FSGS ni iki? Ibimenyetso, Impamvu, n'Ubuvuzi

FSGS bivuga Focal Segmental Glomerulosclerosis, indwara y'impyiko ikubita amafiti mato mato yo mu mpyiko yitwa glomeruli. Iyo ufite FSGS, umunyakazi uba mu bice bimwe na bimwe by'aya mafiti, bigatuma impyiko zawe zikora nabi mu gukuraho imyanda n'amazi y'umubiri.

Iyi ndwara ishobora gutera ubwoba iyo uyumvise bwa mbere, ariko gusobanukirwa ibiri kuba mu mubiri wawe bishobora kugufasha kumva ufite ubushobozi bwo kuyirwanya. FSGS irashyira abantu bose mu kaga, nubwo ari cyane cyane mu matsinda amwe, kandi ukoresheje ubuvuzi bukwiye, abantu benshi babaho ubuzima buzira umuze, bakora ibikorwa byabo, mu gihe bayirwanya.

FSGS ni iki?

FSGS ni ubwoko bw'indwara y'impyiko aho umunyakazi uba mu bice bimwe na bimwe by'ibice by'impyiko bicukura imyanda. Tekereza impyiko zawe nk'izifite amamiliyoni y'amafiti mato mato yitwa glomeruli atandukanya imyanda n'ibintu byiza umubiri wawe ukeneye.

Iryo zina rigaragaza neza icyo kibazo: “focal” bivuga ko bimwe gusa muri glomeruli zawe aribyo bikora nabi, “segmental” bivuga ko ibice bimwe gusa bya buri fiti bikora nabi, naho “glomerulosclerosis” bivuga gukora kw'umunyakazi. Uyu munyakazi utuma aya mafiti adakora akazi kayo neza.

Bitandukanye n'izindi ndwara z'impyiko zikubita amafiti yose kimwe, FSGS ikubita ibice bimwe na bimwe. Amwe mu mafiti y'impyiko yawe akora neza mu gihe ayandi akora nabi. Iyi mibare ifasha abaganga mu gihe bakora isuzuma.

Ibimenyetso bya FSGS ni ibihe?

Ikimenyetso cya mbere cya FSGS ni protein mu nkari, ushobora kubona nk'inkari zifite amabumba cyangwa ibinure. Ibi bibaho kuko amafiti y'impyiko yawe yangiritse atangira kureka protein ica, mu gihe yagombye kuyigumisha mu maraso yawe.

Dore ibimenyetso ushobora kugira igihe FSGS ikomeje gutera imbere:

• Inkari zifite amabumba cyangwa ibinure bidashira
• Kubyimbagira mu birenge, mu maguru, cyangwa hafi y'amaso
• Kwiyongera k'uburemere kubera amazi y'umubiri
• Kumva unaniwe kurusha uko bisanzwe
• Kubura ubushake bwo kurya
• Umuvuduko w'amaraso uri hejuru
• Amaraso mu nkari (bihoraho)

Bamwe mu bantu bafite FSGS nta bimenyetso bagira, ariyo mpamvu iyo ndwara rimwe na rimwe iboneka mu isuzuma rya maraso cyangwa inkari. Kubyimbagira bisanzwe bitangira buhoro buhoro kandi bishobora kugaragara cyane mu gitondo cyangwa nyuma yo kwicara cyangwa guhagarara igihe kirekire.

Mu bihe bikomeye, ushobora kugira ikibazo cyo guhumeka, isereri, cyangwa guhinduka mu buryo bwo kwinjira.

Ubwoko bwa FSGS ni ubuhe?

FSGS ifite ubwoko bubiri nyamukuru: ubw'ibanze n'ubwo kubera izindi ndwara. FSGS y'ibanze ibaho iyo iyo ndwara itera ubwayo idakomoka ku zindi ndwara.

FSGS y'ibanze igabanyijemo ubwoko bw'umurage n'ubwo atari umurage. Ubwoko bw'umurage bukomoka mu muryango kandi buterwa n'impinduka mu gene zimwe na zimwe zigira ingaruka ku buryo amafiti y'impyiko yawe akora.

