Matanho eChirwere cheItsvo Chisingaperi
Zvemukati
- Ongororo yematanho
- Glomerular filtration chiyero (GFR)
- Chikamu 1 chirwere cheitsvo
- Zviratidzo
- Kurapa
- Stage 2 chirwere cheitsvo
- Zviratidzo
- Kurapa
- Stage 3 chirwere cheitsvo
- Zviratidzo
- Kurapa
- Stage 4 chirwere cheitsvo
- Zviratidzo
- Kurapa
- Stage 5 chirwere cheitsvo
- Zviratidzo
- Kurapa
- Hemodialysis
- Peritoneal dialysis
- Makiyi ekutora
Itsvo dzine mabasa mazhinji akakosha kuhutano hwakanaka. Ivo vanoita se mafirita eropa rako, kubvisa tsvina, chepfu, uye zvinowedzera zvinwiwa.
Ivo vanobatsirawo ku:
- gadzirisa BP uye makemikari eropa
- chengetedza mapfupa ane hutano uye kukurudzira kugadzirwa kwemasero matsvuku eropa
Kana iwe uine chirwere chisingaperi cheitsvo (CKD), wave nekukuvara kuitsvo dzako kweinopfuura mwedzi mishoma. Itsvo dzakakuvara hadzisefa ropa sezvazvinofanira kuita, izvo zvinogona kutungamira kune kwakasiyana kunetseka kwehutano.
Kune zvikamu zvishanu zveCKD uye zvakasiyana zviratidzo uye kurapwa kunoenderana nedanho rega rega.
Centers for Disease Control and Prevention (CDC) inofungidzira kuti vakuru veU.S. Vane CKD, asi vazhinji havana kuongororwa. Icho chiitiko chinofambira mberi, asi kurapwa kunogona kuchinonoka. Haasi munhu wese anoenderera mberi kukundikana kwetsvo
Ongororo yematanho
Kugovera danho reCKD, chiremba wako anofanira kuona kuti itsvo dzako dziri kushanda zvakadii.
Imwe nzira yekuita izvi ndeyeyeti yekuyera kuongorora yako albin-creatinine ratio (ACR). Inotaridza kana mapuroteni achidonha mukati merini (proteinuria), chinova chiratidzo chekukuvara kweitsvo.
ACR mazinga akaiswa seinotevera:
A1 | yakaderera pane 3mg / mmol, yakajairwa kune yakapfava kuwedzera |
A2 | 3-30mg / mmol, kuwedzera zvine mwero |
A3 | yakakwirira kupfuura 30mg / mmol, kuwedzera kwakanyanya |
Chiremba wako anogona zvakare kuraira bvunzo dzekufungidzira, senge iyo ultrasound, kuongorora chimiro cheitsvo dzako.
Kuongororwa kweropa kuyera creatinine, urea, uye zvimwe zvigadzirwa muropa kuti uone kuti itsvo dzinoshanda sei. Izvi zvinonzi inofungidzirwa glomerular filtration rate (eGFR). GFR yemazana mL / min yakajairika.
Iyi tafura inoratidza matanho mashanu eCKD. Rumwe ruzivo nezve imwe nhanho inotevera tafura.
Chikamu | Tsananguro | GFR | Percent yeitsvo basa |
1 | zvakajairika kune itsvo inoshanda zvakanyanya | > 90 mL / min | >90% |
2 | kuderera kuderera mukushanda kwetsvo | 60–89 mL / min | 60–89% |
3A | zvinyoro-kusvika-zvine mwero kuderera kweitsvo basa | 45-59 mL / min | 45–59% |
3B | zvinyoro-kusvika-zvine mwero kuderera kweitsvo basa | 30–44 mL / min | 30–44% |
4 | kuderera kwakanyanya mukushanda kwetsvo | 15–29 mL / min | 15–29% |
5 | itsvo kutadza | <15 mL / min | <15% |
Glomerular filtration chiyero (GFR)
GFR, kana glomerular filtration rate, inoratidza kuwanda kweropa rako itsvo mukati meminiti imwe.
Iyo nzira yekuverenga GFR inosanganisira kukura kwemuviri, zera, bonde, uye dzinza. Pasina humwe humbowo hwematambudziko eitsvo, GFR yakaderera se60 inogona kutariswa seyakajairika.
Zviyero zveGFR zvinogona kutsausa kana, semuenzaniso, iwe uri muvaki wemuviri kana uine dambudziko rekudya.
Chikamu 1 chirwere cheitsvo
Muchikamu chekutanga, pane kukuvara kwakapfava kune itsvo. Ivo vanonyatso kuchinjika uye vanogona kugadzirisa izvi, vachivabvumidza kuramba vachiita pa90 muzana kana zvirinani.
