Ukuqina Kwe-Artery Ye-Renal: Izimpawu, Izimbangela, Nokwelapha

Ukuqina kwe-artery ye-renal kuyisimo lapho i-arteries ezondla igazi ezinso zakho ziqina khona noma zivalwa. Lokhu kuqina kunciphisa ukusabela kwegazi kwenye noma kuzo zombili izinso, okungabangela ukucindezeleka kwegazi okuphezulu nezingqinamba zezinso ngokuhamba kwesikhathi.

Cabanga ngayo njengophahla lokugadini oluqiniswe noma oluvalwe ngokwengxenye. Njengoba amanzi ambalwa egeleza ngophahla olucindezelekile, igazi elincane lifika ezinsoni zakho lapho lezi arteries ezibalulekile ziqina. Izinso zakho zidinga ukusabela kwegazi okuzinzile ukuze zihlanze udoti futhi zisize ukulawula ukucindezeleka kwegazi kwakho, ngakho-ke lokhu kunciphisa kungadala uchungechunge lwezinkinga zempilo.

Ziyini izimpawu zokuqina kwe-artery ye-renal?

Abantu abaningi abane-renal artery stenosis ababonisi izimpawu ezicacile ezigabeni zokuqala. Isimo sivame ukuthuthuka kancane kancane, futhi umzimba wakho ungase uzilungiselele izinguquko ekuqaleni ngaphandle kokuthumela izibonakaliso ezicacile zezesixwayiso.

Uma izimpawu zivele, zivame ukuxhumene nokucindezeleka kwegazi okuphezulu nokushintsha kokusebenza kwezinso. Nanka amabhande ongawabona:

• Ukucindezeleka kwegazi okuphezulu okunzima ukulawula ngemithi
• Ukuqala ngokuzumayo kokucindezeleka kwegazi okuphezulu, ikakhulukazi uma uneminyaka engaphansi kuka-30 noma ngaphezulu kuka-50
• Ukuvuvukala ezinyaweni, ezinzwini, noma ezinyaweni
• Ukunciphisa kokusebenza kwezinso okubonakala ekuhlolweni kwegazi
• Ilizwi eliphumula (bruit) elizwile udokotela wakho lapho elalela isisu sakho
• Izinhlungu zikhanda ezihlobene nokucindezeleka kwegazi okuphezulu
• Ukukhathala noma ubuthakathaka
• Ukushintsha kwemikhuba yokumisa

Lezi zimpawu zingase zibe buthakathaka futhi zingase zithuthuke ngezinyanga noma iminyaka. Uma ubona ukucindezeleka kwegazi okuphezulu okuqhubekayo noma noma iyiphi inhlanganisela yalezi zibonakaliso, kufanele uxoxe nodokotela wakho.

Ziyini izinhlobo zokuqina kwe-artery ye-renal?

Kunezinhlobo ezimbili eziyinhloko zokuqina kwe-artery ye-renal, ngayinye inezinga ezahlukene zezimbangela nezici. Ukuqonda ukuthi yiluphi uhlobo olukhona kusiza ukuqondisa indlela yokwelapha ephumelelayo.

Ukuqina kwe-artery ye-renal kwe-Atherosclerotic yilohlobo oluvamile kakhulu, olumelela cishe u-90% lamacala. Lokhu kwenzeka lapho amafutha nama-plaque eqoqwa e-arteries ye-renal, kufana nalokho okwenzeka ekusabela kwenhliziyo. Ngokuvamile kuthinta abadala futhi kuvame ukwenzeka kanye nezinye izimo ze-cardiovascular.

I-Fibromuscular dysplasia (FMD) ayivamile kodwa ivame ukuthinta abantu abasebasha, ikakhulukazi abesifazane abaneminyaka engama-15 kuya kwengu-50. Kulolu hlobo, imisipha nezinsimbi ze-fibrous odongeni lwe-artery zikhula ngokungavamile, zidala ukubukeka “okunqamuzayo” ekuhlolweni kwezithombe. Imbangela eqondile ye-FMD ayiqondakali ngokuphelele, kodwa ayihlobene ne-atherosclerosis.

