Hemodialysis

Ekukhethweni kwegazi, umshini uhlanza izinto ezingcolile, ama-salt namafutha egazini lakho uma ikidney zakho zingasakwazi ukwenza lo msebenzi kahle. Ukukhethwa kwegazi (he-moe-die-AL-uh-sis) yindlela enye yokwelapha ukwehluleka okukhulu kwesibindi futhi kungakusiza ukuqhubeka nokuphila okusebenzayo naphezu kokwehluleka kwezinkidini.

Udokotela wakho uyokusiza ukuthi unqume ukuthi nini kufanele uqale ukuhlanzwa kwegazi ngokusekelwe ezintweni eziningi, okuhlanganisa: Impilo yakho jikelele Ukusebenza kwempilo yamathumbu Izimpawu kanye nezinhlungu Ukuhlangenwe nakho kokuphila Ukukhetha komuntu siqu Ungase uqaphele izimpawu nezinhlungu zokwehluleka kwempilo yamathumbu (uremia), njengokupukeka, ukugabha, ukuvuvukala noma ukukhathala. Udokotela wakho usebenzisa izinga lakho elikalwe lomsebenzi wegazi (eGFR) ukuze alinganise izinga lomsebenzi wakho wezinkalankala. I-eGFR yakho ibalekelwa ngokusebenzisa imiphumela yokuhlolwa kwegazi le-creatinine, ubulili, ubudala nezinye izinto. Inani elijwayelekile liyahlukahluka ngokubudala. Lokhu kulinganisa komsebenzi wakho wezinkalankala kungasiza ekuhleleni ukwelashwa kwakho, okuhlanganisa nokuthi nini kufanele uqale ukuhlanzwa kwegazi. Ukuhlanzwa kwegazi kungasiza umzimba wakho ukuthi ulawule ukucindezeleka kwegazi futhi ugcine ibhalansi efanele yamanzi nezinto eziningi ezibalulekile - njenge-potassium ne-sodium - emzimbeni wakho. Ngokuvamile, ukuhlanzwa kwegazi kuqala ngaphambi kokuthi izinkalankala zakho ziyeke ukusebenza ngokuphelele ngokuthi kubangele izinkinga ezingabulala. Izimbangela ezivamile zokwehluleka kwempilo yamathumbu zihlanganisa: Ubuhlungu beswekile Ukucindezeleka kwegazi (hypertension) Ukuvuvukala kwezinkalankala (glomerulonephritis) Ama-cyst ezinkalankala (polycystic kidney disease) Izifo zezinkalankala eziwusifa Ukusetshenziswa isikhathi eside kwama-drug angapheli-anti-inflammatory noma amanye ama-drug angalimaza izinkalankala Nokho, izinkalankala zakho zingase ziyeke ukusebenza ngokuzumayo (ukulimaza okukhulu kwempilo yamathumbu) ngemva kokugula okukhulu, ukuhlinzwa okuyinkimbinkimbi, ukuhlaselwa yinhliziyo noma enye inkinga enzima. Amanye ama-drug angabangela ukulimala kwezinkalankala. Abanye abantu abane-kidney failure ehlala isikhathi eside (chronic) bangase banqume ukuthi bangaqali ukuhlanzwa kwegazi futhi bakhethe indlela ehlukile. Esikhundleni salokho, bangase bakhethe ukwelashwa okukhulu kwezokwelapha, okuthiwa futhi ukuphathwa okuyisisekelo okukhulu noma ukunakekelwa okuthuthukisayo. Lokhu kwelashwa kuhilela ukuphathwa okuqhubekayo kwezinkinga ze-chronic kidney disease ephakeme, njengokugcwala kwamanzi, ukucindezeleka kwegazi okuphezulu nokuhlupheka kwegazi, ngokugxila ekuphathweni okusekela izimpawu ezithinta ikhwalithi yokuphila. Abanye abantu bangase babe yiziguli zokufakelwa kwesibindi sokuqala, esikhundleni sokuqala ukuhlanzwa kwegazi. Buza iqembu lakho lokukhathalela impilo ukuze uthole ulwazi oluthe xaxa mayelana nezinketho zakho. Lena yisinqumo somuntu ngamunye ngoba izinzuzo zokuhlanzwa kwegazi zingase zihluke, kuye ngezinkinga zakho zempilo.

