwa ropa.
• Mishonga yekudzivirira yako BP.

Taura nemupi wako nezve majekiseni aungade, anosanganisira:

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

Vamwe vanhu vanogona kubatsirwa nekutora chikamu muboka rekutsigira chirwere cheitsvo.

End-stage chirwere cheitsvo chinotungamira kurufu kana iwe usina dialysis kana itsvo kuisazve. Ose marapirwo aya ane njodzi. Mhedzisiro yacho yakasiyana kumunhu wega wega.

Matambudziko ehutano anogona kukonzerwa neESRD anosanganisira:

• Anemia
• Kubuda ropa mudumbu kana ura
• Bone, kubatana, uye kurwadziwa kwemhasuru
• Shanduko muropa shuga (glucose)
• Kukuvadza kune tsinga dzemakumbo nemaoko
• Mvura inovhara yakatenderedza mapapu
• Yakakwira BP, kurwisa kwemoyo, uye kutadza kwemoyo
• Yakakwira potasiamu nhanho
• Kuwedzera njodzi yehutachiona
• Kukuvara kwechiropa kana kukundikana
• Kushaya zvokudya zvinovaka muviri
• Miscarriage kana kushaya mbereko
• Isina zororo makumbo chirwere
• Sitiroko, pfari, uye kuora mwoyo
• Kuzvimba uye edema
• Kuneta kwemapfupa uye kutsemuka zvine chekuita neepamusoro phosphorus uye yakaderera calcium mazinga

Renal kutadza - yekupedzisira nhanho; Itsvo kutadza - yekupedzisira nhanho; ESRD; ESKD

• Itsvo anatomi
• Glomerulus uye nephron

Gaitonde DY, Cook DL, Rivera IM. Chirwere chetsvo chisingaperi: kuona uye kuongorora. Ndiri Chiremba weNzara. 2017; 96 (12): 776-783. PMID: 29431364 www.ncbi.nlm.nih.gov/pubmed/29431364/.

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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.

Yeun JY, Mudiki B, Depner TA, Chin AA. Hemodialysis. 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. 63.