Yini ebangela ukuqina kwe-artery ye-renal?

Izimbangela zokuqina kwe-artery ye-renal ziyahluka kuye ngohlobo olukhona. Ukuqonda lezi zimbangela kungakusiza wena nodokotela wakho ukuba nithuthukise isu elihle kakhulu lokuvimbela nokwelapha.

Ngokuqina kwe-artery ye-renal kwe-atherosclerotic, izici ezifanayo ezifaka isandla ekusabela kwenhliziyo zisebenza:

• Amazinga aphezulu e-cholesterol aholela ekuqokeleleni kwe-plaque
• I-Diabetes, elimaza imithambo yegazi ngokuhamba kwesikhathi
• Ukubhema, okushesisa ukulimala kwemithambo
• Ukucindezeleka kwegazi okuphezulu okuqina odongeni lwe-artery
• Ukushintsha okuphathelene nobudala emithambweni yegazi
• Umlando womndeni wesifo senhliziyo

I-Fibromuscular dysplasia inezimbangela ezahlukene, ezingaqondakali kahle. Abacwaningi bakholelwa ukuthi kungase kuhileleke:

• Izici ze-genetic eziqeda ukuthuthukiswa kwemithambo yegazi
• Imiphumela ye-hormonal, ikakhulukazi kwabesifazane
• Ukukhula okungavamile kweseli odongeni lwe-artery

Emacaleni amancane, ezinye izimo zingabangela ukuqina kwe-artery ye-renal, kufaka phakathi izifo ezithile ezivuvukalayo njenge-Takayasu arteritis noma i-neurofibromatosis. Lezi zimo zithinta imithambo yegazi kulo lonke umzimba futhi zingase zihilele i-arteries ye-renal njengengxenye yesibonelo esibanzi.

Nini okufanele ubone udokotela ngokuqina kwe-artery ye-renal?

Kufanele ucabange ukuya kudokotela wakho uma une-high blood pressure enzima ukuyilawula noma uma ivele ngokuzumayo. Lokhu kubaluleke kakhulu uma uneminyaka engaphansi kuka-30 noma ngaphezulu kuka-50, njengoba lezi zikhathi zokuphila zinezingozi eziphezulu zokuqina kwe-artery ye-renal.

Funani ukunakekelwa kwezokwelapha uma uhlangabezana nanoma yiziphi lezi zimo:

• Ukucindezeleka kwakho kwegazi kuhlala kuphezulu naphezu kokuthatha imithi eminingi
• Uthuthukisa ukucindezeleka okuphezulu kwegazi ngokushesha
• Izivivinyo zegazi zibonisa ukunciphisa kokusebenza kwezinso
• Une-swelling ezinyaweni, ezinzwini, noma ezinyaweni
• Uhlangabezana nezinhlungu zikhanda eziqhubekayo ngokucindezeleka kwegazi okuphezulu
• Une-family history yezingqinamba zezinso noma isifo senhliziyo esiqalayo

Ungalindi uma unezimpawu ezikhathazayo. Ukutholwa kwangaphambi kwesikhathi nokwelapha kungavimbela izinkinga futhi kusize ukulondoloza ukusebenza kwezinso zakho. Udokotela wakho angenza izivivinyo ezilula ukuhlola izibonakaliso zakho zokucindezeleka kwegazi nokusebenza kwezinso.

Ziyini izingozi zokuqina kwe-artery ye-renal?

Izici eziningi zingandisa amathuba akho okuthuthukisa ukuqina kwe-artery ye-renal. Ezinye ungazilawula ngokushintsha indlela yokuphila, kanti ezinye zihlangene ne-genetics yakho noma umlando wakho wezokwelapha.