FSGS y'ubwoko bwa kabiri ibaho iyo indi ndwara cyangwa ikintu cyangiza impyiko zawe bikaba byatuma haba umunyakazi. Ubwo bwoko bushobora guterwa n'indwara nk'umugera wa SIDA, imiti imwe na imwe, umubyibuho ukabije, cyangwa izindi ndwara z'impyiko.

Hariho kandi uburyo butandukanye bwo gukora kw'umunyakazi abaganga bashobora kubona muri microscope. Muganga wawe ashobora kuvuga aya magambo, ariko icy'ingenzi ni uko ikibazo cyawe cyihariye gisubiza ubuvuzi.

Impamvu za FSGS ni izihe?

Impamvu nyamukuru ya FSGS y'ibanze akenshi iba itazwi, ibyo bishobora gutera agahinda ariko ntibisobanura ko wakoze ikintu kibisha. Mu bihe byinshi, bigaragara ko bifitanye isano n'ibibazo by'umubiri wawe cyangwa ibintu by'umurage.

Iyo FSGS ikomoka mu muryango, akenshi iterwa n'impinduka mu gene zifasha kubungabunga imiterere y'amafiti y'impyiko yawe. Izi mpinduka z'umurage zishobora guherwa ku babyeyi, nubwo rimwe na rimwe ziba ari impinduka nshya.

FSGS y'ubwoko bwa kabiri ifite impamvu zisobanuka, zirimo:

• Indwara ziterwa na virusi, cyane cyane SIDA
• Imiti imwe na imwe nk'heroin, lithium, cyangwa imiti igabanya ububabare
• Umubyibuho ukabije, cyane cyane igihe umaze igihe kirekire
• Reflux nephropathy iterwa n'indwara zikubita impyiko
• Indwara ya sickle cell
• Izindi ndwara z'impyiko cyangwa ibibazo by'imiterere yazo

Rimwe na rimwe FSGS itera nyuma y'igihe impyiko zawe zikomerekeye indi ndwara. Inkuru nziza ni uko iyo FSGS y'ubwoko bwa kabiri iboneka hakiri kare kandi impamvu yayo ikavurwa, iyangirika ry'impyiko rishobora gukira.

Mu bihe bitoroshye, FSGS ishobora guterwa n'izindi ndwara cyangwa kuba ingaruka y'imiti ikoreshwa mu kuvura kanseri. Muganga wawe azashaka impamvu zose zishoboka mu gahunda y'ubuvuzi bwawe.

Ni ryari ukwiye kujya kwa muganga kubera FSGS?

Ukwiye kuvugana na muganga wawe niba ubona inkari zifite amabumba zidakira nyuma y'umunsi umwe cyangwa ibiri. Nubwo inkari zifite amabumba rimwe na rimwe zishobora kuba bisanzwe, inkari zifite amabumba buri gihe zigaragaza ko hari protein itakaje.

Kubyimbagira kudakira iyo ukiriwe ni ikindi kimenyetso gikomeye ukwiye kuvugana na muganga wawe. Ibi ni byo cyane cyane niba ubona ubwibyo hafi y'amaso yawe mu gitondo cyangwa niba inkweto zawe zikomereye mu gihe zisanzwe zikubereye.

Shaka ubuvuzi vuba niba ufite:

• Kubyimbagira cyane mu maso, mu ntoki, cyangwa mu birenge
• Kubura umwuka cyangwa kubabara mu gituza
• Kugabanuka cyane kw'inkari
• Amaraso mu nkari hamwe n'ibindi bimenyetso
• Kunaniuka bikabije bigira ingaruka ku bikorwa bya buri munsi

Niba ufite amateka y'indwara y'impyiko mu muryango, ni byiza kuvuga ibyo guhinduka mu nkari zawe kuri muganga wawe nubwo bigaragara nk'ibito. Kubimenya hakiri kare bishobora kugira uruhare mu guhangana na FSGS neza.

Ibyago bya FSGS ni ibihe?

FSGS ishobora kubabaza umuntu wese, ariko ibintu bimwe na bimwe bishobora kongera amahirwe yo kurwara iyo ndwara. Imyaka igira uruhare, FSGS iboneka cyane mu bana no mu rubyiruko, nubwo ishobora kubaho mu myaka yose.

Uko ukomoka bigira uruhare mu byago byawe, Abanyamerika b'Abirabura bafite amahirwe menshi yo kurwara FSGS kurusha indi miryango. Iryo kaga rigaragara ko rifite isano n'ibintu by'umurage.

