Ubuhlungu Bokwehluleka Kwempumputhe: Izimpawu, Izimbangela, Nokwelashwa

Ubuhlungu bokwehluleka kwempumputhe (ESRD) yisigaba sokugcina sesifo sempumputhe esingapheli lapho izinkulungwane zakho zisebenza ngaphansi kuka-10% kwamandla azo avamile. Kulesi sigaba, izinkulungwane zakho azisakuhlanza ubuthi namanzi engeziwe egazini lakho ngokwanele ukukugcina uphilile ngaphandle kokwelashwa kwezokwelapha.

Lesi simo sithinta izinkulungwane zabantu, futhi nakuba kuzwakala kukhulu, kukhona izindlela zokwelapha ezicacile ezingakusiza uphile impilo egcwele, enenjongo. Ukuqonda ukuthi kwenzekani emzimbeni wakho nokwazi izinketho zakho kungakusiza uzizwe ulawula kakhulu ngalesi sikhathi esinzima.

Iyini I-End-Stage Renal Disease?

Ubuhlungu bokwehluleka kwempumputhe kusho ukuthi izinkulungwane zakho zilahlekelwe cishe ngamandla azo onke okwenza umsebenzi wazo. Izinkulungwane zakho ngokuvamile zisebenza njengezihlungi ezihlakaniphile, zihlanza imikhiqizo yokuwohloka namanzi engeziwe egazini lakho ngenkathi zigcina izinto ezinhle umzimba wakho ozidingayo.

Uma ufika kulesi sigaba, izinkulungwane zakho zisebenza ngaphansi kuka-10% komsebenzi wazo ovamile. Cabanga ngakho njengefilitha lamanzi elivalekile kangangokuthi alinaso isikhathi sokuvumela amanzi ahlanzekile ukuba adlule. Umzimba wakho uqala ukuqoqa ubuthi namanzi okuvame ukususwa ngomchamo.

Lokhu kubizwa nangokuthi ukwehluleka kwempumputhe noma isifo sempumputhe esingapheli sesigaba 5. Igama elithi "isigaba sokugcina" libhekisela enkambweni yesifo sempumputhe, hhayi ekuphileni kwakho. Abantu abaningi abane-ESRD baphila iminyaka eminingi ngokwelashwa okulungile nokunakekelwa.

Ziyini Izimpawu Zesifo Sempumputhe Esigabeni Sokugcina?

Izimpawu ze-ESRD zithuthuka kancane njengoba umsebenzi wempumputhe yakho uya ehla, futhi zingathinta kakhulu impilo yakho yansuku zonke. Umzimba wakho uqala ukubonisa izimpawu zokuthi imikhiqizo yokuwohloka namanzi engeziwe ayakwakha.

Nawa zimpawu ezivamile ongazihlangabezana nazo:

• Ukukhathala okukhulu nobuthakathaka obungaphuli ngokuphumula
• Ukukhula ezinyaweni, ezinweleni, ezinyaweni, noma eduze kwamehlo akho
• Ukuphefumula kancane, ikakhulukazi uma ulele phansi
• Ukuphefumula nokuhlanza okungase kube kubi ngokuhamba kwesikhathi
• Ukulahlekelwa ukudla nokunciphisa isisindo ngaphandle kokuhlose
• Ukushintsha ekushiseni, kufaka phakathi ukushisa okuncane noma kungekho kushisa nhlobo
• Ukukhahlela okuqhubekayo emzimbeni wakho wonke
• Ukubamba kwemisipha nezinyawo ezingakhululeki
• Ukuphazamiseka kokulala nobunzima bokuqonda
• Ukunambitheka kwethusi emlonyeni wakho noma umoya omubi

Abanye abantu nabo bahlangabezana nezimpawu ezingavamile kodwa ezinzima. Lezi zifaka phakathi ubuhlungu esifubeni, ukucindezeleka kwegazi okuphezulu okunzima ukulawula, ukubamba, noma ukudideka. Lezi zimpawu zenzeka ngoba ibhalansi yezinto ezikhiqizayo emzimbeni wakho iyahlaziswa kakhulu.