Izingozi zokuqina kwe-artery ye-renal kwe-atherosclerotic zifaka:

• Iminyaka engaphezulu kwengu-50
• Ukubhema noma ukusetshenziswa kwe-tobacco
• Amazinga aphezulu e-cholesterol
• I-Diabetes
• Ukucindezeleka kwegazi okuphezulu
• Umlando womndeni wesifo senhliziyo noma isifo sobuchopho
• Ukuba owesilisa (ingozi encane ephakeme)
• Ukukhuluphala
• Indlela yokuphila engasebenzi

Ngokuqina kwe-fibromuscular dysplasia, izingozi zihlukile:

• Ukuba owesifazane, ikakhulukazi phakathi kweminyaka engama-15-50
• Umlando womndeni we-FMD
• Ukuba nezinye izimo ze-vascular

Ukuqonda izingozi zakho kusiza ukusebenzisana neqembu lakho lezokunakekelwa kwezempilo ukuqapha impilo yakho eduze futhi wenze izinguquko zendlela yokuphila ezinganciphisa ingozi yezinkinga.

Ziyini izinkinga ezingase zenzeke ngokuqina kwe-artery ye-renal?

Uma ukuqina kwe-artery ye-renal kungelaphiwa, kungabangela izinkinga ezinkulu ezithinta izinso zakho kanye nesistimu yakho ye-cardiovascular. Lezi zinkinga zithuthuka kancane kancane njengoba isimo sibuhlungu ngokuhamba kwesikhathi.

Izinkinga ezivamile kakhulu zifaka:

• I-Chronic kidney disease noma ukwehluleka kwezinso
• Ukucindezeleka kwegazi okuphezulu okunzima ukulawula
• Izingqinamba zenhliziyo, kufaka phakathi ukuhlaselwa kwenhliziyo nokuhluleka kwenhliziyo
• Isifo sobuchopho ngenxa yokucindezeleka kwegazi okuphezulu okungalawuleki
• Ukugcinwa kwamanzi nokuvuvukala
• Ukungahlangani kahle kwe-electrolyte

Emacaleni aqinile, ungase uthuthukise okuthiwa yi-“flash pulmonary edema,” lapho amanzi eqoqwa ngokuzumayo emaphaphwini akho. Lokhu kuyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa ngokushesha. Izindaba ezinhle ukuthi ngokunakekelwa okuqondile nokwelapha, izinkinga eziningi zingavikeleka noma ziphathwe kahle.

Ukuqina kwe-artery ye-renal kunqunywa kanjani?

Ukunqunywa kokuqina kwe-artery ye-renal ngokuvamile kuqala ngodokotela wakho obuyekeza izimpawu zakho nomlando wakho wezokwelapha. Bayokunaka ngokukhethekile izibonakaliso zakho zokucindezeleka kwegazi nanoma yikuphi ukushintsha kokusebenza kwezinso okubonakala ekuhlolweni kwegazi okuvamile.

Udokotela wakho cishe uzoqala ngokuhlolwa komzimba, elalela imisindo engavamile ebizwa ngokuthi yi-bruits phezu kwesisu sakho. Lezi zizwi eziphumula zingabonisa ukusabela kwegazi okuphazamisekile nge-arteries ecindezelekile.

Izivivinyo eziningi zezithombe zingakuqinisekisa ukunqunywa:

• I-Doppler ultrasound ilinganisa ukusabela kwegazi nge-arteries yakho ye-renal
• I-CT angiography inikeza izithombe eziningi ze-blood vessels zakho
• I-MR angiography isebenzisa ama-magnetic fields ukuze ibonise i-arteries zakho
• I-Renal angiography iyivivinyo eliqondile kakhulu kodwa ihilela ukufaka i-catheter

Izivivinyo zegazi zizohlola ukusebenza kwezinso zakho futhi zibheke izibonakaliso zokunciphisa kokusiza. Udokotela wakho angase futhi ayale ezinye izivivinyo ukuze akhiphe ezinye izimbangela zokucindezeleka kwegazi okuphezulu noma izingqinamba zezinso.