Amateka y'umuryango ni ikindi kintu gikomeye cy'ibyago, cyane cyane ku bwoko bw'umurage bwa FSGS. Niba ufite abavandimwe barwaye indwara y'impyiko, cyane cyane niba yatangiye bakiri bato, ibyago byawe bishobora kuba byinshi.

Ibindi byago birimo:

• Kurwara SIDA
• Umubyibuho ukabije, cyane cyane igihe umaze igihe kirekire
• Amateka yo gukoresha ibiyobyabwenge, cyane cyane ibiyobyabwenge byinjizwa mu mubiri
• Indwara zimwe na zimwe z'umurage nk'indwara ya sickle cell
• Iyangirika ry'impyiko mbere cyangwa indwara
• Gukoresha imiti imwe na imwe igihe kirekire

Kugira ibyago ntibisobanura ko uzahita urwara FSGS, kandi abantu benshi bafite ibyago byinshi ntibarwara iyo ndwara. Mu buryo bunyuranye, bamwe barwara FSGS badafite ibyago byagaragaye.

Ingaruka zishoboka za FSGS ni izihe?

FSGS ishobora gutera ingaruka nyinshi, ariko kuzimenya bifasha wowe n'itsinda ry'abaganga bawe kureba ibimenyetso bya mbere no gufata ingamba zo kwirinda. Ikibazo gikomeye ni iyangirika ry'impyiko rishobora gutuma impyiko zidakora.

Umuvuduko w'amaraso uri hejuru ugaragara cyane muri FSGS kandi ushobora gutuma haba iyangirika ry'impyiko. Niyo mpamvu kugenzura umuvuduko w'amaraso biba ingenzi mu gahunda y'ubuvuzi bwawe.

Ingaruka zisanzwe ushobora kugira harimo:

• Nephrotic syndrome ifite igihombo gikomeye cya protein no kubyimbagira
• Ilipide nyinshi mu maraso
• Ibyago byiyongereye by'amaraso akabana
• Kugira ubudahangarwa buke
• Indwara y'amagufwa kubera impinduka mu mikorere y'impyiko
• Anemia igihe impyiko zidakora neza

Igihombo cya protein muri FSGS rimwe na rimwe gishobora kuba gikomeye ku buryo gitera nephrotic syndrome, aho utakaza protein nyinshi ku buryo umubiri wawe udashobora kubungabunga amazi neza. Ibi bituma habaho kubyimbagira bikomeye n'ibindi bibazo.

Mu bihe bitoroshye, abantu bafite FSGS bashobora kugira ikibazo cyo gucika kw'impyiko, cyane cyane niba iyo ndwara ikomeje kwihuta cyangwa niba hari ibindi bibazo ku mpyiko. Ariko, ukoresheje ubugenzuzi n'ubuvuzi bukwiye, ingaruka nyinshi zishobora kwirindwa cyangwa guhangana nazo neza.

Bamwe mu bantu bafite FSGS baza kenera dialysis cyangwa gutera impyiko, ariko ibyo ntibibaho buri gihe. Abantu benshi bagumana imikorere y'impyiko myiza imyaka myinshi bakoresheje ubuvuzi bukwiye.

FSGS ishobora kwirindwa gute?

Nubwo udashobora kwirinda ubwoko bw'umurage bwa FSGS, hari intambwe ushobora gufata kugira ngo urinde ubuzima bw'impyiko zawe kandi ukaba wakwirinda FSGS y'ubwoko bwa kabiri. Kugumana ibiro byiza bigabanya umutwaro ku mpyiko zawe kandi bigabanya ibyago byo kurwara indwara y'impyiko iterwa n'umubyibuho ukabije.

Niba ufite indwara zishobora gutera FSGS y'ubwoko bwa kabiri, kuyirwanya neza ni ingenzi. Ibi birimo kugumisha SIDA mugenzuwe hakoreshejwe imiti, kugabanya ibiro niba umubyibuho ukabije ari ikibazo, cyangwa guhagarika imiti yangiza impyiko zawe.

