Nephropathy Yeshuga (Chirwere Cheitsvo)

Nephropathy yehukaha chirwere chakakomba chinokonzerwa nechirwere cheshuga chemarudzi maviri, rudzi rwekutanga nerudzi rwechipiri. Inonziwo chirwere cheitsvo cheshuga. MuUnited States, munhu mumwe chete pakati pevatatu vanorarama nechirwere cheshuga ane nephropathy yehukaha.

Kwemakore, nephropathy yehukaha inokuvadza zvishoma nezvishoma sisitimu yekuchenesa yemitsvo. Kurapwa kwekutanga kunogona kudzivirira mamiriro ezvinhu aya kana kuideredza uye kuderedza mukana wezvinetso.

Chirwere cheitsvo cheshuga chinogona kukonzera kutadza kweitsvo. Izvi zvinonziwo chirwere cheitsvo chekupedzisira. Kutadza kweitsvo mamiriro anotyisa hupenyu. Nzira dzekurapa kutadza kweitsvo ndidzo dialysis kana kupanwa kweitsvo.

Rimwe remabasa akakosha emitsvo nderekuchenesa ropa. Sezvo ropa richifamba mumuviri, rinotora mvura yakawandisa, kemikari nemarara. Mitsvo inoparadzanisa zvinhu izvi kubva muropa. Inotakurwa kunze kwemuviri mumukaka. Kana mitsvo ikasakwanisa kuita izvi uye mamiriro acho asingarapwi, matambudziko ehutano akakomba anozviratidza, nekurasikirwa nehupenyu pakupedzisira.

Pakutanga kwenguva yekuchema kweitsvo nekuda kweglucose yakawanda, zvingangove kusina zviratidzo. Mumavambo ekupedzisira, zviratidzo zvinogona kusanganisira:

• Kugombama kwemakumbo, makwati, maoko kana maziso.
• Weewee ine mhangura.
• Kusanzwisisa kana kuoma kufunga.
• Kushomeka kwemhepo.
• Kurasikirwa nechido chekudya.
• Kurutsa nekuvharirwa.
• Kutsamwa.
• Kuneta nekushaya simba.

Enda kunachiremba wako kana uine zviratidzo zvechirwere cheitsvo. Kana uine chirwere cheshuga, shanya nachiremba wako gore rega rega kana kazhinji sezvaunoudzwa kuitira bvunzo dzinoratidza kuti itsvo dzako dziri kushanda zvakanaka sei.

Nephropathy yehukaha inowanzoitika kana hukaha hwakanganisa ropa nemweya iri munyongo.

Nyongo inobvisa tsvina nemvura yakawandisa muropa kuburikidza nezvikamu zvekusefa zvinonzi nephrons. Iyo nephron imwe neimwe ine firitha, inonzi glomerulus. Iyo firitha imwe neimwe ine midziyo midiki yeropa inonzi capillaries. Kana ropa richipinda glomerulus, zvidiki zvidiki, zvinonzi molecules, zvemvura, maminerari nezvokudya, uye tsvina zvinopfuura nema capillaries. Molecules makuru, akadai semapuroteni nema cell eropa matsvuku, hazviiti. Chikamu chinoyerwa chinopinda mune chimwe chikamu che nephron chinonzi tubule. Mvura, zvokudya, uye maminerari anomutwa muviri anotumirwa kudzokera muropa. Mvura yakawandisa netsvina inova weewee inoyerera kuenda kubladder.

Nyongo ine mamirioni emidziyo midiki yeropa inonzi glomeruli. Glomeruli inoyerera tsvina kubva muropa. Kukuvadzwa kwemidziyo iyi yeropa kunogona kukonzera nephropathy yehukaha. Kukuvadzwa kunogona kudzivirira nyongo kushanda sezvazvinofanira uye kukonzera kutadza kwenyongo.

Nephropathy yehukaha chirwere chinowanzoitika chehukaha hwerudzi rwe 1 nerudzi rwe 2.