Ubunzima kanye nokuhlanganiswa kwezimpawu kuyahlukahluka kumuntu ngamunye. Abanye abantu bazizwa begula kakhulu, kanti abanye bangaba nezimpawu ezilula ekuqaleni, ikakhulukazi uma bathola ukwelashwa kwasekuqaleni.

Ziyini Izimbangela Zesifo Sempumputhe Esigabeni Sokugcina?

I-ESRD ayenzeki ngobusuku obubodwa. Iyisiphumo sokugcina sesifo sempumputhe esingapheli esithuthukile izinyanga noma iminyaka, silimaze izinkulungwane zakho kancane kancane kuze zingasasebenzi.

Izimo eziyisisekelo ezivamile eziholela ku-ESRD zifaka phakathi:

• I-Diabetes (bobabili uhlobo 1 nohlobo 2) - ibalelwa cishe ku-40% yezimo ze-ESRD
• Ukucindezeleka kwegazi okuphezulu okulimaza imithambo yegazi yempumputhe ngokuhamba kwesikhathi
• I-Polycystic kidney disease, lapho ama-cyst akhula khona ezinkulungwaneni
• I-Glomerulonephritis, ukuvuvukala kwama-unit okuhlunga kwempumputhe
• Izifo zokuziphatha komzimba njenge-lupus ezihlasela inyama yempumputhe
• Izifo zezakhiwo ezithinta ukuthuthukiswa noma umsebenzi wempumputhe
• Ukutheleleka kwempumputhe okuvamile noma ukuvimba
• Ukusetshenziswa isikhathi eside kwamakhambi athile angalimaza izinkulungwane

Ngokungavamile, i-ESRD ingabangelwa izimo zezakhiwo ezingavamile njenge-Alport syndrome, ethinta amaprotheni ezihlungi zempumputhe. Abanye abantu bathuthukisa i-ESRD ngenxa yokulimazeka kwempumputhe okungaphuli, nakuba lokhu kungavamile.

Kweminye imicimbi, odokotela abakwazi ukubona imbangela ethile, okuthiwa yi-idiopathic ESRD. Okubaluleke kakhulu ukuthola ukwelashwa okulungile lapho ukhona manje, kungakhathaliseki ukuthi yini eyaqala ukubangela isifo sempumputhe sakho.

Nini Okufanele Ubone Udokotela Ngesifo Sempumputhe Esigabeni Sokugcina?

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nezimpawu ezinkulu ezingabonisa ukuthi izinkulungwane zakho ziyahluleka. Ungalindi uma unezinkinga zokuphefumula, ubuhlungu esifubeni, noma izimpawu zokwakheka okukhulu kwamanzi.

Xhumana nodokotela wakho ngokushesha uma uqaphela ukukhula okukhulu ezinyaweni zakho noma ebusweni, ushisa kakhulu kunokujwayelekile, noma uzizwa ubuthakathaka kakhulu futhi uhlanza. Lezi zimpawu zingaba zimbi ngokushesha ngaphandle kokwelashwa.

Uma usuvele unesifo sempumputhe esingapheli, ukulandelela njalo nodokotela wakho we-nephrologist (ochwepheshe wezinkulungwane) kubalulekile. Bazolandelela umsebenzi wempumputhe yakho ngokuhlolwa kwegazi futhi bakusize ukulungiselela izinketho zokwelashwa ngaphambi kokuba ufike esigabeni sokugcina sesifo.

Isimo esiphuthumayo sifaka phakathi ubunzima bokuphumula, ubuhlungu esifubeni, ukukhula okukhulu, ukudideka, noma ukubamba. Lezi zimpawu zidinga ukunakekelwa kwesibhedlela ngokushesha njengoba zingaba yingozi ekuphileni.

Ziyini Izingozi Zesifo Sempumputhe Esigabeni Sokugcina?

Izici eziningi zingandisa amathuba akho okuthuthukisa i-ESRD, nakuba ukuba nezici zengozi akusho ukuthi uzokuthuthukisa ngokuqinisekile lesi simo. Ukuqonda lezi zici kungakusiza wena neqembu lakho lokunakekelwa kwezempilo ukuba nithathe izinyathelo zokuvimbela uma kungenzeka.