Uburyo bwo kurinda impyiko muri rusange burimo:

• Kugenzura umuvuduko w'amaraso n'indwara ya diyabete niba ubaye ufite
• Kunywa amazi ahagije ariko udatakaza amazi menshi
• Kugabanya ibiryo bitetse bifite umunyu mwinshi
• Kudakora cyangwa kureka kunywa itabi niba ubinywa
• Kujya gukorerwa isuzuma buri gihe harimo ibizamini by'imikorere y'impyiko
• Kwitonda ku miti igabanya ububabare idasabwe na muganga

Niba ufite amateka y'indwara y'impyiko mu muryango, inama y'abaganga ku by'umurage ishobora kugufasha gusobanukirwa ibyago byawe no kuganira ku buryo bwo gukora isuzuma.

Ubuvuzi buhoraho ni bwo bwirinzi bwiza, cyane cyane niba ufite ibyago. Kubimenya hakiri kare no kuvura bishobora kugabanya kwihuta kw'indwara y'impyiko igihe iba ibayeho.

FSGS imenyekanwa gute?

Kumenya FSGS bisanzwe bitangira hakoreshejwe ibizamini bisanzwe bigaragaza protein mu nkari cyangwa impinduka mu mikorere y'impyiko. Muganga wawe azategeka ibizamini bya maraso n'inkari kugira ngo apime uko impyiko zawe zikora n'ingano ya protein utakaza.

Biopsy y'impyiko ikenerwa kugira ngo hamenyekane FSGS. Muri uwo muhango, igice gito cy'umubiri w'impyiko gikurwaho kandi kigenzurwa muri microscope kugira ngo harebwe imiterere y'umunyakazi.

Uburyo bwo kumenya busanzwe burimo:

1. Ibizamini by'inkari kugira ngo harebwe protein n'amaraso
2. Ibizamini bya maraso kugira ngo harebwe imikorere y'impyiko n'ibipimo bya protein
3. Kugenzura umuvuduko w'amaraso
4. Ultrasound y'impyiko kugira ngo harebwe imiterere y'impyiko
5. Biopsy y'impyiko kugira ngo hamenyekane neza
6. Isuzuma ry'umurage niba FSGS ikomoka mu muryango ikekwirwa

Muganga wawe ashobora kandi gusuzuma indwara zishobora gutera FSGS y'ubwoko bwa kabiri, nka SIDA, izindi ndwara, cyangwa izindi ndwara.

Ibyavuye muri biopsy bizagaragaza FSGS gusa, ahubwo bizafasha kumenya ubwoko bw'indwara n'ingano y'ibyangiritse. Aya makuru ayobora gahunda y'ubuvuzi bwawe kandi afasha kumenya uko iyo ndwara ishobora gutera imbere.

Ubuvuzi bwa FSGS ni ubuhe?

Ubuvuzi bwa FSGS bugamije kugabanya iyangirika ry'impyiko, guhangana n'ibimenyetso, no kuvura impamvu zose zishoboka. Uburyo bwihariye biterwa n'uko ufite FSGS y'ibanze cyangwa iy'ubwoko bwa kabiri n'uburemere bw'indwara yawe.

Kuri FSGS y'ubwoko bwa kabiri, kuvura impamvu yayo ni ingenzi. Ibi bishobora gusobanura kugenzura SIDA hakoreshejwe imiti, kugabanya ibiro niba umubyibuho ukabije ari ikibazo, cyangwa guhagarika imiti yangiza impyiko zawe.

Ubuvuzi busanzwe bwa FSGS burimo:

• ACE inhibitors cyangwa ARBs kugira ngo zirinde impyiko kandi zigenzure umuvuduko w'amaraso
• Corticosteroids kugira ngo zigabanye kubyimbagira mu bihe bimwe na bimwe
• Imiti igabanya ubudahangarwa ku bwoko bumwe na bumwe
• Diuretics kugira ngo ifashe kubyimbagira
• Imiti igabanya cholesterol
• Kugabanya ibiryo bifite protein mu bihe bimwe na bimwe

Steroids nk'iya prednisone akenshi ni yo ivurwa bwa mbere ya FSGS y'ibanze, cyane cyane mu bana no mu rubyiruko. Iyi miti ishobora kugabanya ibikorwa by'umubiri bishobora gutera iyangirika ry'impyiko.

