Ni iki cyitwa Kwimura impyiko y’uwapfuye? Impamvu, Uburyo & Ibivamo

Kwimura impyiko y’uwapfuye ni kubaga bikiza ubuzima aho wakira impyiko nziza ivuye ku muntu wapfuye kandi wari warabyemeye gutanga ingingo ze. Ubu buryo butanga icyizere iyo impyiko zawe zitagishobora gukora neza mu gushungura imyanda n’amazi y’umurengera mu maraso yawe.

Uru rugendo rugizwe no guhuza neza hagati yawe n’impyiko y’uwatanze kugira ngo habeho ibisubizo byiza bishoboka. Nubwo gutegereza urugingo ruhuye bishobora kumera nk’ibigoye, gusobanukirwa n’inzira birashobora kugufasha kumva witeguye kandi ufite icyizere kuri ubu buryo bw’ingenzi bwo kuvurwa.

Ni iki cyitwa kwimura impyiko y’uwapfuye?

Kwimura impyiko y’uwapfuye bisimbuza impyiko yawe idakora neza n’impyiko nziza ivuye ku muntu wapfuye. Impyiko itangwa n’abantu bafashe icyemezo cyiza cyo gutanga ingingo zabo nyuma yo gupfa, bagaha abandi amahirwe ya kabiri yo kubaho.

Impyiko yawe nshya izashyirwa mu gice cyo hasi cy’inda yawe, akenshi ku ruhande rw’iburyo. Mu buryo butunguranye, impyiko zawe ubwazo zisanzwe ziguma aho ziri keretse ziteje ibibazo byihariye. Impyiko yimuriwe ihuzwa n’imitsi y’amaraso yegereye ndetse n’uruhago rwawe, aho itangira gushungura amaraso yawe no gukora inkari.

Ubu bwoko bwo kwimura butandukanye no kwimura kw’uwatanze akiriho kuko impyiko iba ivuye ku muntu wapfuye. Uru rugingo rugomba kubungabungwa neza kandi rugahabwa abantu vuba kugira ngo rukomeze gukora ku wemeye kurwakira.

Kuki kwimura impyiko y’uwapfuye bikorwa?

Muganga wawe agushishikariza kwimura impyiko iyo impyiko zawe zitagishobora kugufasha kuguma mu buzima bwiza. Indwara y’impyiko yo mu rwego rwa nyuma bisobanura ko imikorere y’impyiko zawe iri munsi ya 10% y’ubushobozi bwayo busanzwe, bigatuma dialysis cyangwa kwimura impyiko biba ngombwa kugira ngo ubashe kubaho.

Ibyo bibazo bishobora gutuma ugera kuri urwo rwego, kandi kubisobanukirwa bifasha gusobanura impamvu kwimurira ingingo biba ari uburyo bwiza. Impamvu zisanzwe zirimo:

• Uburwayi bwa diyabete bwangiza impyiko (diabetic nephropathy)
• Umubyigano w'amaraso mwinshi utera ibibara ku mpyiko
• Uburwayi bw'impyiko bwa polycystic hamwe n'impyiko zabyimbye, zuzuyemo ibibyimba
• Glomerulonephritis, yangiza ibice by'impyiko bishinzwe gutunganya
• Indwara ziterwa n'umubiri w'umuntu ubwawo nka lupus zigira ingaruka ku mikorere y'impyiko
• Uburwayi bw'impyiko bwandurira mu mvugo buhari kuva mu gihe cyo kuvuka
• Impyiko zangirika biturutse ku miti cyangwa uburozi

Kwimurira ingingo neza akenshi bitanga ubuzima bwiza kurusha dialysis y'igihe kirekire. Abantu benshi bumva bafite imbaraga nyinshi kandi bashobora gusubira mu bikorwa bakundaga mbere y'uko indwara y'impyiko ikura.

Ni iki gikorerwa kwimurira ingingo y'impyiko yatanzwe n'uwapfuye?

Kubaga kwimurira ingingo akenshi bifata amasaha 3 kugeza kuri 4 kandi bikorwa nk'uburyo bwihutirwa igihe impyiko ihuye ibonetse. Uzasuzumwa n'umuti wo mu mutwe, bityo uzaba uryamye rwose mu gihe cyose cyo kubaga.