Kana uine chirwere cheshuga, zvinhu zvinotevera zvinogona kuwedzera njodzi yekukuvara kweitsvo nekuda kwebvudzi:

• Shuga yakakwirira isina kudzorwa, inonziwo hyperglycemia.
• Kusvuta.
• Cholesterol yakakwirira yeropa.
• Kufuta.
• Nhoroondo yemhuri yehutachiona hweshuga nechirwere cheitsvo.

Zvinetso zve diabetic nephropathy zvinogona kuuya zvishoma nezvishoma kwemwedzi kana makore. Zvinogona kusanganisira:

• Kuwanda kwe potassium mumubvunzo, kunonzi hyperkalemia.
• Zvirwere zve mwoyo nemidziyo yeropa, zvinonziwo cardiovascular disease. Izvi zvinogona kukonzera stroke.
• Masero mashoma matsvuku eropa anotakura oksijeni. Iyi mamiriro anonziwo anemia.
• Zvinetso zve pamuviri zvine ngozi kumukadzi ane pamuviri ne fetus iri kukura.
• Kukuvadzwa kweitsvo kunogona kuregererwa. Izvi zvinonzi end-stage kidney disease. Kurapa ndiko dialysis kana kupanwa itsvo.

Kuderedza njodzi yako yekuwana diabetic nephropathy:

• Ona timu yako yehutano nguva dzose kuti utarise chirwere cheshuga. Chengeta nguva dzako dzekuongororwa kuti uone kuti uri kutarisira sei chirwere cheshuga uye kuti uone diabetic nephropathy nemamwe matambudziko. Nguva dzako dzekuongororwa dzinogona kunge dziri gore negore kana kazhinji.
• Kurapa chirwere cheshuga. Nekurapa kwakanaka kwechirwere cheshuga, unogona kuchengetamazinga eshuga rako muropa munzvimbo yakatarwa sezvinobvira. Izvi zvinogona kudzivirira kana kunonoka diabetic nephropathy.
• Tora mishonga yaunowana pasina chinyorwa chechiremba sezvakarayirwa chete. Verenga mavara emishonga yekurwadziwa yaunotora. Izvi zvinogona kusanganisira aspirin uye mishonga inorwisa kuzvimba, senge naproxen sodium (Aleve) uye ibuprofen (Advil, Motrin IB, nezvimwewo). Kune vanhu vane diabetic nephropathy, marudzi aya emishonga yekurwadziwa anogona kukonzera kukuvara kweitsvo.
• Ramba une uremu hwakakodzera. Kana uri une uremu hwakakodzera, shanda kuti urambe wakadaro nekushanda muviri mazuva mazhinji evhiki. Kana uchida kuderedza uremu, taura nemumwe munhu wetimu yako yehutano nezve nzira yakanakisa yekuderedza uremu kwauri.
• Usafume. Kusvuta fodya kunogona kukuvadza itsvo kana kuita kuti kukuvara kweitsvo kuwedzere. Kana uri mufumi, taura nemumwe munhu wetimu yako yehutano nezve nzira dzekurega. Mapoka ekutsigira, mazano uye mimwe mishonga inogona kubatsira.

Panguva yekuongorora itsvo, mushandi wehutano anoshandisa tsono kubvisa sampuro duku yetsvina yetsvo kuti iongororwe murabhoritari. Tsono yekuongorora inopfuudzwa ne ganda kusvika kutsvo. Maitiro acho kazhinji anoshandisa chishandiso chekuona, sekunge transducer ye ultrasound, kuitungamira tsono.

Nephropathy yehutachiona kazhinji inoonekwa panguva yekuyedza kwenguva dzose kuri chikamu chekutarisira chirwere cheshuga. Ita bvunzo gore rega rega kana uine chirwere cheshuga chemarudzi maviri kana wava nechirwere cheshuga chemarudzi mumwe kweanopfuura makore mashanu.

