Yiyiphi i-Nephrologist kwaye nini kufanele uyibone enye?
Ama-Nephrologists ngamagqirha anesigxina ekuxilongweni nasekupheni izifo zesifo. Ziziphi iimeko eziphathiswe ngugqirha wezintso, kwaye nini ukuthunyelwa kwelinye leengcali ezifunekayo?
Izifo Zengqondo ngokubanzi
Ukuba awuzange uve nge-nephrology (isifundo sesifo sesifo) ngaphambili, akumangalisi. Izifo zesifo esingasigxina (CKD) ngokuqhelekileyo zibizwa ngokuthi "umbulali ongenangqondo," abantu abaninzi banempawu ezinobungozi okanye kungekho zibonakaliso xa zifunyaniswa.
Kukho amagama amaninzi ahlukeneyo angasetyenziselwa ukuchaza isifo seesifo esinokubangela ukudideka. Njengoko kuphawuliwe ngasentla, iiNafrologists ziogqirha abaphatha isifo sesifo, ngegama lesiGrike elithi "nephros" elithetha intsholongwane. Unokuva kwakhona isigama sesifo sokuguqulwa esetyenziswayo ukuchaza iingxaki zeengtso. Igama elithi renal livela kwisiqhamo saseLatini "renes" esithetha izintso.
Ziziphi iindidi zonyango ezinokuchaphazela izintso zakho, zeziphi ezinye iimpawu eziqhelekileyo, kwaye xa kufuneka uthunyelwe kwi-nephrologist? Izifundo zibonisa ukuba ukulibazisa ukutyelela kwi-nephrologist kunokunyusa umngcipheko weengxaki okanye nokufa, ngoko lo ngumbuzo obalulekileyo.
Imiqathango Elandelwa yiiNtsingwane zeeNtshi (i-Nephrologists)
Oogqirha beezintso banakekele abantu abaninzi beentlobo ezahlukeneyo zesifo sezintso kubandakanya:
- Ukulimala kweentliziyo eziqhelekileyo: Izifo zesifo esiswini zibhekiselele ekuhambeni kokukhawuleza kwesifo seengso ngokubhekiselele kwiziganeko ezifana nokutshatyalaliswa (ukunciphisa igazi lokutshatyalaliswa kweengso), ukungcola, okanye iingxaki zeengtso ezinxulumene nokuhlinzwa
- Ukungaphumeleli kwimizimba engapheliyo: Isifo esingasigxina sesifo singabangela iimeko ezininzi ezahlukeneyo (jonga ngezantsi)
- Amatye eentso: Kukho iintlobo ezahlukeneyo zamatye ezintso ezinokuthi zingabangela okanye zingabangeli iimpawu
- Izifo zentsholongwane (i-pyelonephritis): Igama elithi "ukusuleleka kwe-urinary tract" libhekiselele kwimimandla yeemeko ezivela kwiibhaktheriya kumchamo, ukuya kwiintsholongwane zesifo se-bladder, kwiintsholongwane ( pyelonephritis )
Kukho uluhlu olubanzi lweengxaki zonyango ezinokuchaphazela izintso ngezindlela ezahlukeneyo. Ezinye zeemeko eziqhelekileyo ezingabangela ukuhluleka kwezintso zibandakanya:
- Isifo sikashukela ( isifo senesifo seesifo sikashukela ): I- diabetes yimbangela ebangela ukuhluleka kwezintso eUnited States
- Izifo zesifo ezinxulumene nokuxinzelelo lwegazi kunye nesifo senhliziyo ( cardiorenal syndrome )
- Ukunyanya
- Izifo zengqondo ezingapheliyo
- Amatye eentso ezibangela ukuphazamiseka
- Ukuzalwa kwama-Congenital (ukusuka ekuzalweni) iingxaki zeengtso ezinjengeenkomo zamahashe
- I-Glomerulonephritis: I-Glomerulonephritis kukuvuvukala kweentso ezingabangelwa yinkalo yeenkqubo ezahlukeneyo, kubandakanywa ne-bhakteriya ebangela ukuba i-strep throat.
- Izifo zesifo ezinxulumene ne-lupus ( lupus nephritis )
- Isifo sezintso zePolycystic: Izifo zesifo seengqondo zifa, nangona ubunzima besifo, kunye nobudala bokuqala, bunokuhluka
- Izifo ezizimela ngokuzenzekelayo ezifana ne-IgA nephropathy
- Ukungaphumeleli kweengso kwisifo sesibindi (i- hepatorenal syndrome )
Isifo sesifuba esingapheli sichazwa ngamagangatho ama-5 esekelwe ubunzima besifo. Ukungaphumeleli kweentso zeBanga 1 kubhekisela kwizifo ezintle, kanti ukuhluleka kweengqungquthela ze-5 kubonisa ukuba i-dialysis okanye ukutshintshwa kweengtso kuya kufuneka.