Abantu abaningi abadinga ukuhlanzwa kwegazi banezinkinga eziningi zempilo. Ukuhlanzwa kwegazi kuhlala isikhathi eside kubantu abaningi, kepha ukulindela kokuphila kwabantu abakudingayo kusencane kunalabo abantu jikelele. Ngenkathi ukwelashwa kokuhlambulula igazi kungasebenza kahle ekufakeni imisebenzi ethile yeqiniso elilahlekile, ungase uhlangabezane nezinye zezimo ezihlobene ezibalwe ngezansi, yize kungekho muntu ohlangabezana nazo zonke lezi zinkinga. Iqembu lakho lokuhlanzwa lingakusiza ukuba ubhekane nazo. Ukuhla kwegazi (hypotension). Ukuwa kwegazi kuyisici esivamile sokuhlanzwa kwegazi. Ukuhla kwegazi kungase kuhambisane nokuqina kokuphefumula, ukugabha, ukugabha kwemisipha, isicanucanu noma ukugabha. Ukugabha kwemisipha. Nakuba imbangela ingacaci, ukugabha kwemisipha ngesikhathi sokuhlanzwa kwegazi kuyinto evamile. Ngezinye izikhathi ukugabha kungakhululeka ngokulungisa iresiphi yokuhlanzwa kwegazi. Ukulungisa ukudla kwamanzi nokudla okunosadimu phakathi kokwelashwa kokuhlambulula igazi kungasiza futhi ukuvimbela izimpawu ngesikhathi sokwelashwa. Ukukhahlela. Abantu abaningi abenza ukuhlanzwa kwegazi banezinhlungu zesikhumba, okuvame ukuba kubi kakhulu ngesikhathi noma ngemuva nje kwesinqumo. Izinkinga zokulala. Abantu abamukela ukuhlanzwa kwegazi bavame ukuba nezinkinga zokulala, ngezinye izikhathi ngenxa yokuphazamiseka kokuphefumula ngesikhathi sokulala (ukuphazamiseka kokuphefumula ngesikhathi sokulala) noma ngenxa yokubuhlungu, ukungakhululeki noma imilenze engaphumuli. Ukugula kwegazi. Ukungabi namaseli abomvu egazini lakho (ukugula kwegazi) kuyinkinga evamile yokwehluleka kwesibindi nokuhlanzwa kwegazi. Izibindi ezihlulekayo zunciphisa ukukhiqizwa kohormoni oluthiwa yi-erythropoietin (uh-rith-roe-POI-uh-tin), okuvuselela ukwakheka kwamaseli abomvu egazi. Ukunciphisa ukudla, ukungadli kahle kwentsimbi, ukuhlolwa kwegazi njalo, noma ukususwa kwentsimbi namavithamini ngokuhlanzwa kwegazi kungase futhi kuhlanganyele ekuguleni kwegazi. Izifo zamanfu. Uma izibindi zakho ezonakele zingasakwazi ukucubungula i-vitamin D, esikusiza ukuba uthathe i-calcium, amanfu akho angase abuthakathaka. Ngaphezu kwalokho, ukukhiqizwa okukhulu kohormoni lwe-parathyroid - inkinga evamile yokwehluleka kwesibindi - kungakhulula i-calcium emathanjeni akho. Ukuhlanzwa kwegazi kungase kwenze lezi zimo zibe zimbi ngokususa okuningi noma okuncane kakhulu kwe-calcium. Ukuhla kwegazi (hypertension). Uma uthola usawoti omningi noma uphuza amanzi amaningi, ukuphakama kwegazi lakho cishe kuzoba kubi futhi kuholele ezinkingeni zenhliziyo noma eziqhumini. Ukugcwala kwamanzi. Njengoba amanzi asuswa emzimbeni wakho ngesikhathi sokuhlanzwa kwegazi, ukuphuza amanzi amaningi kunconywayo phakathi kokwelashwa kokuhlambulula igazi kungabangela izinkinga ezisongela impilo, njengokwehluleka kwenhliziyo noma ukuqoqwa kwamanzi emaphashini (pulmonary edema). Ukuvuvukala kwe-membrane ezungezile inhliziyo (pericarditis). Ukuhlanzwa kwegazi okungenele kungabangela ukuvuvukala kwe-membrane ezungezile inhliziyo yakho, okungaphazamisa ikhono lenhliziyo yakho lokupompa igazi kwenye ingxenye yomzimba wakho. Amazinga aphezulu e-potassium (hyperkalemia) noma amazinga aphansi e-potassium (hypokalemia). Ukuhlanzwa kwegazi kususa i-potassium eyengeziwe, okuyiminwali evamile esuswa emzimbeni wakho yizibindi zakho. Uma i-potassium eningi noma encane kakhulu isuswa ngesikhathi sokuhlanzwa, inhliziyo yakho ingase ibetha ngokungajwayelekile noma iyeke. Izinkinga zendawo yokufinyelela. Izinkinga ezingaba yingozi - njengokuqunjelwa, ukuncipha noma ukukhula kodonga lwegazi (aneurysm), noma ukuvimba - kungathinta ikhwalithi yokuhlanzwa kwegazi. Landela imiyalelo yeqembu lakho lokuhlanzwa mayelana nendlela yokuhlola izinguquko endaweni yakho yokufinyelela ezingase zibonise inkinga. I-Amyloidosis. I-Dialysis-related amyloidosis (am-uh-loi-DO-sis) ithuthukiswa lapho amaprotheni egazini efakwa ezinhlanganweni nasemithanjeni, ebangela ubuhlungu, ubunzima namanzi ezinhlanganweni. Isimo sivame kakhulu kubantu abenze ukuhlanzwa kwegazi iminyaka eminingana. Ukuhlunguluka. Izinhlungu zimo yinto evamile kubantu abanehluleka kwesibindi. Uma uhlangabezana nokucindezeleka noma ukukhathazeka ngemuva kokuqala ukuhlanzwa kwegazi, khuluma neqembu lakho lezeMpilo mayelana nezinketho zokwelashwa ezisebenzayo.