Iyini indlela yokwelapha yokuqina kwe-artery ye-renal?

Ukwelapha ukuqina kwe-artery ye-renal kugxile ekulawuleni ukucindezeleka kwegazi, ukulondoloza ukusebenza kwezinso, nokuvimbela izinkinga. Indlela ixhomeke ekuqineni kwesimo sakho nempilo yakho yonke.

Ukwelapha kwezokwelapha ngokuvamile kuza kuqala futhi kufaka:

• I-ACE inhibitors noma i-ARBs ukunciphisa ukucindezeleka kwegazi nokukhuthaza izinso
• I-Diuretics ukusiza ukususa amanzi engeziwe
• I-Calcium channel blockers ukulawula ukucindezeleka kwegazi
• I-Statins ukulawula amazinga e-cholesterol
• I-Antiplatelet therapy ukuvimbela ukugqwala kwegazi

Ngokuqina okukhulu, udokotela wakho angase akhuthaze izinqubo zokuvula i-arteries evaliwe:

• I-Angioplasty ne-stenting ukuze banwebe i-artery ecindezelekile
• Ukuhlinzwa kwe-bypass ukudala indlela entsha yokusabela kwegazi

Ukukhetha phakathi kokwelapha kwezokwelapha nokwenziwa kwenqubo kuyahlukahluka kuye ngezici ezinjengokuthi ukuqina kakhulu kangakanani, izimpawu zakho, nokusebenza kwezinso zakho. Iqembu lakho lezokunakekelwa kwezempilo lizosisebenzisana nawe ukuze unqume indlela engcono kakhulu yesimo sakho esithile.

Indlela yokwelapha ekhaya ngesikhathi sokuqina kwe-artery ye-renal?

Ukuphatha ukuqina kwe-artery ye-renal ekhaya kuhilela ukushintsha indlela yokuphila nokuqapha okucophelelayo okusekela ukwelashwa kwakho kwezokwelapha. Lezi zinyathelo zingasiza ekulawuleni ukucindezeleka kwakho kwegazi nokukhuthaza ukusebenza kwezinso zakho.

Gxilisa kulezi zindawo eziyinhloko:

• Thatha imithi yakho ngokuqondile njengoba kuyalelwe, ngisho noma uzizwa kahle
• Qapha ukucindezeleka kwakho kwegazi njalo ekhaya
• Landela ukudla okune-sodium ephansi ukuze usize ukulawula ukucindezeleka kwegazi
• Hlala usebenza ngokomzimba ngemvume yodokotela wakho
• Yekela ukubhema uma ubhema njengamanje
• Linganisela ukusetshenziswa kotshwala
• Gcina isisindo esinempilo
• Lawula ukucindezeleka ngezindlela zokupumula

Gcina ulandelela izimpawu zakho nokufunda kokucindezeleka kwegazi ukuze uhlanganyele neqembu lakho lezokunakekelwa kwezempilo. Lolu lwazi lubasiza ukulungisa uhlelo lwakho lokwelapha njengoba kudingeka. Ungenzi izinguquko emithini yakho ngaphandle kokubonisana nodokotela wakho kuqala.

Ukuqina kwe-artery ye-renal kungavikeleka kanjani?

Nakuba ungakwazi ukuvimbela wonke amacala okuqina kwe-artery ye-renal, unganciphisa kakhulu ingozi yakho ngokulawula izici ezifaka isandla esifweni se-atherosclerotic. Izindlela eziningi ezivimbela inhliziyo yakho zivikela izinso zakho.

