Ukungaphumeleli kwe-renal ngokukhawuleza yilahleko yentsholongwane yenkomo. Yimimiselo eyenza ngokukhawuleza kwixesha leeyure okanye iintsuku eziliqela kwaye ngokuqhelekileyo ivela kubantu abagula kakhulu kwaye sele besesibhedlele.
Njengoko iintso ziyeka ukusebenza, iimveliso zentengiso ekufuneka zihlanjululwe kwigazi ziqala ukuqokelela, ukucima iimpawu ezibandakanya ukucuthwa, ukunciphisa umoya, ukuphefumula, nokuvuvukala ngenxa yokugcinwa kwamanzi.
Ezinye iimeko ze-ARF ziza kuba nezimpawu ezinqabileyo ezingabonakali. Abanye banokuba nzima kwaye basongela ubomi.
Iimpawu Zamaxesha amaninzi
Ukungaphumeleli kwe-renal (ARF) , ebizwa ngokuba yi-AKI), ayisoloko idala iimpawu kwaye ingafumaneka kuphela kwiimvavanyo zelabhu okanye utshintsho olusuka kamsinya kwi-urinary output. Xa kubonakala iimpawu, bavame ukwenza njalo ngaphakathi kweveki yokukhubazeka okanye ukulimala kwaye ngamanye amaxesha kwiiyure.
Iziganeko ezininzi zeempawu ze-ARF zihlobene nemeko eyaziwa ngokuba yi-uremic encephalopathy apho ukuqoqwa kwe- urea , i- creinine kunye nezinye izinto eziphazamisekile kwigazi, ezingathinti imisebenzi yenyama kuphela kodwa neenkqubo zengqondo, ngokunjalo.
Ezinye iimpawu zibangelwa ukungalingani kwi- potassium okanye kumanqanaba amanzi achaphazela ngqo intliziyo, ukujikeleza kunye negazi.
Iimpawu eziqhelekileyo kunye neempawu ze-ARF zingabandakanya:
- Ukwenyuka komchamo
- Ukuvuvuka kwemilenze, amaqaqa, kunye neenyawo (i- edema )
- Ukuphefumula ( dyspnea )
- Ukukhathala
- Ukuphelelwa kwesidlo
- Isihlunu kunye nokuhlanza
- Iintliziyo ezingavamile (i- arrhythmia )
- Intlungu yesifuba okanye uxinzelelo
- Ukusuka okulula okanye okungavamile (okubangelwa iiplatelet eziphantsi )
- Ukudideka
- Ukuxhamla
- Coma
Iziganeko ezinzima zingakhokelela ekufeni, ngenxa yeengxaki ze- sepsis , ukungaphumeleli kokuphefumula, okanye ukuhluleka kwamalungu amaninzi.
Umngcipheko wokufa ukhulu xa ukuhluleka kwezinso kubangelwa ukuxhatshazwa, ukusuleleka, okanye ukuhlinzwa (ngokuyinhloko ukuhlinzwa kwengqondo).
Izimpawu ze-ARR ze-Prerenal
Ukungaphumeleli kwe-renal echaphazelekayo kunokwenzeka nokuba kukho naziphi na izizathu kodwa kubalwa ngokubanzi njenge-prerenal (kubangelwa ukuhla kwegazi kwiintliziyo zombini), ukungena ngaphakathi (kubangelwa ukulimala kweentso), okanye i-postrenal (ngenxa yexesha eliqhelekileyo kwi-urinary tract obstruction ).
Nangona nganye iya kubakhokelela kwisiphumo esifanayo-ukwakhiwa kwenkunkuma engcolileyo emzimbeni-ukukhubazeka kwangaphakathi kuza kuthwala iimpawu zazo, apho i-ARF iza kuthathwa njengengxaki.
Izizathu eziqhelekileyo zezizathu zokuqala ze-ARF (eyaziwa nangokuthi i-prerenal azotemia) zichithwa ngamandla, ukungaphumeleli kwintliziyo , kunye ne- cirrhosis yesibindi , zonke izinto ezingaphazamisa ukuhamba kwegazi kwiintso. Izizathu ezingundoqo zihlala zihlukana ngokweempawu zabo.
Imizekelo yale nto ibandakanya:
- Izimpawu ezinzima zokudambisa umzimba zingabonakalisa amehlo aqhekekileyo, isikhumba esomileyo, ukuncipha kwesikhumba, ukunyuka komlomo kunye nomso, intliziyo ye-speed speed (i- tachycardia ), kunye nesimo sezulu okanye ukukhanya ngokukhawuleza xa uhleli okanye uhleli ( hypotension orthostatic hypotension ).
- Iimpawu zengqondo yokuhluleka kwintliziyo zingabandakanyeka iintsholongwane zentamo, ukukhahlela okanye ukubetha izandi kwimiphaphu (i-pulmonary rales), i-tachycardia, i-heartpress, i-short breath breathing, ukukhukhuma kwesisu ( ascites ), kunye nokukhwehlela okuqhubekayo okanye ukuqhuma i-phlegm .
- Izimpawu zesifo se- cirrhosis zingabandakanya ukunyuka kwamabala, i-yellowing yamehlo nesikhumba (i- jaundice ), imivilini yesisu (spider angioma), i-urine-sweet or ammonia-smelling urine, kwaye ifake imithanjeni emlonyeni wesisu esisuka kwintonga (caput medusae).