Panguva ino, CKD inogona kunge yakawanikwa netsaona panguva yekujairidzwa kweropa uye neweti. Iwe unogona zvakare kuve neiyi bvunzo kana iwe uine chirwere cheshuga kana yakakwira BP, zvikonzero zvepamusoro zveCKD muUnited States.
Zviratidzo
Kazhinji, hapana zviratidzo kana itsvo dzichishanda pa90 muzana kana zvirinani.
Kurapa
Iwe unogona kudzora kufambira mberi kwechirwere nekutora matanho aya:
- Shanda pakubata mashuga eropa kana uine chirwere cheshuga.
- Tevedza rairo yechiremba wako yekudzikisa BP kana iwe uine hypertension.
- Chengetedza chikafu chine hutano, chakaringana.
- Usashandise fodya.
- Shingairira kuita zvekuita zvemuviri kwemaminitsi makumi matatu pazuva, kana mazuva mashanu pasvondo.
- Edza kuchengetedza huremu hwakakodzera hwemuviri wako.
Kana usati watoona nyanzvi yeitsvo (nephrologist), bvunza chiremba wako kuti akuendese kune imwe.
Stage 2 chirwere cheitsvo
Muchikamu chechipiri, itsvo dziri kushanda pakati pe60 uye 89 muzana.
Zviratidzo
Panguva ino, iwe unogona kunge uchiri chiratidzo chisina. Kana zviratidzo hazvina kunyatsojeka, senge:
- kuneta
- kuvava
- kurasikirwa nenzara
- matambudziko ekurara
- kushaya simba
Kurapa
Inguva yekuvandudza hukama nehunyanzvi hweitsvo. Iko hakuna mushonga weCKD, asi kurapwa kwekutanga kunogona kunonoka kana kumisa kufambira mberi.
Zvakakosha kugadzirisa chinokonzera chikonzero. Kana iwe uine chirwere cheshuga, BP, kana chirwere chemwoyo, tevera mirairo yechiremba wako yekugadzirisa aya mamiriro.
Zvakakoshawo kuchengetedza kudya kwakanaka, kugara uchirovedza muviri, uye kugadzirisa huremu hwako. Ukasvuta, bvunza chiremba wako nezve mapurogiramu ekurega kusvuta.
Stage 3 chirwere cheitsvo
Chikamu 3A zvinoreva kuti itsvo yako iri kushanda pakati pe45 ne 59 muzana. Chikamu 3B zvinoreva kuti itsvo inoshanda iri pakati pe30 ne44 muzana.
Itsvo hadzisi kusefa marara, chepfu, uye zvinwiwa zvakanaka uye izvi zviri kutanga kuvaka.
Zviratidzo
Haasi munhu wese ane zviratidzo padanho re3. Asi iwe unogona kuve uine:
- kurwadziwa shure
- kuneta
- kurasikirwa nenzara
- kuramba uchichiva
- matambudziko ekurara
- kuzvimba kwemaoko nemakumbo
- kuita weti zvakanyanya kana zvishoma pane zvakajairwa
- kushaya simba
Zvinetso zvinogona kusanganisira:
- kupererwa neropa
- chirwere chepfupa
- BP
Kurapa
Izvo zvakakosha kugadzirisa zviri pasi pemamiriro ekubatsira kuchengetedza itsvo kushanda. Izvi zvinogona kusanganisira:
- kuwedzera kweropa mishonga yakadai seangiotensin-inoshandura enzyme (ACE) inhibitors kana angiotensin II receptor blockers
- diuretics uye yakaderera munyu chikafu kuti usunungure kuchengetedza kwemvura
- cholesterol-kudzikisa mishonga
- erythropoietin inowedzera kushomeka kweropa
- vitamini D inowedzera kugadzirisa mapfupa asina simba
- phosphate binders kudzivirira calcification mumidziyo yeropa
- uchitevera wakaderera mapuroteni chikafu saka itsvo dzako hadzifanirwe kushanda zvakaoma
Iwe ungangoda kazhinji kushanya kwekutevera-kumusoro uye bvunzo kuitira kuti zvigadziriswe zviitwe kana zvichidikanwa.
Chiremba wako anogona kukuendesa kune chiremba wezvekudya kuti ave nechokwadi chekuti uri kuwana zvese zvinovaka muviri zvaunoda.
Stage 4 chirwere cheitsvo
Chikamu chechina chinoreva kuti une kukuvara kweitsvo kusvika pakati. Vari kushanda pakati pegumi neshanu nepfumbamwe muzana, saka unogona kunge uchivaka marara akawanda, chepfu, uye zvinwiwa mumuviri wako.
Izvo zvakakosha kuti iwe uite zvese zvaunogona kudzivirira kufambira mberi kune itsvo kutadza.
Sekureva kweCDC, yevanhu vane itsvo yakadzikira zvakanyanya havatoziva kuti vanayo.