Umuvuzi wawe akora igikomere mu nda yawe yo hasi kugira ngo agere ahantu impyiko yawe nshya izashyirwa. Ibi bikorwa bikubiyemo intambwe nyinshi zitunganye kugira ngo zemeze ibisubizo byiza:

1. Umuvuzi ashyira impyiko yatanzwe mu nda yawe yo hepfo iburyo
2. Imitsi y'amaraso iva mu mpyiko nshya ihuzwa n'imitsi yawe y'amaraso isanzwe
3. Ureter y'impyiko (urugero rutwara inkari) ruhuzwa n'uruhago rwawe
4. Umuvuzi wawe agerageza imiterere kugira ngo yemeze imikorere y'amaraso neza
5. Igikomere gifungwa hamwe n'imitsi cyangwa ibyuma

Impyiko nshya akenshi itangira gukora inkari ako kanya, nubwo rimwe na rimwe bifata iminsi cyangwa ibyumweru kugira ngo itangire gukora neza. Itsinda ryawe ry'abaganga rigukurikiranira hafi muri iki gihe cy'ingenzi kugira ngo rimenye niba byose bikora neza.

Ni gute witegura kwimurira ingingo y'impyiko yatanzwe n'uwapfuye?

Kitegura kwimurwa kw'igice cy'umubiri birimo kwandikwa ku rutonde rw'abategereje no kuba witeguye guhamagarwa igihe impyiko zibonetse. Uburyo bwo gusuzuma butuma wizezwa ko ufite ubuzima bwiza buhagije bwo kubagwa kandi ko bizagufasha.

Itsinda ryawe ryo kwimura ibice by'umubiri rizagufasha mu bizami birambuye bisuzuma ubuzima bwawe muri rusange. Iki gihe cyo kwitegura gikunze kuba kirimo:

• Ibizamini by'amaraso byo kureba imikorere y'ingingo n'uko wanduye indwara
• Ibizamini by'umutima nk'ibya EKG na echocardiogram
• Ibizamini by'imikorere y'ibihaha n'imirasire ya X y'igituza
• Gusuzuma kanseri bikwiye ukurikije imyaka yawe
• Isuzuma ry'amenyo kugira ngo hamenyekane niba hariho ubwandu ubwo aribwo bwose
• Isuzuma ryo mu mutwe kugira ngo hamenyekane niba witeguye
• Inama zijyanye n'amafaranga ku bijyanye n'ibiciro byo kwimura ibice by'umubiri

Iyo wemejwe, uzinjira ku rutonde rw'abategereje ku rwego rw'igihugu unyuze mu muryango w'Abanyamerika wunga ubumwe mu guhana ingingo (UNOS). Komeza kuba wazagerwaho igihe cyose kuko uzaba ukeneye kujya mu bitaro mu masaha make nyuma yo guhamagarwa.

Komeza ubuzima bwawe bube bwiza uko bishoboka kose mu gihe utegereje. Komeza kuvurwa na dialysis, unywe imiti wandikiwe, kandi ugire imirire myiza kugira ngo wemeze ko uri mu bihe byiza byo kubagwa igihe amahirwe abonekeye.

Ni gute usoma ibisubizo byawe byo kwimura impyiko?

Nyuma yo kwimura impyiko, itsinda ryawe ry'abaganga rikoresha ibizamini by'amaraso byihariye kugira ngo barebe uko impyiko yawe nshya ikora neza. Ikimenyetso cy'ingenzi ni urwego rwawe rwa creatinine, rugomba kugabanuka cyane ugereranyije na mbere yo kwimura impyiko igihe imikorere y'impyiko yawe irushaho kuba myiza.