Izingozi eziyisisekelo zifaka phakathi:

• Ukuba ne-diabetes, ikakhulukazi uma amazinga e-blood sugar alawulwa kabi
• Ukucindezeleka kwegazi okuphezulu okungalawulwa kahle ngokuhamba kwesikhathi
• Umlando womndeni wesifo sempumputhe noma izifo zezakhiwo zempumputhe
• Ukuba ngaphezu kweminyaka engama-60, njengoba umsebenzi wempumputhe uyancipha ngokwemvelo ngokuya kweminyaka
• Ubuzwe base-Afrika Amerika, i-Hispanic, noma i-Native American
• Ukuba nesifo senhliziyo noma izinkinga zenhliziyo
• Ukukhuluphala, okungenza i-diabetes nokucindezeleka kwegazi okuphezulu kube kubi
• Ukubhema, okulimaza imithambo yegazi kufaka phakathi eyempumputhe

Izingozi ezengeziwe zifaka phakathi ukuba nezifo zokuziphatha komzimba njenge-lupus, umlando wokulimazeka kwempumputhe okukhulu, noma ukusetshenziswa isikhathi eside kwamakhambi okuhlunguza ubuhlungu. Abanye abantu banezimo zezakhiwo ezingavamile ezenza isifo sempumputhe sibe ngokuvamile.

Izindaba ezinhle ukuthi izici eziningi zengozi zingalawulwa. Ukusebenzisana neqembu lakho lokunakekelwa kwezempilo ukulawula i-diabetes, ukucindezeleka kwegazi, nezinye izimo kunganciphisa ukuqhubeka kwesifo sempumputhe kakhulu.

Ziyini Izingozi Ezingase Zenzeke Ngesifo Sempumputhe Esigabeni Sokugcina?

I-ESRD ithonya izinhlelo eziningi emzimbeni wakho ngoba izinkulungwane zakho zenza imisebenzi eminingi ebalulekile ngaphandle kokuhlamba ubuthi. Uma zingasasebenzi kahle, izinkinga eziningi ezinzima zingathuthuka.

Izingozi ezivamile ongazihlangabezana nazo zifaka phakathi:

• Izinkinga zenhliziyo, kufaka phakathi isifo senhliziyo nokubetha okungavamile kwenhliziyo
• I-Bone disease nokunyuka kengozi yokugqwala
• I-Anemia (ukuncane kwamaseli egazi abomvu) okubangela ukukhathala okukhulu
• Ukucindezeleka kwegazi okuphezulu okuba nzima ukulawula
• Ukukhula kwamanzi emaphashini, okwenza ukuphefumula kube nzima
• Ukungahambisani kwama-electrolyte okuthonya umsebenzi wenhliziyo nemisipha
• Ukunyuka kengozi yokutheleleka ngenxa yesistimu yokuvimbela esibuthakathaka
• Izinkinga zokopha ngenxa yokungabi kahle kokugqwala kwegazi

Abanye abantu bahlangabezana nezingozi ezingavamile kodwa ezinzima. Lezi zifaka phakathi ubuhlungu obukhulu emathanjeni, ukulimala kwama-nerve okubangela ukungathandeki noma ukukhahlela, nezinkinga zokuqonda njengobunzima bokuqonda noma izinkinga zokukhumbula.

Izinselele zempilo yengqondo nazo zivamile, kufaka phakathi ukucindezeleka nokukhathazeka ngokuxilongwa nokwelashwa. Lokhu kuqondakala ngokuphelele futhi kulashwa ngokusekelwa okulungile nokunakekelwa.

Eziningi zalezi zingozi zingalawulwa kahle ngokwelashwa okulungile. Iqembu lakho lokunakekelwa kwezempilo lizokulandela eduze futhi lilungise ukwelashwa ukuvimbela noma ukunciphisa lezi zinkinga.

Indlela Yokuxilongwa Kwesifo Sempumputhe Esigabeni Sokugcina?

Ukuxilongwa kwe-ESRD kuhilela ukuhlolwa kwegazi okuqapha ukuthi izinkulungwane zakho zihlanza kahle kangakanani ubuthi egazini lakho. Udokotela wakho uzosebenzisa ukubalwa okuthiwa yi-estimated glomerular filtration rate (eGFR) ukuqonda umsebenzi wempumputhe yakho.