Izindlela zokuvimbela zifaka:

• Ungabhemi noma uyeke uma ubhema njengamanje
• Lawula ukucindezeleka kwakho kwegazi ngokudla nokuzivocavoca
• Phatha i-diabetes ngokucophelela uma unayo
• Gcina amazinga e-cholesterol anempilo
• Zivocavoca njalo ngesiqondiso sodokotela wakho
• Dla ukudla okunempilo kwenhliziyo okunothile izithelo nemifino
• Linganisela ukungenisa i-sodium kuya phansi kuka-2,300 mg ngosuku
• Gcina isisindo esinempilo

Ukuhlolwa okuvamile nodokotela wakho kubalulekile ekutholweni kwangaphambi kwesikhathi. Uma unezingozi zokuqina kwe-artery ye-renal, udokotela wakho angase akhuthaze ukuqapha okuvamile kokucindezeleka kwakho kwegazi nokusebenza kwezinso.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela i-appointment yakho kusiza ukuqinisekisa ukuthi uthola okuningi kakhulu ekuhambeni kwakho futhi kunikeza udokotela wakho ulwazi oluyidingayo ukuze akusize ngokuphumelelayo. Ukulungiselela okuhle kungenza umehluko ekutholeni ukunqunywa okuqondile nokwelashwa okufanele.

Ngaphambi kwe-appointment yakho, buza lolu lwazi:

• Bala yonke imithi yakho yangamanje, kufaka phakathi imithamo
• Bhala izimpawu zakho nokuthi zaqala nini
• Letha ukufunda kwakamuva kokucindezeleka kwegazi uma uqapha ekhaya
• Qaphela umlando womndeni wezingqinamba zezinso noma izinkinga zenhliziyo
• Lungisa imibuzo mayelana nesimo sakho nezinketho zokwelapha

Cabanga ukuletha ilungu lomndeni noma umngani ongakusiza ukukhumbula ulwazi oluxoxwe ngesikhathi sokuvakasha. Bhala imibuzo yakho ngaphambi kwesikhathi ukuze ungakhohlwa ukuyibuza. Udokotela wakho ufuna ukukusiza ukuqonda isimo sakho futhi uzizwe uqinisekile ngohlelo lwakho lokunakekelwa.

Iyini into ebalulekile mayelana nokuqina kwe-artery ye-renal?

Ukuqina kwe-artery ye-renal kuyisimo esilawuleka uma kutholakala ngokushesha futhi kuphathwe ngokufanele. Nakuba kungabangela izinkinga ezinkulu uma kungelaphiwa, abantu abaningi abanesimo esinjalo bangaphila impilo evamile, enempilo ngokunakekelwa kwezokwelapha okuqondile nokuphathwa kwendlela yokuphila.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukutholwa kwangaphambi kwesikhathi nokwelapha kwenza umehluko omkhulu emiphumeleni yakho yempilo yesikhathi eside. Ukusebenzisana eduze neqembu lakho lezokunakekelwa kwezempilo nokulandela uhlelo lwakho lokwelapha kungasiza ekuvimbeleni izinkinga nokugcina ukusebenza kwezinso zakho.

Unganqikazi ukubuza imibuzo noma ufune umbono wesibili uma ukhathazekile ngesimo sakho. Uyilungu elibalulekile ekuhlengeni kwakho, futhi ukuqonda isimo sakho kukwenza ukwazi ukuthatha izinqumo ezilwemi mayelana nokwelashwa kwakho nokukhetha kwakho kwendlela yokuphila.

Imibuzo evamile ebuzwa mayelana nokuqina kwe-artery ye-renal

Q.1: Ingabe ukuqina kwe-artery ye-renal kungelapheka ngokuphelele?