Abaganga bawe bakurikirana ibipimo byinshi by'ingenzi kugira ngo bamenye niba impyiko yawe ikomeza kuba nzima. Ibi bizamini bifasha kumenya ibibazo kare igihe bivurwa neza:

• Urugero rwa creatinine (rugomba kuba 0.6-1.2 mg/dL mu mpyiko zifite ubuzima bwiza)
• Nitrogen ya urea mu maraso (BUN) yerekana gukuraho imyanda
• Urwego rwo gutunganya amaraso mu mpyiko (GFR) rupima ijanisha ry'imikorere y'impyiko
• Urugero rwa poroteyine mu bipimo by'inkari
• Urugero rw'imiti igabanya ubudahangarwa mu maraso yawe

Ibisubizo bisanzwe bitandukanye ku muntu ku muntu, kandi impyiko yawe nshya ntishobora gukora neza nk'impyiko isanzwe ifite ubuzima bwiza. Itsinda ryawe ry'abakozi b'ubuvuzi bazagusobanurira imibare ikwiye kubera uko ubuzima bwawe bumeze kandi bagahindura imiti uko bikwiye.

Ni gute wakoresha neza impyiko yaguhinduriwe?

Kurengera impyiko yawe nshya bisaba ubuzima bwose kwitanga ku miti no guhitamo imibereho myiza. Sisitemu yawe y'ubudahangarwa karemano yifuza kwanga urugingo rwahinduwe, bityo imiti igabanya ubudahangarwa ni ingenzi kugirango wirinde iryo yanga.

Gufata imiti uko yategetswe neza ni cyo kintu cy'ingenzi ushobora gukora ku rugingo rwawe rwahinduwe. Iyi miti ikomeye isaba gukurikiranwa neza kuko igira ingaruka ku mikorere y'ubudahangarwa bwawe bwose:

• Imiti irwanya kwangwa ifatwa ku gihe kimwe buri munsi
• Imiti igabanya umuvuduko w'amaraso kugirango irengere imikorere y'impyiko
• Imiti yo kwirinda indwara zandura n'indwara z'amagufa
• Ibizami by'amaraso bya buri gihe kugirango bagenzure urwego rw'imiti

Guhitamo imibereho myiza bishyigikira intsinzi y'urugingo rwawe rwahinduwe mu gihe kirekire. Ibi birimo kurya indyo yuzuye, gukora imyitozo ngororamubiri buri gihe nkuko byemejwe na muganga wawe, kwirinda kwandura indwara, no kurengera uruhu rwawe ku zuba kuko imiti igabanya ubudahangarwa yongera ibyago bya kanseri.

Ni iki gisubizo cyiza nyuma yo guhindurirwa impyiko?

Igisubizo cyiza gisobanura ko impyiko yawe nshya ikora neza mu myaka myinshi, ikakwemerera kubaho ubuzima bufite akamaro, bwuzuye. Abantu benshi bumva bameze neza cyane kurusha uko bari bameze kuri diyarese, bafite imbaraga nyinshi n'umudendezo mu bikorwa byabo bya buri munsi.

Uburyo bwo gukira ku bantu bahabwa impyiko z'abapfuye birashimishije, nubwo ibisubizo by'umuntu ku giti cye bitandukanye. Hafi 95% by'impyiko zatewe zikora neza mu mwaka wa mbere, kandi hafi 85% zigakomeza gukora nyuma y'imyaka itanu.

Kugira ngo umuntu agire ubuzima bwiza mu gihe kirekire biterwa n'ibintu byinshi birimo imyaka yawe, ubuzima bwawe muri rusange, uburyo ukurikiza amabwiriza ya muganga, n'uburyo impyiko y'uwatanze ihura n'ubwoko bw'imitsi yawe. Abantu benshi basubira mu kazi, bagakora ingendo, bakora imyitozo ngororamubiri, kandi bakishimira ibikorwa byari bigoye mu gihe cyo kurwara impyiko bikomeye.

Ubuvuzi buhoraho hamwe n'ikipe yawe y'abavura impyiko bifasha kugumana ibisubizo byiza. Kumenya no kuvura hakiri kare ibibazo byose birinda ingorane zikomeye kandi bigafasha kubungabunga imikorere y'impyiko zawe mu myaka myinshi.

Ni ibihe bintu byongera ibyago byo kugira ingorane nyuma yo guterwa impyiko?