Niba steroids zitakora cyangwa zikagira ingaruka nyinshi, muganga wawe ashobora kugutegeka indi miti igabanya ubudahangarwa nk'iya cyclosporine, tacrolimus, cyangwa mycophenolate. Iyi miti isaba ubugenzuzi bukomeye ariko ishobora kugira akamaro ku bantu bamwe.

Kugenzura umuvuduko w'amaraso ni ingenzi ukoresheje ubundi buvuzi ukoresha. Nubwo umuvuduko w'amaraso yawe usa n'usanzwe, imiti irinda impyiko zawe ishobora kugabanya kwihuta kwa FSGS.

Uko wakwitwara muri FSGS iwawe

Kwitwara muri FSGS iwawe bisobanura guhindura imibereho ifasha ubuzima bw'impyiko zawe n'imibereho yawe muri rusange. Gukurikiza indyo y'impyiko bishobora kugabanya umutwaro ku mpyiko zawe no guhangana n'ibimenyetso nk'ubwimbagira.

Muganga wawe cyangwa umuhanga mu mirire ashobora kugutegeka kugabanya ibiryo bifite protein kugira ngo ugabanye umutwaro ku mpyiko zawe, nubwo ibi biterwa n'uko uhagaze. Kugabanya umunyu bifasha kugenzura umuvuduko w'amaraso no kubyimbagira.

Uburyo bwo kwitwara iwawe buri munsi burimo:

• Gufata imiti uko yategetswe
• Kugenzura ibiro byawe buri munsi kugira ngo ugenzure amazi y'umubiri
• Kugabanya umunyu kuri munsi ya 2,300mg ku munsi
• Kuguma ukora imyitozo ngororamubiri yoroheje uko bishoboka
• Kuryama bihagije no guhangana n'umunaniro
• Kwirinda imiti igabanya ububabare idasabwe na muganga

Andika buri munsi ibiro byawe, umuvuduko w'amaraso (niba ufite igikoresho cyo kuwupima iwawe), n'ibimenyetso byose nk'ubwimbagira cyangwa impinduka mu nkari. Aya makuru afasha itsinda ry'abaganga bawe guhindura ubuvuzi bwawe uko bikenewe.

Komeza ubone inkingo, kuko imiti imwe ya FSGS ishobora kugira ingaruka ku budahangarwa bwawe. Irinde abantu barwaye igihe bishoboka, kandi ukore isuku y'intoki.

Ntuzuzagira ikibazo cyo kuvugana na muganga wawe niba ubona kwiyongera kw'uburemere, kwiyongera kw'ubwimbagira, cyangwa ibindi bimenyetso bishya. Kugira ingamba hakiri kare bishobora kwirinda ingaruka zikomeye.

Uko wakwitegura gusura muganga wawe

Kwitwara neza mbere yo gusura muganga wawe bifasha kugira ngo ubone igihe gihagije cyo kuvugana na we. Zana urutonde rw'imiti yose ufata, harimo imiti igurwa mu maduka, imiti y'inyongera, n'imiti y'ibimera.

Andika ibibazo byawe mbere kugira ngo utabyibagirwa. Ni byiza gushyira ibibazo byawe mu byiciro niba igihe cyabuze mu gihe cy'isura.

Amakuru ukwiye kuzana mu gihe ugiye kwa muganga:

• Urutonde rwuzuye rw'imiti ukoresha n'ingano yayo
• Ibisobanuro by'ibiro byawe bya buri munsi niba wabikurikiranye
• Ibisobanuro by'umuvuduko w'amaraso niba uwupima iwawe
• Urutonde rw'ibimenyetso n'igihe bibaho
• Amateka y'indwara y'impyiko mu muryango
• Ibisubizo by'ibizamini byakozwe n'abandi baganga

Tegura kuzana inshuti cyangwa umuryango wawe kugira ngo bagufashe kwibuka amakuru akomeye yavuzwe mu gihe cy'isura. Bashobora kandi kugufasha mu buryo bw'amarangamutima no guharanira ibyo ukeneye.

Tegura kuvuga ku mibereho yawe ya buri munsi, harimo indyo, imyitozo ngororamubiri, n'ibibazo uhanganye na byo mu gahunda y'ubuvuzi bwawe. Muganga wawe akeneye aya makuru kugira ngo aguhe ubuvuzi bwiza.