Ukongezelela ekulawuleni iingxaki zeengtso (ukuzama ukulungisa imeko okanye ukuyikhusela ukuba ingadluli), oogqirha bezintso baphatha iimpawu ezihlala zihambelana nezifo zengqondo, ezifana nokuphazamiseka kwe-electrolyte (ingakumbi iingxaki ngezinga le-potassium) kunye negazi eliphezulu.
Iimpawu zezifo zengqondo
Ukuze uqonde iimpawu eziqhelekileyo zesifo seengtso, kunceda ukuphonononga isakhiwo kunye nomsebenzi wezintso . Izintso zakho zifumaneka kwiintlanti zakho, kufuphi nomqolo wakho. Ukulimala kumqolo wakho okanye kwicala elingaphantsi kwesihlunu sakho kunokubangela ukulimala ezintso zakho. Izintso zakho zenza imisebenzi emininzi ebalulekileyo. Ezi ziquka ukucoca igazi lakho ukususa i-toxins, ukugcina amanqanaba afanelekileyo e-electrolytes (njenge-sodium ne-potassium) ukuqinisekisa ukusetyenziswa kakuhle kweeseli zakho, nokugcina ukulinganisela kwamanzi emzimbeni wakho.
Ukuba usuke ungciniwe, iintsho zakho ziqala ukusebenza ukubuyisela isimo sesimo somzimba kumzimba wakho, kodwa ukulimala kweengtso kungenzeka ngexesha elide okanye elibi kakhulu. Ukuba iintso zakho zingasebenzi kakuhle, izinga le-sodium ne-potassium emzimbeni wakho lungachaphazeleka. Iingxaki ze-Electrolyte ezinezifo zengqondo zingabonakali, ekubeni ixabiso le potassium liyimfuneko ekusebenzeni kakuhle kwentliziyo yakho, iingxaki zeengtso zingakhokelela kwisimo sengqondo esingavamile.
Ingcinezelo yegazi engaqhelekanga, nokuba iphakamileyo okanye iphantsi ingabangela ukulimala kwezintso. Ukulimala kweentso, kwakhona, kunokubangela iingxaki ngokulawula uxinzelelo lwegazi.
Iinjongo nazo zijongene nokwenza ihomoni echaphazelekayo kwimveliso yeeseli ezibomvu zegazi. Ngenxa yesi sizathu, isifo sesifo singabangela ukuba i- anemia , inani elincinci le-cell red.
Abanye abantu baneengxaki ze-urinary, ezifana nobunzima bokuchama. Ngamanye amaxesha abantu banomvandedwa weentlungu, ngenxa yeendawo zeentso. Amatye eentso angazixela ngentlungu enzima efaniswa nokubeleka kodwa ingaba khona ngaphandle kwentlungu.
Izibonakaliso ezingabonakaliyo okanye ezingacacanga ziqhelekileyo, kwaye isizathu sokuba ufanele ubone ugqirha wakho nokuba awukwazi ukuchaza kakuhle iimpawu zakho. Ezi zibandakanya ukukhathala, ukulala, okanye ukunambitha kwentsimbi emlonyeni wakho.
Ekuqaleni kunye nezifo zengqondo, kwaye ngamanye amaxesha kunye nezifo ezintle zesifo, abantu banokuba nemiqondiso embalwa. Enyanisweni, uphawu oluqhelekileyo lwesifo sesifo asinayo impawu !
Ukuchonga izifo zengqondo
Kukho iintlobo ezahlukeneyo zeemvavanyo ezingenziwa ukwenzela ukukhenkcela nokulandela iingxaki zeengtso. Ezi ziquka ukuhlolwa kwegazi (njenge- BUN (igazi urea nitrogen), i-cr (creatinine), kunye ne-GFR (izinga lokuhlanjululwa kwe-glomerular)), iimvavanyo zomchamo (ngokukodwa zikhangela iproteinuria ), kunye neemvavanyo zokucinga ezifana ne-CT, iMRI, ne-IVP.