Zviratidzo
Zviratidzo zvinogona kusanganisira:
- kurwadziwa shure
- kurwadziwa pachipfuva
- yakadzikira kupinza kwepfungwa
- kuneta
- kurasikirwa nenzara
- mhasuru kana kukakavara
- kusvotwa uye kurutsa
- kuramba uchichiva
- mweya wekufema
- matambudziko ekurara
- kuzvimba kwemaoko nemakumbo
- kuita weti zvakanyanya kana zvishoma pane zvakajairwa
- kushaya simba
Zvinetso zvinogona kusanganisira:
- kupererwa neropa
- chirwere chepfupa
- BP
Iwe zvakare uri panjodzi yekuwedzera yehosha yemoyo uye sitiroko.
Kurapa
Muchikamu chechina, iwe uchafanirwa kushanda zvakanyanya pamwe nachiremba wako. Pamusoro pekurapwa kumwechete sematanho ekutanga, iwe unofanirwa kutanga hurukuro nezve dialysis uye kuisirwa itsvo kana itsvo dzako dzikundikana.
Maitiro aya anotora zvakarongeka kurongeka uye yakawanda nguva, saka zvine hungwaru kuve nehurongwa munzvimbo ikozvino.
Stage 5 chirwere cheitsvo
Stage 5 zvinoreva kuti itsvo dzako dziri kushanda zviri pasi pegumi neshanu muzana muzana kana iwe uine kukundikana kwetsvo.
Kana izvozvo zvikaitika, kuwanda kwemarara uye chepfu kunoisa upenyu pangozi. Iyi ndiyo yekupedzisira-nhanho renal chirwere.
Zviratidzo
Zviratidzo zveitsvo kutadza zvinogona kusanganisira:
- musana uye kurwadziwa pachipfuva
- matambudziko ekufema
- yakadzikira kupinza kwepfungwa
- kuneta
- zvishoma kusvika pakudya
- mhasuru kana kukakavara
- kusvotwa kana kurutsa
- kuramba uchichiva
- kunetseka kurara
- kushaya simba kwakanyanya
- kuzvimba kwemaoko nemakumbo
- kuita weti zvakanyanya kana zvishoma pane zvakajairwa
Ngozi yechirwere chemwoyo uye sitiroko iri kukura.
Kurapa
Paunenge uchinge uine kukwana kwakakwana kweitsvo, tarisiro yehupenyu ingori mwedzi mishoma isina dialysis kana itsvo kuisazve.
Dialysis haisi mushonga wehosha yeitsvo, asi maitiro ekubvisa marara uye mvura kubva muropa rako. Kune mhando mbiri dzedialysis, hemodialysis uye peritoneal dialysis.
Hemodialysis
Hemodialysis inoitwa pane dialysis nzvimbo pane yakatarwa purogiramu, kazhinji katatu pavhiki.
Pamberi pekurapwa kwese, tsono mbiri dzinoiswa muruoko rwako. Iwo akasungirirwa kune dialyzer, iyo dzimwe nguva inonzi seyakagadzirwa itsvo. Ropa rako rinopomberwa nepasefa ndokudzoserwa mumuviri wako.
Unogona kudzidziswa kuti uite izvi kumba, asi zvinoda nzira yekuvhiya kugadzira vein kuwana. Imba dialysis inoitwa kazhinji kazhinji kupfuura dialysis munzvimbo yekurapa.
Peritoneal dialysis
Kune peritoneal dialysis, iwe unenge uine catheter yekuvhiya yakaiswa mudumbu rako.
Munguva yekurapwa, dialysis solution inoyerera nepasefaeti ichienda mudumbu, mushure meizvozvo iwe unogona kuenda nezve rako rakajairika zuva. Maawa mashoma gare gare, unogona kukwevera iyo catheter muhombodo uye woirasa. Izvi zvinofanirwa kudzokororwa 4 kana katanhatu pazuva.
Kuisa itsvo kunosanganisira kutsiva itsvo yako nehutano. Itsvo dzinogona kubva kune vapenyu kana vakafa vanopa. Iwe hauzodi dialysis, asi uchafanirwa kutora anti-kurambwa mishonga kweupenyu hwako hwese.
Makiyi ekutora
Pane zvikamu zvishanu zvechirwere cheitsvo chisingaperi. Matanho akatsanangurwa neropa uye weti bvunzo uye chiyero chekukuvara kweitsvo.
Kunyange chiri chirwere chiri kufambira mberi, havazi vese vanoenderera mberi nekukudziridza itsvo kutadza.
Zviratidzo zvechikamu chekutanga cheitsvo chirwere chiri munyoro uye chinogona kurerutswa nyore. Ndosaka zvakakosha kuti ugare uchiongororwa kana uine chirwere cheshuga kana BP, zvikonzereso zvechirwere cheitsvo.
Kutanga kuongororwa uye manejimendi emamiriro ezvinhu aripo kunogona kubatsira kunonoka kana kudzivirira kufambira mberi.