Icy'ingenzi kuri FSGS

FSGS ni indwara y'impyiko ishobora kuvurwa kandi ikubita buri wese mu buryo butandukanye, kandi kugira iyi ndwara ntibisobanura ko ubuzima bwawe bugomba guhinduka cyane. Ukoresheje ubuvuzi bukwiye n'impinduka mu mibereho, abantu benshi bafite FSGS bagumana imikorere myiza y'impyiko imyaka myinshi.

Ikintu cy'ingenzi cyane ushobora gukora ni ugukorana n'itsinda ry'abaganga bawe no gukomeza gahunda y'ubuvuzi bwawe. Ubugenzuzi buhoraho bufasha guhindura ibintu bishobora kugabanya kwihuta kw'indwara no kwirinda ingaruka.

Wibuke ko ubushakashatsi kuri FSGS bugikomeje, kandi hari ubuvuzi bushya burimo gukorwa. Icyo kitabaho uyu munsi gishobora kubaho ejo, bityo kubungabunga ubuzima bw'impyiko zawe ubu bigufungurira amarembo menshi mu gihe kizaza.

Nubwo FSGS isaba kwitabwaho buri gihe, ntigomba kukumenya cyangwa kugabanya intego zawe. Abantu benshi bafite iyo ndwara bakomeza gukora, gukora ingendo, gukora imyitozo ngororamubiri, no kwishimira ubuzima buzira umuze, mu gihe bayirwanya.

Ibibazo byakenshi bibazwa kuri FSGS

FSGS irashobora gukira burundu?

Kuri ubu, nta muti wa FSGS, ariko iyo ndwara ishobora guhangana nayo neza kugira ngo igabanye kwihuta kwayo. Bamwe mu bantu, cyane cyane abafite FSGS y'ubwoko bwa kabiri, bashobora kubona impinduka nziza niba impamvu yayo ivuwe neza. Intego y'ubuvuzi ni ukubungabunga imikorere y'impyiko no kwirinda ingaruka aho gukuraho iyo ndwara burundu.

Nzakenera dialysis niba mfite FSGS?

Si buri wese ufite FSGS ukeneye dialysis. Abantu benshi bagumana imikorere myiza y'impyiko imyaka myinshi bakoresheje ubuvuzi bukwiye. Gukenera dialysis biterwa n'uburyo imikorere y'impyiko yawe igabanuka n'uburyo usubiza ubuvuzi. Ubugenzuzi buhoraho bufasha itsinda ry'abaganga bawe gutabara hakiri kare kugira ngo bagabanye kwihuta kw'indwara.

Nashobora kubyara niba mfite FSGS?

Abagore benshi bafite FSGS bashobora gutwita neza, ariko bisaba gutegura neza no kugenzura hamwe na muganga w'impyiko n'umuganga w'abagore ufite ubunararibonye mu gutwita gugoye. Imiti imwe ikoreshwa mu kuvura FSGS ishobora guhinduka mbere y'igihe cyo gutwita no mu gihe cyo gutwita. Ikintu cy'ingenzi ni ukuganira n'itsinda ry'abaganga bawe ku ntego zawe zo kubyara hakiri kare.

FSGS ihora ikomoka ku murage?

Oya, FSGS ntihora ikomoka ku murage. Nubwo ubwoko bumwe bukomoka mu muryango kubera impinduka z'umurage, ibice byinshi bya FSGS ntibyarazwe. FSGS y'ubwoko bwa kabiri iterwa n'izindi ndwara cyangwa ibintu, kandi FSGS y'ibanze ishobora kubaho nta mateka y'umuryango. Isuzuma ry'umurage rishobora gufasha kumenya niba FSGS yawe ikomoka ku murage.

Ngahe nkwiye gusura muganga wanjye niba mfite FSGS?

Ubwinshi bw'amasura biterwa n'uko iyo ndwara yawe imeze n'ubuvuzi ukoresha. Mu ntangiriro, ushobora kenera amasura buri mezi make kugira ngo harebwe uko usubiza ubuvuzi. Iyo iyo ndwara yawe imeze neza, amasura buri mezi 3-6 ni yo asanzwe, ariko muganga wawe azagena gahunda ikwiye bitewe n'ibyo ukeneye n'ibyavuye mu bizamini.