Ixesha elihle lokubona uNogrologist
Ixesha elona lungcono ukubona i-nephrologist ngokuqinisekileyo iyahlukahluka ngokwemiqathango ethile. Oko kwathiwa, kufanele ukuba ubonwe ngumbono we-nephrologist xa i-creatinine yakho iphakamileyo ngokwaneleyo kuthiwa yi-CKD Stage 4. Oku kuthetha ukuba i-GFR ingaphantsi kwama-30.
Kubaluleka kokubhekiswa kwi-Nephrologist
Andiyi kugxininisa ukubaluleka kokuthunyelwa kwi-nephrologist kuba ndingomnye. Enyanisweni, uphando oluninzi lwezonyango luye lwabonisa ngokucacileyo ukuba izigulane ezithunyelwa ngokukhawuleza kuma-nephrologists zinokufa, okanye ziqhubela phambili kwi-dialysis!
Izinto ezijongene nobungozi beSifo seNtliziyo
Ekubeni isifo sengqondo singasilungelelanisi phambi kokuba iimpawu zikhoyo, kubalulekile ukuba ube nesicatshulwa esiphakamileyo sokusola kwaye uqaphele iimeko ezikubeka kwisifo seengtso. Abantu abasemngciphekweni omkhulu wokuphulukana kwenkunkuma kubandakanya abo:
- Sikashukela
- Umxhasi wegazi ophezulu
- Izifo zentliziyo ezifana nesifo se-coronary disease, okanye ukuhluleka kwentliziyo ye-congestive
- Ezinye izifo ze-vascular ezifana nesifo se-cerebrovascular (strokes) kunye nesifo se-vascular dispersion (njengama-aneurysms aortic)
- Imbali yentsapho yesifo seengtso
- Ukusetyenziswa ixesha elide leziyobisi ezingekho-steroidal ezichasayo (i-NSAIDS) njenge-Advil (ibuprofen) kunye neCelebrex
Unyango
Unyango lwezifo zengqondo ziyahluka ngokubanzi ngokusekelwe kwimbangela ethile. Xa umsebenzi wezintso uncitshiswa kakhulu umntu unokufuna i- dialysis yokuhluleka kwezintso okanye ukutshintshwa kwezintso.
Ukuba nguMmeli Wakho Ngamazinyo zakho
Xa kuziwa kwisifo seengtso, ukufumana ngokuphindaphindiweyo akunakwenzeka xa i-GFR yakho ihlala iyanqatshelwe kwizigaba eziphambili. Ngako oko, kugxininiswa ngokwenene kulukhuseleko. Ngexesha elizayo xa ubona ugqirha wakho uyaqiniseka ukuba uxoxe ngeziphumo ze-GFR yakho kwaye ubuze ukuba kufuneka ubonwe yingcali.
Ngaphantsi kwindlela yokujonga iDokotela weeNtliziyo
Ixesha elifanelekileyo lokubona ugqirha wezintso ziya kuhluka ngokusekelwe kwintsebenzo yezintso, imeko ethile yokugonywa, kunye nezinye izinto ezinobungozi. Kubonakala ukuba ukudluliselwa ekuboneni i-nephrologist kufuneka ithathelwe ingqalelo kwiCr ephakamileyo (isigaba 4) okanye i-GFR ngaphantsi kwama-30, kodwa abanye abantu kufuneka babone ugqirha wengqondo ngokukhawuleza. Ekubeni ukubonisana ngexesha elifanelekileyo kunye nephrologist kuhambelana nokusinda, kukulungele ukuphambuka kwicala lokubona omnye wala ogqirha ngaphambili kunokuba kamva.
> Imithombo:
> Kim, D., Kim, M, Kim, H. et al. Ukubhekiswa kwangaphambili kwi-Nephrologist Ukuphucula ukuPhelelwa kweMonde: IsiFundo esiPhambili seChort Study for Stage-Stage Dalase Disease eKorea. PLoS One . 2013. 8 (1): e55323.
> Smart, N., Dieberg, G., Ladhani, M., kunye noT. Titus. Ukudluliselwa kwangaphambili kwiingcali zeNefrology IiNkonzo zokuKhusela ukuPhucula ukuPhelelwa kweSifo seSifo. Idatha yeCchrane yeeNkqubo eziPhezulu . 2014. (6): CD007333.
> Smart, N., noT. Titus. Iziphumo zokuqala ngokubhekiselele kwixesha elidlulileyo le-Nephrology Ukudluliselwa kwiSifo esingasigxina seNtsholongwane: UkuHlola okuHlolo. I-American Journal of Medicine . 2011. 124 (11): 1073-80.e2.