I-eGFR engaphansi kuka-15 milliliters ngomzuzu ibonisa isifo sempumputhe esigabeni sokugcina. Ukuqhathanisa, umsebenzi wempumputhe ovamile yi-eGFR engu-90 noma ngaphezulu. Udokotela wakho uzohlola namazinga akho e-creatinine, enyuka uma izinkulungwane zingahlambululi kahle.

Ukuhlolwa okuengeziwe kusiza ukuhlola umthelela empilweni yakho yonke. Lokhu kufaka phakathi ukuhlola amazinga akho e-hemoglobin ye-anemia, ukulinganisa ama-electrolyte njenge-potassium ne-phosphorus, nokulinganisa impilo yamathambo akho ngezinga le-calcium ne-parathyroid hormone.

Udokotela wakho angase futhi ayalele ukuhlolwa kwezithombe njenge-ultrasounds noma i-CT scans ukubuka usakhiwo lwempumputhe yakho. Ngezinye izikhathi i-kidney biopsy idingeka ukuqonda imbangela eqondile yesifo sempumputhe sakho, nakuba lokhu kungadingeki njalo ekucwaningeni kokwelashwa.

Iyini Indlela Yokwelashwa Kwesifo Sempumputhe Esigabeni Sokugcina?

Ukwelashwa kwe-ESRD kuhilela ukufaka esikhundleni umsebenzi ozinkulungwane zakho ezingasawenzi. Kukhona izinketho eziningi ezisebenzayo, futhi iqembu lakho lokunakekelwa kwezempilo lizokusiza ukukhetha okulungile esimweni sakho nendlela yakho yokuphila.

Izinketho zokwelashwa eziyinhloko zifaka phakathi:

1. I-Hemodialysis: Umshini uhlanza igazi lakho kathathu ngesonto, ngokuvamile esikhungweni se-dialysis. Iseshini ngayinye ithatha cishe amahora angu-4, futhi umshini wenza umsebenzi wokuhlamba izinkulungwane zakho ezingasawenzi.
2. I-Peritoneal dialysis: Isebenzisa ukugqoka esiswini sakho ukuhlanza ubuthi. Ungakwenza lokhu ekhaya, ngosuku noma ebusuku ngenkathi ulele.
3. Ukuhlinzwa kwempumputhe: Ufaka izinkulungwane zakho ezilimele ngempumputhe enempilo evela kumnikelo. Lokhu kungaveza umnikelo ophilayo noma umuntu ofile.

Udokotela wakho uzobhala namakhambi ukulawula izinkinga. Lokhu kungafaka phakathi amakhambi e-anemia, isifo samathambo, ukucindezeleka kwegazi okuphezulu, nokusiza ukulawula amazinga e-phosphorus egazini lakho.

Abanye abantu abalona abakhethiwe be-dialysis noma ukuhlinzwa ngenxa yezinye izimo zempilo. Kulezi zimo, iqembu lakho lokunakekelwa kwezempilo lizogxila ekunakekelweni kokunethezeka nokuphatha izimpawu ukuze ugcine ikhwalithi yakho yokuphila.

Ukukhetha phakathi kokwelashwa kuncike ezintweni eziningi kufaka phakathi iminyaka yakho, impilo yonke, ukukhetha indlela yokuphila, namasiko akho siqu. Alukho ukwelashwa olulodwa "oluhle" kubo bonke.

Indlela Yokunakekela Wena Ngesikhathi Sesifo Sempumputhe Esigabeni Sokugcina?

Ukukhathalela wena nge-ESRD kuhilela kokubili ukwelashwa kwezokwelapha nokwenza izinguquko ekuphileni okungakusiza uzizwe ukhulu futhi uvikele izinkinga. Izinqubo ezincane zingenza umehluko obalulekile endleleni ozizwa ngayo usuku nosuku.

Izinqubo zokudla zivame ukudingeka futhi zingasiza ukunciphisa izimpawu. Cishe uzodinga ukulinganisela amaprotheni, i-phosphorus, i-potassium, ne-sodium ekudleni kwakho. Uchwepheshe wokudla we-renal angakusiza ukudala izinhlelo zokudla ezinobungane ezinkulungwaneni futhi zijabulise.