Ibintu byinshi bishobora kongera ibyago byo kugira ibibazo nyuma yo guterwa impyiko, nubwo byinshi bishobora gukemurwa no kwitabwaho neza. Kumva ibyo byago bifasha wowe n'ikipe yawe y'abaganga gukorera hamwe kugabanya ingorane.

Ibintu bimwe byongera ibyago ntushobora guhindura, mu gihe ibindi byitabira impinduka z'imibereho n'imicungire y'ubuvuzi yitondewe. Ibintu by'ingenzi bigira ingaruka ku bisubizo byo guterwa impyiko birimo:

• Imyaka (abantu bakuze bahura n'ibibazo byinshi)
• Indwara ya diyabete cyangwa indwara y'umutima mbere yo guterwa impyiko
• Kuba waratewe impyiko mbere cyangwa gutererwa amaraso
• Urugero rwo hejuru rw'amaso mu maraso yawe
• Kutubahiriza imiti neza nyuma yo guterwa impyiko
• Umunuko cyangwa kunywa inzoga nyinshi
• Umubyibuho ukabije ugira ingaruka ku gukira nyuma yo kubagwa

Ikipe yawe y'abavura impyiko isuzuma ibyo bintu mu gihe cyo gusuzuma kandi ikorana nawe kugira ngo itunganye ubuzima bwawe mbere yo kubagwa. Ibintu byinshi byongera ibyago bishobora kunozwa binyuze mu mpinduka z'imibereho, guhindura imiti, cyangwa ubuvuzi bwongereweho.

Mbese ni byiza guterwa impyiko kuruta kuguma kuri diyarese?

Ku bantu benshi barwaye indwara y’impyiko igeze ku rwego rwo kurangira, guhabwa impyiko bishobora gutanga inyungu zikomeye ugereranyije no gukoresha imiti ya dialysis igihe kirekire. Ubushakashatsi buhora bwerekana ko abantu bahabwa impyiko akenshi babaho igihe kirekire kandi bakagira ubuzima bwiza kurusha abakomeza gukoresha dialysis.

Ibyiza ntibigarukira gusa ku mibare y’ubuzima. Abantu benshi basanga guhabwa impyiko bibafasha kongera kumva bameze nkuko bari, bafite imbaraga nyinshi kandi bafite imbogamizi nkeya z’imirire ugereranyije nuko dialysis ibisaba.

Ariko, guhabwa impyiko ntibikwiriye kuri buri wese. Abantu bamwe barwaye indwara zikomeye z'umutima, kanseri ikora, cyangwa izindi ngorane zikomeye z'ubuzima bashobora kurushaho gukomeza dialysis. Itsinda ryawe rishinzwe guhabwa impyiko risuzuma neza niba ushobora kungukirwa no kubagwa kugira ngo uhabwe impyiko.

Icyemezo kirimo gupima ibyago byo kubagwa ugereranyije n'inyungu zishoboka. Nubwo guhabwa impyiko bisaba imiti igihe cyose yo kugabanya ubudahangarwa bw'umubiri ifite ibyago byayo, abantu benshi basanga iyi mpinduka ikwiriye kubera imibereho myiza yiyongereye.

Ni izihe ngaruka zishobora guterwa no guhabwa impyiko?

Kimwe n'ubundi bwoko bwose bwo kubagwa bukomeye, guhabwa impyiko bifite ibyago byihuse n'igihe kirekire. Kumva ibi bishoboka bifasha kumenya ibimenyetso byo kwitondera no gushaka ubufasha bw'ubuvuzi bwihuse igihe bibaye ngombwa.

