Acute tubular necrosis

Acute tubular necrosis (ATN) chirwere cheitsvo chinosanganisira kukanganisa maseru ehubhu eitsvo, izvo zvinogona kutungamira kukundikana kwetsvo. Iwo mahubhu madhiri madiki mune itsvo ayo anobatsira kusefa ropa parinopfuura nemuitsvo.

ATN inowanzo kukonzerwa nekushaikwa kweropa kuyerera uye okisijeni kune itsvo tishu (ischemia yeitsvo). Izvo zvinogona zvakare kuitika kana itsvo maseru akakuvadzwa nehupfu kana chinhu chinokuvadza.

Zvimiro zvemukati zveitsvo, kunyanya zvinyama zveitsvo tubule, zvinokuvara kana kuparadzwa. ATN ndiyo imwe yenzira dzakajairika shanduko dzinogona kutungamira kukundikana kwetsvo.

ATN chikonzero chinowanzoitika cheitsvo kukundikana muvanhu vari muchipatara. Ngozi dzeATN dzinosanganisira:

• Kuwedzerwa kweropa
• Kukuvadza kana kushungurudzika kunokanganisa mhasuru
• Kuderera kweropa (hypotension) iyo inogara kwenguva refu kupfuura maminetsi makumi matatu
• Nguva pfupi yapfuura kuvhiyiwa
• Septic kuvhunduka (zvakakomba mamiriro anoitika kana hutachiona hwakazara nemuviri hunotungamira kune yakaderera BP)

Chirwere chechiropa uye kukuvara kweitsvo kunokonzerwa nechirwere cheshuga (chirwere cheshuga nephropathy) kunogona kuita kuti munhu awedzere kukura ATN.

ATN inogona zvakare kukonzerwa nemishonga ine chepfu kune itsvo. Iyi mishonga inosanganisira aminoglycoside antibiotics uye antifungal drug amphotericin.

Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Kupera kuziva, coma, delirium kana kuvhiringidzika, kukotsira uye kuneta
• Yakadzikira weti kubuda kana pasina weti kuburitsa
• Kazhinji kuzvimba, kuchengetedza kwemvura
• Nausea, kurutsa

Anopa hutano anoita bvunzo dzepanyama. Iye mupi anogona kunzwa manzwi asina kujairika kana achiteerera kumoyo nemapapu aine stethoscope. Izvi zvinokonzeresa kuwanda kwemvura mumuviri.

Miedzo inogona kuitwa inosanganisira:

• BUN uye serum creatinine
• Fractional excretion yesodhiya
• Itsvo biopsy
• Kuongorora urinal
• Weti sodium
• Weti yakatarwa giravhiti uye weti osmolarity

Muvanhu vazhinji, ATN inodzoserwa. Chinangwa chekurapa ndechekudzivirira hupenyu hunotyisidzira matambudziko eakanyanya itsvo kutadza

Kurapa kunotarisa kudzivirira kuwanda kwemvura uye marara, nepo uchibvumira itsvo kupora.

Kurapa kunogona kusanganisira chero chinotevera:

• Kuziva nekurapa chinokonzera chinetso
• Kurambidza kudya kwemvura
• Kutora mishonga kubatsira kudzora potasiamu muropa
• Mishonga inotorwa nemuromo kana kuburikidza neIV kubatsira kubvisa zvinoyerera kubva mumuviri

Yediki dialysis inogona kubvisa yakawandisa marara uye zvinwiwa. Izvi zvinogona kubatsira kuvandudza zviratidzo zvako kuti unzwe zvirinani. Izvo zvinogona zvakare kuita kuti itsvo kutadza kuve nyore kudzora. Dialysis inogona kunge isingadiwe kuvanhu vese, asi inowanzo kuponesa hupenyu, kunyanya kana potasium ine ngozi zvine ngozi.

Dialysis inogona kudikanwa mune inotevera kesi:

• Kuderera kwepfungwa
• Urume hwakawanda
• Kuwedzera kwe potassium level
• Pericarditis (kuzvimba kwesaga-kunge kufukidza kutenderedza moyo)
• Kubviswa kwehupfu hunokuvadza kune itsvo
• Kwose kushomeka kwekugadzira weti
• Isingadzorwi buildup yenitrogen marara zvigadzirwa

ATN inogona kugara kwemazuva mashoma kusvika kumavhiki matanhatu kana kupfuura. Izvi zvinogona kuteverwa ne1 kana maviri mazuva ekugadzira yakawandisa yakawanda weti sezvo itsvo dzichipora. Itsvo basa rinowanzo dzokera pane zvakajairwa, asi panogona kunge paine mamwe matambudziko akakomba nematambudziko.

Fonera mupiki wako kana weti yako ikadzika ikadzikira kana kumira, kana kana iwe ukaita zvimwe zviratidzo zveATN.

Kukurumidza kurapa mamiriro anogona kutungamira kudzikira kweropa kuyerera pamwe nekudzikira okisijeni kune itsvo kunogona kudzora njodzi yeATN.

Kuwedzerwa ropa kunoenzanisirwa kudzikisa njodzi yekusawirirana.

Chirwere cheshuga, kusagadzikana kwechiropa, uye matambudziko emoyo anoda kutarisirwa zvakanaka kudzikisa njodzi yeATN.

Kana iwe uchiziva kuti uri kutora mushonga unogona kukuvadza itsvo dzako, bvunza mupiki wako nezvekutariswa kwako huwandu hweropa remushonga.

Inwa mvura zhinji mushure mekuita chero madhayi ekusiyanisa kuti vabvumirwe kubviswa mumuviri uye kudzikisira njodzi yekukuvara kweitsvo.

Necrosis - itsvo tubular; ATN; Necrosis - yakaoma chubhu

• Itsvo anatomi
• Itsvo - kuyerera kweropa uye weti

Turner JM, Coca SG. Acute tubular kukuvara uye acute tubular necrosis. Mune: Gilbert SJ, Weiner DE, eds. National Kidney Foundation Primer pane itsvo Zvirwere. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 32.

Weisbord SD, Palevsky PM. Kudzivirira uye manejimendi yeakanyanya itsvo kukuvara. 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 29.