Ukulungiselela ukuhlanzwa kwegazi kuqala amasonto ambalwa kuya ezinyangeni ezimbalwa ngaphambi kwesenzo sakho sokuqala. Ukuze kube lula ukufinyelela egazini lakho, udokotela wezokuthunga uzokwenza ukufinyelela kwezinsimbi. Ukufinyelela kunikeza indlela yokuthi inani elincane legazi lisuswe ngokuphepha ekujikelezeni kwakho bese libuyiselwa kuwe ukuze inqubo yokuhlambulula igazi isebenze. Ukufinyelela kokuthunga kudinga isikhathi sokuphulukisa ngaphambi kokuba uqale ukwelashwa kokuhlambulula igazi. Kunezinhlobo ezintathu zokufinyelela: I-fistula ye-Arteriovenous (AV). I-fistula ye-AV eyenziwe ngokuthunga iyixhumi phakathi kwe-artery ne-vein, ngokuvamile engalweni oyisebenzisi kangako. Lolu uhlobo oluthandwayo lokufinyelela ngenxa yokuphumelela nokuphepha. I-AV graft. Uma imithambo yakho yegazi incinyane kakhulu ukwenza i-fistula ye-AV, udokotela wezokuthunga angase enze indlela phakathi kwe-artery ne-vein esebenzisa i-tube eguquguqukayo, ye-synthetic ebizwa nge-graft. I-catheter ye-venous ephakathi. Uma udinga ukuhlanzwa kwegazi okuphaphandwayo, i-tube yepulasitiki (i-catheter) ingafakwa emthambeni omkhulu entanyeni yakho. I-catheter iyisikhashana. Kubalulekile kakhulu ukunakekela indawo yakho yokufinyelela ukuze kuncishiswe amathuba wokutheleleka nezinye izinkinga. Landela imiyalo yeqembu lakho lokuphatha impilo mayelana nokunakekela indawo yakho yokufinyelela.

Ungathola i-hemodialysis esikhungweni se-dialysis, ekhaya noma esibhedlela. Isikhathi sokwelashwa sihlukahlukene, kuye ngesimo sakho: I-hemodialysis esikhungweni. Abantu abaningi bathola i-hemodialysis kathathu ngesonto ezikhathini eziyi-3 kuya kwezi-5 amahora ngalinye. I-hemodialysis yansuku zonke. Lokhu kuhilela izikhathi ezivame kakhulu, kodwa ezimfushane - ngokuvamile kwenziwa ekhaya izinsuku eziyisithupha noma eziyisikhombisa ngesonto cishe amahora amabili ngesikhathi. Imishini ye-hemodialysis elula yenze i-hemodialysis yasekhaya ingabi nzima, ngakho-ke ngokuqeqeshwa okukhethekile nokuthola usizo, ungase ukwazi ukwenza i-hemodialysis ekhaya. Ungase ukwazi ngisho nokwenza inqubo ebusuku ngenkathi ulele. Kunezindawo zokwelapha i-dialysis ezise-United States nasemazweni amanye, ngakho-ke ungahamba ezindaweni eziningi futhi uthole i-hemodialysis yakho ngesikhathi. Iqembu lakho le-dialysis lingakusiza ukwenza izikhathi zokubonisana kwezinye izindawo, noma ungaxhumana nesikhungo se-dialysis lapho uya khona ngokuqondile. Hlela kusengaphambili ukuqinisekisa ukuthi kukhona isikhala futhi kwenziwe amalungiselelo afanele.