Ingaruka zo hambere zishobora kubaho mu byumweru bike nyuma yo kubagwa, mugihe ibibazo bimwe bishobora kuza nyuma y'amezi cyangwa imyaka. Aha hari impungenge nyamukuru itsinda ryawe ry'abaganga rikora:

• Kwanga kwihuse aho ubudahangarwa bw'umubiri wawe butera impyiko nshya
• Udukoko duterwa n'imiti igabanya ubudahangarwa bw'umubiri
• Amaraso yiziba mu miyoboro y'amaraso y'impyiko
• Udukoko tw'inzira y'inkari cyangwa ibiziba
• Ibibazo byo gukira ibikomere ahakorewe kubagwa
• Ingaruka ziterwa n'imiti igabanya kwangwa kw'impyiko
• Kuzamuka kw'ibibazo bya kanseri bitewe no kugabanya ubudahangarwa bw'umubiri
• Kuzamuka kw'indwara z'umutima n'imitsi y'amaraso

Ibikomere byinshi biravurwa iyo byamenyekanye hakiri kare, ibyo ni byo bituma gahunda yo gusuzumwa buri gihe ari ingenzi cyane. Itsinda ryanyu ryo kubaga rikubwira ibimenyetso byo kwitondera kandi rigatanga amakuru yo kubahamagara amasaha 24 ku byerekeye ibibazo byihutirwa.

Ibikomere byo mu gihe kirekire bishobora kuba birimo kwangwa kw'igice, aho impyiko itakaza imikorere gahoro gahoro mu myaka myinshi, cyangwa ingaruka ziterwa n'imiti nko kurwara amagufa cyangwa kongera ibyago byo kwandura indwara. Gusuzuma buri gihe bifasha kumenya no gukemura ibi bibazo mbere yuko biba bikomeye.

Ni ryari nkwiriye kubona umuganga nyuma yo kubagwa impyiko?

Ugomba guhita uvugana n'itsinda ryawe ryo kubaga niba ubonye ibimenyetso bibangamiye nyuma yo kubagwa. Kwitabwaho n'abaganga vuba bishobora gukumira ibibazo bito kutaba ibikomere bikomeye.

Ibimenyetso bimwe na bimwe bisaba isuzuma ryihutirwa ry'ubuvuzi kuko bishobora kugaragaza kwangwa cyangwa kwandura indwara ikomeye. Ntukazuyaze guhamagara umuhuza wawe w'ibikorwa byo kubaga cyangwa kujya mu cyumba cy'abarwayi b'igitaraganya niba ubonye:

• Urubore rurenze 100.4°F (38°C) cyangwa guhinda umushyitsi
• Kugabanuka kw'inkari cyangwa impinduka mu ibara ry'inkari
• Ukubura amaguru, ibibero, cyangwa hafi y'amaso
• Kongera ibiro bitasobanutse (birenze ibiro 3 mu minsi 2)
• Urubabare cyangwa ububabare ahantu habagwe
• Isesemi ikabije, kuruka, cyangwa impiswi
• Kugorana guhumeka cyangwa kuribwa mu gituza
• Urubabare rukabije mu mutwe cyangwa impinduka mu iyerekwa

Gahunda yo gusuzumwa buri gihe ni ingenzi kimwe no gukurikirana ubuzima bw'igice cyawe cy'impyiko. Ubusanzwe izi ngendo zibaho kenshi mu ntangiriro, hanyuma zigenda zigabanuka gahoro gahoro uko ugenda ukira kandi impyiko yawe nshya ikaguma itajegajega.

Itsinda ryawe ryo kubaga riba umufatanyabikorwa wawe w'ubuvuzi bw'igihe kirekire, bityo ukomeze kuganira ku byerekeye ibibazo by'ubuzima, ingaruka ziterwa n'imiti, cyangwa impinduka mu buryo wumva. Guhagarara hakiri kare akenshi birinda ibibazo bito kuba ibibazo bikomeye.

Ibikoresho bikunze kubazwa ku bijyanye no kubagwa impyiko by'uwapfuye

Q.1 Ese gukoresha impyiko yatanzwe n'uwapfuye biruta gukoresha impyiko yatanzwe n'uzima?

Impyiko zitangwa n'abantu bazima akenshi zimara igihe kirekire kandi zikora neza kurusha impyiko zitangwa n'abapfuye, ariko zombi zishobora kurokora ubuzima. Impyiko zitangwa n'abantu bazima akenshi zitangira gukora ako kanya kandi zishobora gukora imyaka 20-25, mu gihe impyiko zitangwa n'abapfuye zimara imyaka 15-20 zikora.

