I-Metabolic acidosis

I-Metabolic acidosis yisimo lapho kune-asidi eningi khona oketshezini lomzimba.

I-Metabolic acidosis iba lapho kukhiqizwa i-asidi eningi emzimbeni. Kungenzeka futhi lapho izinso zingakwazi ukukhipha i-asidi eyanele emzimbeni. Kunezinhlobo eziningi ze-metabolic acidosis:

• I-diabetic acidosis (ebizwa nangokuthi i-ketoacidosis yesifo sikashukela kanye ne-DKA) iba lapho izinto ezibizwa ngokuthi yimizimba ye-ketone (eyi-acidic) zakha ngesikhathi sesifo sikashukela esingalawulwa.
• I-Hyperchloremic acidosis ibangelwa wukulahleka kwe-bicarbonate eningi kakhulu emzimbeni, engenzeka ngohudo olunzima.
• Isifo sezinso (i-uremia, i-distal renal tubular acidosis noma i-proximal renal tubular acidosis).
• I-Lactic acidosis.
• Ubuthi nge-aspirin, i-ethylene glycol (etholakala ku-antifreeze), noma i-methanol.
• Ukuphela kwamanzi emzimbeni.

I-Lactic acidosis ibangelwa ukwakheka kwe-lactic acid. I-Lactic acid ikhiqizwa kakhulu kumaseli emisipha namaseli abomvu egazi. Yakha lapho umzimba wephula ama-carbohydrate ukuze uwasebenzisele amandla lapho amazinga e-oxygen ephansi. Kungabangelwa:

• Umdlavuza
• Ubuthi be-Carbon monoxide
• Ukuphuza kakhulu utshwala
• Ukuzivocavoca ngamandla isikhathi eside kakhulu
• Ukuhluleka kwesibindi
• Ushukela wegazi ophansi (i-hypoglycemia)
• Imithi efana ne-salicylates, i-metformin, ama-anti-retrovirals
• I-MELAS (isifo esingavamile kakhulu se-mitochondrial disorder esithinta ukukhiqizwa kwamandla)
• Ukungabi khona komoya-mpilo isikhathi eside ngenxa yokushaqeka, ukwehluleka kwenhliziyo, noma i-anemia enamandla
• Ukuquleka

Izimpawu eziningi zibangelwa yisifo esiyisisekelo noma isimo esidala i-metabolic acidosis. I-Metabolic acidosis uqobo ivame ukudala ukuphefumula okusheshayo. Ukwenza sengathi udidekile noma ukhathele kakhulu nakho kungenzeka. I-metabolic acidosis enamandla ingaholela ekushaqekeni noma ekufeni. Kwezinye izimo, i-metabolic acidosis ingaba isimo esimnene, esiqhubekayo (esingapheli).

Lezi zivivinyo zingasiza ukuxilonga i-acidosis. Bangakwazi futhi ukunquma ukuthi imbangela yinkinga yokuphefumula noma inkinga yemethabolic. Ukuhlolwa kungafaka:

• Igazi legazi lomzimba
• Iphaneli eyisisekelo ye-metabolic, (iqembu lezivivinyo zegazi ezilinganisa amazinga akho e-sodium ne-potassium, ukusebenza kwezinso, namanye amakhemikhali nemisebenzi)
• Amaketanga egazi
• Ukuhlolwa kwe-Lactic acid
• Amaketoni omchamo
• Umchamo pH

Kungadingeka ezinye izivivinyo ukuthola imbangela ye-acidosis.

Ukwelashwa kuhloselwe inkinga yezempilo ebanga i-acidosis. Kwezinye izimo, i-sodium bicarbonate (ikhemikhali eliku-baking soda) inganikezwa ukunciphisa i-asidi yegazi. Imvamisa, uzothola uketshezi oluningi ngomthambo wakho.

Umbono uzoncika kwisifo esiyimbangela yalesi simo.

I-metabolic acidosis enamandla kakhulu ingaholela ekushaqekeni noma ekufeni.

Funa usizo lwezokwelapha uma unezimpawu zanoma yisiphi isifo esingadala i-metabolic acidosis.

I-ketoacidosis yesifo sikashukela ingavinjelwa ngokugcina uhlobo lwesifo sikashukela silawulwa.

Acidosis - umzimba

• Ukukhiqizwa kwe-insulin nesifo sikashukela

UHamm LL, uDuBose TD. Ukuphazamiseka kwebhalansi ye-acid-base. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ama-eds. IBrenner neRector's The Kidney. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 16.

I-Palmer BF. I-Metabolic acidosis. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, abahleli. I-Nephrology Yomtholampilo Ephelele. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2019: isahluko 12.

Seifter JL. Izinkinga ze-acid-base. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 110.