Ukusebenza njengoba kungenzeka ngaphakathi kwemingcele yakho kusiza ukugcina amandla emisipha futhi kuthuthukisa isimo sengqondo. Ngisho nemisebenzi elula njengokuhamba noma ukwelula ingaba usizo. Iqembu lakho lokunakekelwa kwezempilo lingancoma izinketho zokuzivocavoca ezifanele esimweni sakho.

Ukuphatha amakhambi akho ngokucophelela kubalulekile. Thatha wonke amakhambi abhalwe ngokuqondile njengoba aqondiswe, futhi ungalokothi uyeke noma ushintshe izilinganiso ngaphandle kokukhuluma nodokotela wakho kuqala. Gcina uhlu lwamakhambi akho onalo.

Ukusekelwa ngokomzwelo kubaluleke kakhulu njengokunakekelwa komzimba. Cabanga ngokujoyina iqembu lokuzoxhasa labantu abanesifo sempumputhe, ukukhuluma nomeluleki, noma ukuxhumana nabanye abaqonda ukuthi uhamba ngani.

Kufanele Uzilungiselele Kanjani Ukuya Kwinduna Yakho?

Ukulungiselela izihlalo zokulalela nodokotela wakho wezinkulungwane kusiza ukuqinisekisa ukuthi uthola okuningi ekuhambeni kwakho futhi ubuze yonke imibuzo yakho. Ukuba uhlelile kungasiza ukunciphisa ukukhathazeka futhi kwenze izihlalo zokulalela zibe nomphumela omkhulu.

Ngaphambi kokulalela kwakho, bhala zonke izimpawu zakho, ngisho noma zibonakala zingahlobene nezinkulungwane zakho. Faka lapho zaqala khona, ukuthi zinkulu kangakanani, nokuthi yini ezenza zibe ngcono noma zimbi. Lolu lwazi lusiza udokotela wakho ukuqonda ukuthi uzizwa kanjani.

Letha uhlu oluphelele lwawo wonke amakhambi, izithasiselo, namavithamini owathathayo. Faka izilinganiso nokuthi uwasebenzisa kangaki. Letha nawo wonke imiphumela ye-lab yakamuva noma amarekhodi avela kwabanye odokotela obabonile.

Lungiselela uhlu lwemibuzo ofuna ukuyibuza. Ungakhathazeki ngokubuza imibuzo eminingi kakhulu - iqembu lakho lokunakekelwa kwezempilo lifuna ukukusiza uqonde isimo sakho nezinketho zokwelashwa ngokuphelele.

Cabanga ngokuletha ilungu lomndeni noma umngani emihlanganweni ebalulekile. Bangakusiza ukukhumbula ulwazi oluxoxwe futhi banike ukusekelwa ngokomzwelo ngesikhathi sokuqonda okunzima ngezinketho zokwelashwa.

Iyini Iphuzu Eliyinhloko Ngesifo Sempumputhe Esigabeni Sokugcina?

Ubuhlungu bokwehluleka kwempumputhe yisimo esinzima, kodwa akuyona isahlulelo sokufa. Ngokwelashwa okulungile, abantu abaningi baphila iminyaka eminingi futhi bagcina ikhwalithi enhle yokuphila. Okubalulekile ukusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo nokugcina impilo enhle ngangokunokwenzeka.

Ukulungiselela kwasekuqaleni nokufunda ngezinketho zakho zokwelashwa kungakusiza ukwenza izinqumo ezinolwazi ezivumelana namasiko akho nendlela yakho yokuphila. Kungakhathaliseki ukuthi ukhetha i-dialysis, ulandele ukuhlinzwa, noma ugxile ekunakekelweni kokunethezeka, kunezindlela zokuphatha lesi simo ngokuphumelelayo.

Khumbula ukuthi ukuba ne-ESRD akuchazi wena. Abantu abaningi baqhubeka besebenza, behamba, futhi bajabulela ubuhlobo ngenkathi bephethe isifo sempumputhe sabo. Ukuhlungekela kuthatha isikhathi, kodwa ngokusekelwa nokunakekelwa okulungile, ungazivumelanisa naleli qophelo elisha ekuphileni kwakho.