Ariko, gukoresha impyiko yatanzwe n'uwapfuye bikomeza kuba uburyo bwiza iyo abantu bazima bataboneka. Ikintu cy'ingenzi ni ukwakira impyiko aho kureba ubwoko bw'uwatanze, kuko byombi bigira uruhare runini mu kurushaho kubaho no kugira ubuzima bwiza ugereranyije no gukoresha imiti ya dialysis igihe kirekire.

Q.2 Ese gutegereza igihe kirekire kugira ngo umuntu abone impyiko bimugiraho ingaruka?

Igihe kirekire cyo gutegereza gishobora kugira ingaruka ku gutsinda kwa transplant, cyane cyane niba ubuzima bwawe buzamba cyane mu gihe utegereje. Abantu bakira impyiko mbere yo gutangira dialysis cyangwa nyuma gato yo gutangira dialysis akenshi bagira ibisubizo byiza kurusha abategereza imyaka myinshi.

Ariko, kwakira impyiko ijyanye neza n'umubiri wawe nabyo ni ingenzi kugira ngo bigende neza mu gihe kirekire. Itsinda ryawe rishinzwe gukora transplant rigereranya ibi bintu iyo rigiye gutanga impyiko, rimwe na rimwe rigasaba gutegereza impyiko ijyanye neza n'umubiri wawe niba ubuzima bwawe bukomeje kuba bwiza.

Q.3 Ese nshobora kubyara nyuma yo gukorerwa transplant y'impyiko?

Abagore benshi babasha kubyara abana bazima nyuma yo gukorerwa transplant y'impyiko, nubwo bisaba gutegura neza no gukurikiranwa. Ugomba gutegereza byibuze umwaka umwe nyuma yo gukorerwa transplant mbere yo gutwita kugira ngo wemeze ko imikorere y'impyiko yawe ihagaze neza.

Gutwita nyuma yo gukorerwa transplant bifatwa nk'ibifite ibyago byinshi kandi bisaba ubufasha bwihariye butangwa n'itsinda ryawe rishinzwe gukora transplant n'inzobere mu gutwita kw'abafite ibyago byinshi. Imwe mu miti igabanya ubudahangarwa bw'umubiri ishobora gukenera guhindurwa, kandi uzakenera gukurikiranwa kenshi mu gihe cyose utwite.

Q.4 Nshobora kumara igihe kingana iki mfite impyiko yatanzwe?

Abantu benshi babaho imyaka 20-30 cyangwa irenga bafite impyiko yatewe, kandi zimwe mu mpyiko zikora neza imyaka irenga 40. Ibyo uzageraho ku giti cyawe biterwa n'ibintu nk'imyaka yawe, ubuzima bwawe muri rusange, uko ukurikiza imiti, n'uko umubiri wawe wakira neza iyo mpyiko nshya.

Igice kimwe cy'impyiko z'abantu bapfuye zikomeza gukora nyuma y'imyaka 15-20, mu gihe abantu benshi bakira impyiko babaho ubuzima busanzwe bafite izo ngingo zatewe. Iterambere mu miti igabanya ubudahangarwa n'ubuvuzi bwo gutera impyiko rikomeza guteza imbere ibizava mu gihe kirekire.

Q.5 Ni iki gihinduka iyo impyiko yanjye yatewe inanirwa?

Niba impyiko yawe yatewe inanirwa, ushobora gusubira kuri diyareze kandi ushobora kongera guterwa indi mpyiko. Abantu benshi bakira neza guterwa impyiko ya kabiri cyangwa iya gatatu, nubwo guterwa indi mpyiko bishobora kugorana bitewe n'uko urwego rw'abasirikare b'umubiri ruzamuka.

Itsinda ryawe rishinzwe gutera impyiko rikora isuzuma rya hafi ry'imikorere y'impyiko yawe kugira ngo ribone ibibazo hakiri kare igihe kuvura bishobora kubungabunga imikorere igihe kirekire. Niba kunanirwa guterwa impyiko bitabujijwe, bazagufasha gusubira kuri diyareze kandi bakugenzure niba bikwiriye guterwa indi mpyiko.