Ukuqina kwe-artery ye-renal kuvame ukuphathwa kahle, futhi kwezinye izimo, izinqubo ezinjenge-angioplasty zingabuyisela ukusabela kwegazi okuvamile ezinsoni. Noma kunjalo, izimo eziyisisekelo ezazibangela, njenge-atherosclerosis, zidinga ukuphathwa okuqhubekayo. Ngokwelashwa okuqondile, abantu abaningi bahlangabezana nokuthuthuka okukhulu ekulawuleni ukucindezeleka kwegazi nokusebenza kwezinso. Ukuqonda ukusebenzisana neqembu lakho lezokunakekelwa kwezempilo ukuthola inhlanganisela efanele yokwelapha yesimo sakho esithile.

Q.2: Ukuqina kwe-artery ye-renal kuyaqhubeka ngokushesha kangakanani?

Ukuqhubeka kokuqina kwe-artery ye-renal kuyahluka kakhulu kumuntu nomuntu. Ukuqina kwe-artery ye-renal kwe-Atherosclerotic ngokuvamile kuthuthuka kancane kancane eminyakeni eminingi, kanti i-fibromuscular dysplasia ingase iqhubeke ngokushesha kwezinye izimo. Ukuqapha okuvamile kusiza udokotela wakho ukulandelela noma yikuphi ukushintsha futhi alungise ukwelapha ngokufanele. Abantu abaningi abane-stenosis ephansi bahlala beqinile iminyaka eminingi ngokuphathwa okuqondile kwezokwelapha, kanti abanye bangase badinge ukungenelela okukhulu.

Q.3: Ingabe kunoma yikuphi ukulinganiselwa kokudla ngokuqina kwe-artery ye-renal?

Abantu abaningi abane-renal artery stenosis bayazuza ekudleni okunempilo kwenhliziyo okune-sodium ephansi namafutha agcwele. Uzothanda ukulinganisela i-sodium kuya phansi kuka-2,300 mg ngosuku ukuze usize ukulawula ukucindezeleka kwegazi. Uma ukusebenza kwezinso zakho kuthinteka, udokotela wakho angase akhuthaze ukulinganisela ukungenisa i-protein noma i-phosphorus. Noma kunjalo, izidingo zokudla ziyahlukahluka kuye ngesimo sakho esithile nokusebenza kwezinso, ngakho-ke kungcono ukusebenzisana nodokotela wezondlo obhalisiwe ongakwenzela uhlelo oluqondene nawe.

Q.4: Ingabe ukuzivocavoca kungasiza ngokuqina kwe-artery ye-renal?

Yebo, ukuzivocavoca okuvamile kungaba usizo kakhulu kubantu abane-renal artery stenosis, njengoba kusiza ekulawuleni ukucindezeleka kwegazi nokwenza impilo yonke ye-cardiovascular ibe ngcono. Noma kunjalo, kufanele uthole imvume yodokotela wakho ngaphambi kokuthi uqale noma yiluphi uhlelo lokuzivocavoca. Bangakhuthaza imisebenzi efanele ngokusekelwe esimweni sakho samanje sempilo nanoma yiziphi izinqubo ongazihlangabezana nazo. Abantu abaningi bangasebenza ngokuphepha emisebenzini ephansi njengokuhamba, ukubhukuda, noma ukuhamba ngebhayisikili uma isimo sabo siqine.

Q.5: Ingabe ngizodinga i-dialysis uma ngine-renal artery stenosis?

Abantu abaningi abane-renal artery stenosis abadingi i-dialysis, ikakhulukazi uma isimo sitholakala ngokushesha futhi siphathwe ngokufanele. I-Dialysis idingeka kuphela uma ukusebenza kwezinso kulimala kakhulu, okungavikeleka ngokuvamile ngokwelashwa okuqondile. Umgomo wokwelapha ukuqina kwe-artery ye-renal ukulondoloza ukusebenza kwezinso nokunciphisa ukuqhubeka kokwehluleka kwezinso. Ngokuphathwa okuhle kwezokwelapha nokushintsha kwendlela yokuphila, abantu abaningi bagcina ukusebenza okuqondile kwezinso kulo lonke impilo yabo.