Iqembu lakho lokunakekelwa kwezempilo likhona ukukusekela yonke inyathelo lendlela. Unganqikazi ukubuza imibuzo, ubonise ukukhathazeka, noma ucele usizo uma ukudinga.

Imibuzo Evamile Ebuzwayo Ngesifo Sempumputhe Esigabeni Sokugcina

UMbuzo 1: Ungaphila isikhathi esingakanani unesifo sempumputhe esigabeni sokugcina?

Isikhathi sokuphila nge-ESRD sihluka kakhulu kuye ngeminyaka yakho, impilo yonke, nokukhetha ukwelashwa. Abantu abaningi abasebenzisa i-dialysis baphila iminyaka engama-10-20 noma ngaphezulu, kanti labo abamukela ukuhlinzwa kwempumputhe bavame ukuphila isikhathi eside. Okubalulekile ukuthola ukwelashwa okulungile nokukhathalela impilo yakho yonke. Udokotela wakho angakunika umbono oqondile ngesimo sakho esithile.

UMbuzo 2: Ingabe i-Cannabis noma ukudla okuthile kuyaphilisa isifo sempumputhe esigabeni sokugcina?

Alukho ukwelashwa kwemvelo, ukudla, noma isithasiselo esingaphilisa i-ESRD noma sibuyise umsebenzi wempumputhe uma usuvele ufike kulesi sigaba. Nakuba ukugcina ukudla okuhle kubalulekile empilweni yakho yonke, izinkulungwane ezilimele azikwazi ukuzithuthukisa noma ziziphilise. Ukwelashwa kwezokwelapha kuphela njenge-dialysis noma ukuhlinzwa kwempumputhe kungafaka esikhundleni umsebenzi wezinkulungwane ezilimele. Hlala uxoxa nanoma yiziphi izithasiselo noma izindlela zokwelashwa ezihlukile nodokotela wakho ngaphambi kokuzizama.

UMbuzo 3: Ingabe i-dialysis ibuhlungu?

Abantu abaningi abazihlangabezani nobuhlungu obukhulu ngesikhathi sokwelashwa kwe-dialysis. Ungase uzizwe ungakhululekile uma izimpumputhe zifakwa nge-hemodialysis, kufana nokuthatha igazi. Abanye abantu bazizwa bekhathele noma babe nemisipha ngesikhathi noma ngemuva kokwelashwa, kodwa lezi zimpawu ngokuvamile ziyaphuli njengoba uzivumelanisa ne-dialysis. Iqembu lakho lokunakekelwa kwezempilo lingakusiza ukuphatha noma yiluphi ubunzima obuhlangabezana nalo.

UMbuzo 4: Ungahamba yini uma unesifo sempumputhe esigabeni sokugcina?

Yebo, abantu abaningi abane-ESRD baqhubeka behamba, nakuba kudingeka uhlele kusengaphambili. Uma usebenzisa i-hemodialysis, kuzodingeka uhlalele ukwelashwa ezikhungweni ze-dialysis ekuhambeni kwakho. I-Peritoneal dialysis inikeza inkululeko enkulu ngoba ngokuvamile ungathatha izinto ozidingayo nawe. Abantu abane-kidney transplants ngokuvamile banekhululeko enkulu yokuhamba uma sebeqinile ngamakhambi abo.

UMbuzo 5: Ngizokwazi yini ukusebenza ngesifo sempumputhe esigabeni sokugcina?

Abantu abaningi baqhubeka besebenza ngenkathi bephethe i-ESRD, nakuba kungase kudingeke wenze izinguquko ezithile. Uhlobo lomsebenzi owenzayo, isimiso sakho sokwelashwa, nendlela ozizwa ngayo kuzothinta ikhono lakho lokusebenza. Abanye abantu basebenza isikhathi esigcwele, abanye isikhathi esingaphansi, kanti abanye kungase kudingeke bayeke ukusebenza okwesikhashana noma unomphela. Iqembu lakho lokunakekelwa kwezempilo lingakusiza uqonde ukuthi yini efanele esimweni sakho futhi likuxhumanise nezinsiza uma kudingeka.