Iimpawu ze-ARF zangaphakathi
Iyona nto ibangela ukuba i-ARF yangaphakathi ibonakale yonakalise iimeko ezifana ne-glomerulonephritis, i-necrost tubular acute, kunye nephritis ye-interstitial interstitial.
Phakathi kwezinye zeempawu ezihlukeneyo:
- I-Glomerulonephritis , ukuvuvukala kwemithambo yegazi ezintsheni, kunokubangela iimpawu ezinjengobomvu okanye umchamo wegazi ( hematuria ), umchamo we-foamy ukusuka kwiprotheni engaphezulu ( proteinuria ), kunye nokuvuvukala ubuso, izandla, iinyawo kunye nesisu.
- I-tubular necrosis eqhelekileyo (ATN) , imeko apho izicubu zeengtso ziqala ukufa ngenxa yokungabi naso kwomoya, zingabonakalisa ngeempawu ezinjengeentlungu ezinzulu kunye eziqhubekayo, ukuxhamla imisipha, ukuvalelwa kwezikhonkwane kunye neenaliti ( neuropathy ), jikelele ukuvuvukala komzimba, kunye nokudideka okanye i-delirium.
- I-nephritis eqhelekileyo ye-interstitial (AIN) , ukuvuvukala kwezicubu phakathi kwee-tubules zezintso (ngokuqhelekileyo kubangelwa ukusabela kwezidakamizwa okanye isifo sokuzimela ), kunokuhamba kunye nomkhuhlane, i-hematuria, ukuvuvukala komzimba, ukuhlanza nokudideka ( ukuba unxulumene neziyobisi).
ARF Izimpawu
Iyona nto ibangela ukuba i-ARF ye-postrenal isithintelo somugudu ongabangelwa i-prostate gland ( benign prostatic hyperplasia ), amatye eentso , amatye e-bladder , okanye umdlavuza wezintso , i- vestile okanye i- prostate .
- Izimpawu zeBenign prostatic hyperplasia (BPH) ziquka ukuqhuma emva kokungcola, ukuvuthwa ngokugqithiseleyo ebusuku ( nocturia ), ukuvuthwa rhoqo, ingcamango yokungaphelelanga kwesigxina, ukunyanzeliswa kokuvuthwa ( ukuphuthuma kwe-urinary ) okanye ukukhupha umchamo obuthathaka.
- Izimpawu zeezinso kunye ne-bladder zamatye zibandakanya ubuhlungu obukhulu besisu esiswini okanye i-flank, i-hematuria, i-urine efufayo, ukuvutha komlilo ngexesha lokucoca (i- dysuria ), ubunzima bokuvuthwa, kunye neentlungu okanye ukuphazamiseka kumathambo okanye ipeni kumadoda.
- Izimpawu zomhlaza zingaphinda zibandakanye ukulahleka kwesisindo, i-hematuria, i-dysuria, ukunyanzeliswa kwemigodi, ukunyuka kwamanzi emzimbeni, ukungakwazi ukuvuthwa, iintlungu ezingaphantsi komzimba kunye neentlungu zethambo.
Nini ukubona iDokotela
Ngelixa i-ARF ingenakubangela iimpawu kwaye ifunyanwe kuphela xa kuhlolwa isifo esingahambelaniyo, kukho imiqondiso ethile kunye nesifo esinokubonisa ukuba ukuhluleka kweentso. Xhumana nodokotela wakho xa unamava alandelayo:
- Ukwandiswa kwamanzi kunye nokuvuvukala kwemilenze, ubuso okanye izandla
- Ukuphefumula ngokukhawuleza
- Ukukhathala ngokukhawuleza okanye ukuguqulwa kwamanqanaba emandla
- Ukunciphisa umkhiqizo we-urinary, amaxesha amaninzi kunye nomchamo omnyama kakhulu
- Ukululaza
- Ukuzondla okuqhubekayo okanye okuphindaphindiweyo kunye nobunzima bokukhanya
Nangona le miqondiso ingabangelwa yiphina inombolo yeemeko zonyango, akukho nto ifanele ithathwa njengesiqhelo. Kubalulekile ukuba bahlole.
Ngakolunye uhlangothi, kufuneka ufune unyango olukhawulezileyo xa unamava alandelayo:
- Utshintsho kwinqanaba lokuqonda, kubandakanya ukulala okugqithiseleyo, ubunzima bokuvuka okanye ukuphelelwa amandla
- Iintlungu zesifuba
- Ukuphefumula okunzima
- Ukucabisa kakhulu kunye nokuhlanza
- Ukungakwazi ukuvota
- Ukuphuma kwamanzi kwanoma yimuphi na uhlobo
> Imithombo:
> Rahman, M .; Shad, F .; kunye no-Smith, M. Ulungelelaniso lweezintso eziNyango: Isikhokelo sokuLawula kunye neNgciliso. Amer Fam Phys. 2012; 86 (7): 631-9.
> Hertzberg, D .; Ryden, L .; Pickering, J. et al. Ukulimala kweentso ezinzulu-ukujonga ngokubanzi iindlela zokuxilonga kunye nokulawulwa kweeklinikhi. Iiklinikhi ze-Kidney J. 2017 10 (3): 323-331. INGXELO: 10.1093 / ckj / sfx003.