Kuongorora kwenguva dzose kunogona kusanganisira:

• Bvunzo ye albumin yemukombama. Bvunzo iyi inogona kuona puroteni yeropa inonzi albumin mumukombama. Kazhinji, itsvo hadziri kusiyanisa albumin kubva kweropa. Albumin yakawanda mumukombama inogona kureva kuti itsvo hadzisi kushanda zvakanaka.
• Chiyero che albumin/creatinine. Creatinine chigadzirwa chemarara chemakemikari chaitsvo dzakagwinya dzinosiyanisa kubva kweropa. Chiyero che albumin/creatinine chinoyera kuti albumin yakawanda sei ichienzaniswa ne creatinine iri musampuro yemukombama. Inoratidza kuti itsvo dziri kushanda zvakanaka sei.
• Glomerular filtration rate (GFR). Kuyerwa kwe creatinine musampuro yeropa kunogona kushandiswa kuona kuti itsvo dziri kusiyanisa ropa nekukurumidza sei. Izvi zvinonzi glomerular filtration rate. Chiyero chiduku chinoreva kuti itsvo hadzisi kushanda zvakanaka.

Kuongorora kwakasiyana kunogona kusanganisira:

• Kuongorora kwemuenzaniso. X-rays ne ultrasound inogona kuratidza kugadzirwa kukuru nehukuru hwetsvo. CT ne MRI scans inogona kuratidza kuti ropa riri kufamba zvakanaka sei mukati memutsvo. Ungada mamwe maitiro ekutsvaga, zvakare.
• Biopsy yetsvo. Iri ibasa rekuitora sampuro yetsvina yetsvo kuti iongororwe murabhoritari. Rinobatanidza mushonga unodonhedza unonzi local anesthetic. Tsono yakatetepa inoshandiswa kubvisa zvidimbu zviduku zvetsiva yetsvo.

Pakutanga kwechirwere cheitsvo chinotapukira chirwere cheshuga, kurapwa kwako kungasanganisira mishonga yekurapa zvinotevera:

• Shuga yeropa. Mishonga inogona kubatsira kudzora shuga yakakwirira yeropa muvanhu vane chirwere cheitsvo chinotapukira chirwere cheshuga. Inosanganisira mishonga yekare yeshuga senge insulin. Mishonga mitsva inosanganisira Metformin (Fortamet, Glumetza, nezvimwewo), glucagon-like peptide 1 (GLP-1) receptor agonists uye SGLT2 inhibitors.

Bvunza nyanzvi yako yehutano kana kurapwa senge SGLT2 inhibitors kana GLP-1 receptor agonists kungakushandira. Kurapwa uku kunogona kudzivirira mwoyo neitsvo pakukuvara kunokonzerwa nechirwere cheshuga.

• Kolesterol yakakwirira. Mishonga inoderedza cholesterol inonzi statins inoshandiswa kurapa kolesterol yakakwirira uye kuderedza huwandu hwe protein mumukaka.
• Kuora kweitsvo. Finerenone (Kerendia) inogona kubatsira kuderedza kuora kwe tishu mune chirwere cheitsvo chinotapukira chirwere cheshuga. Kutsvagisa kwakaratidza kuti mushonga unogona kuderedza njodzi yekukundikana kweitsvo. Inogona zvakare kuderedza njodzi yekufa nekuda kwechirwere chemwoyo, kuva nemwoyo inorwadza uye kudikanwa kwekuenda kuchipatara kurapa kukundikana kwemwoyo muvakuru vane chirwere cheitsvo chisingaperi chinobatanidzwa nechirwere cheshuga chemarudzi maviri.

Shuga yeropa. Mishonga inogona kubatsira kudzora shuga yakakwirira yeropa muvanhu vane chirwere cheitsvo chinotapukira chirwere cheshuga. Inosanganisira mishonga yekare yeshuga senge insulin. Mishonga mitsva inosanganisira Metformin (Fortamet, Glumetza, nezvimwewo), glucagon-like peptide 1 (GLP-1) receptor agonists uye SGLT2 inhibitors.

Bvunza nyanzvi yako yehutano kana kurapwa senge SGLT2 inhibitors kana GLP-1 receptor agonists kungakushandira. Kurapwa uku kunogona kudzivirira mwoyo neitsvo pakukuvara kunokonzerwa nechirwere cheshuga.

Kana ukatora mishonga iyi, uchada kuongororwa nguva dzose. Kuongororwa kunoitwa kuona kana chirwere cheitsvo chako chakaoma kana kuti chiri kuipa.

Panguva yekuvhiya kwekusimudza itsvo, itsvo yemupi inoiswa mudumbu riri pasi. Midziyero yeropa yetsvo itsva inobatanidzwa kune midziyero yeropa iri pazasi pedumbu, pamusoro pembwa imwe chete. Chubhu chitsva cheitsvo chinopfuura nacho weewee kuenda kubladder, chinonzi ureter, chinobatanidzwa kubladder. Kunze kwekunge zviri kukonzera matambudziko, itsvo dzimwe dzinosiiwa panzvimbo.

Nekukundikana kweitsvo, kunonziwo chirwere cheitsvo chekupedzisira, kurapwa kunotarisa pakutsiva basa reitsvo dzako kana kukugadzirira zvakanaka. Sarudzo dzinosanganisira:

• Dialysis yeitsvo. Kurapwa uku kunobvisa zvinhu zvinoraswa uye mvura yakawandisa muropa. Hemodialysis inoshambadza ropa kunze kwemuviri uchishandisa muchina unoita basa reitsvo. Kune hemodialysis, ungada kushanyira nzvimbo yekurapa dialysis katatu pavhiki. Kana kuti ungave uine dialysis inoitirwa kumba nemurwepi akarovedzwa. Session imwe neimwe inotora maawa 3 kusvika ku5.

Peritoneal dialysis inoshandisa mukati memukati wedumbu, rinonzi peritoneum, kusimbisa marara. Mvura yekuchenesa inoyerera kuburikidza nechubhu kuenda kuperitoneum. Kurapwa uku kunogona kuitwa kumba kana kubasa. Asi kwete munhu wese anogona kushandisa nzira iyi yekurapa dialysis.

• Kusimudza. Dzimwe nguva, kusimudza itsvo kana kusimudza itsvo-pancreas ndiyo sarudzo yakanaka yekurapa kukundikana kweitsvo. Kana iwe nechikwata chako chehutano muchisarudza kusimudza, muchaongororwa kuti muone kana muchigona kuita kuvhiya.
• Kurapa zviratidzo. Kana uine kukundikana kweitsvo uye haudi dialysis kana kusimudza itsvo, ungararama mwedzi mishoma chete. Kurapwa kunogona kubatsira kukuchengetedza wakasununguka.

Dialysis yeitsvo. Kurapwa uku kunobvisa zvinhu zvinoraswa uye mvura yakawandisa muropa. Hemodialysis inoshambadza ropa kunze kwemuviri uchishandisa muchina unoita basa reitsvo. Kune hemodialysis, ungada kushanyira nzvimbo yekurapa dialysis katatu pavhiki. Kana kuti ungave uine dialysis inoitirwa kumba nemurwepi akarovedzwa. Session imwe neimwe inotora maawa 3 kusvika ku5.

Peritoneal dialysis inoshandisa mukati memukati wedumbu, rinonzi peritoneum, kusimbisa marara. Mvura yekuchenesa inoyerera kuburikidza nechubhu kuenda kuperitoneum. Kurapwa uku kunogona kuitwa kumba kana kubasa. Asi kwete munhu wese anogona kushandisa nzira iyi yekurapa dialysis.

Mumazuva anouya, vanhu vane chirwere cheitsvo chinotapukira chirwere cheshuga vangabatsirwa nekurapwa kuri kuvandudzwa uchishandisa matekinoroji anobatsira muviri kuzvigadzirisa, anonzi regenerative medicine. Matekinoroji aya anogona kubatsira kudzorera kana kunonoka kukuvara kweitsvo.

Semuenzaniso, vamwe vatsvakurudzi vanofunga kuti kana chirwere cheshuga chemumunhu chingarapwa nekurapwa kwenguva yemberi senge kusimudza masero epancreas islet kana kurapwa kwemasero estem, itsvo dzingashanda zvakanaka. Kurapwa uku, pamwe chete nemishonga mitsva, kuri kufundwa zvakare.

• Tarisa shuga yeropa rako. Timu yako yekutarisira utano ichakuudza kuti ungatarisa shuga yeropa rako kakawanda sei kuti uve nechokwadi chekuti uri munzvimbo yaunofanira kuva mairi. Semuenzaniso, ungada kuitarisa kamwe chete pazuva uye usati waitamba kana mushure mekutamba. Kana ukatora insulin, ungada kuitarisa shuga yeropa rako kanopfuura kamwe pazuva.
• Iva ane basa mazuva mazhinji evhiki. Edza kwemaminitsi anenge makumi matatu kana kupfuura ekutamba kwakasimba kwemuviri zuva nezuva. Ita kwemaminitsi anenge zana nemakumi mashanu pavhiki. Mabasa anogona kusanganisira kufamba nekukurumidza, kushambira, kukwira bhasikoro kana kumhanya.
• Idya zvokudya zvine utano. Idya zvokudya zvine fiber yakawanda ine michero yakawanda, miriwo isina starch, zviyo zvizere uye nzungu. Dzivisa mafuta akawanda, nyama yakagadzirwa, zvinonaka uye munyu.
• Rega kusvuta. Kana uchisvuta, taura nachiremba wako nezve nzira dzekurega.
• Ramba une uremu hwakakodzera. Kana uchida kuderedza uremu, taura nachiremba wako nezve nzira dzekudaro. Kune vamwe vanhu, kuvhiya kwekuderedza uremu inzira imwe.
• Tora aspirin zuva nezuva. Taura nachiremba wako kana uchifanira kutora aspirin shoma zuva nezuva kuderedza njodzi yechirwere chemwoyo.
• Taura nechikwata chako chekutarisira utano. Ita shuwa kuti vanachiremba vako vose vanoziva kuti une diabetic nephropathy. Vanogona kutora matanho ekudzivirira itsvo dzako kuti dzirege kukuvadzwa zvakanyanya nekurega kuita bvunzo dzezvokurapa dzinoshandisa contrast dye. Izvi zvinosanganisira angiograms uye computerized tomography (CT) scans.

Kana uine diabetic nephropathy, matanho aya anogona kukubatsira kubata nezvinetso:

• Batana nevamwe vanhu vane chirwere cheshuga neitsvo. Bvunza nhengo yechikwata chako chekutarisira utano nezve mapoka ekutsigira munzvimbo yako. Kana kuti taura nemapoka akadai seAmerican Association of Kidney Patients kana National Kidney Foundation emapoka ari munzvimbo yako.
• Namata pane zvaunowanzoita, kana zvichibvira. Edza kuchengeta zvaunowanzoita, uchiita zvinhu zvaunofarira uye kushanda, kana mamiriro ako akubvumira. Izvi zvinogona kukubatsira kubata nemanzwiro ekusuruvara kana kurasikirwa kwaunogona kuva nawo mushure mekuongororwa kwako.
• Taura nemumwe munhu waunovimba naye. Kurarama ne diabetic nephropathy kunogona kunetsa, uye zvinogona kubatsira kutaura nezvemanzwiro ako. Ungave une shamwari kana nhengo yemhuri inoteerera zvakanaka. Kana kuti ungawana zvichibatsira kutaura nemutevedzeri wechitendero kana mumwe munhu waunovimba naye. Bvunza nhengo yechikwata chako chekutarisira utano nezita remushandi wemagariro kana mukuru wekurapa.