Isifo sikashukela insipidus

Isifo sikashukela i-insipidus (DI) yisimo esingajwayelekile lapho izinso zingakwazi ukuvimbela ukuphuma kwamanzi.

I-DI ayifani nezinhlobo zesifo sikashukela mellitus 1 no-2. Kodwa-ke, uma kungelashwa, womabili ama-DI nesifo sikashukela kubanga ukoma okungapheli nokuchama njalo. Abantu abanesifo sikashukela baneshukela ephezulu egazini (i-glucose) ngoba umzimba awukwazi ukusebenzisa ushukela wegazi ukuthola amandla. Labo abane-DI banamazinga ajwayelekile kashukela egazini, kodwa izinso zabo azikwazi ukulinganisa uketshezi emzimbeni.

Emini, izinso zakho zihluza lonke igazi lakho izikhathi eziningi. Imvamisa, iningi lamanzi liphinde lafakwa kabusha, futhi kukhishwa inani elincane lomchamo ogxilisiwe. I-DI yenzeka lapho izinso zingakwazi ukugxilisa umchamo ngokujwayelekile, futhi kukhishwa inani elikhulu lomchamo ohlanjululwayo.

Inani lamanzi elikhishwe emchameni lilawulwa yi-hormone elwa namagciwane (ADH). I-ADH ibizwa nangokuthi i-vasopressin. I-ADH ikhiqizwa engxenyeni yobuchopho ebizwa nge-hypothalamus. Ngemuva kwalokho iyagcinwa bese idedelwa endlala ye-pituitary. Le yindlala encane engezansi kwesisekelo sobuchopho.

I-DI edalwe ukuntuleka kwe-ADH ibizwa ngokuthi yi-central diabetes insipidus. Lapho i-DI ibangelwa ukwehluleka kwezinso ukuphendula i-ADH, lesi simo sibizwa nge-nephrogenic diabetes insipidus. Izindlela zeNephrogenic ezihlobene nezinso.

I-Central DI ingabangelwa ukulimala kwe-hypothalamus noma i-pituitary gland ngenxa ye:

• Izinkinga zofuzo
• Ukulimala ekhanda
• Ukutheleleka
• Inkinga ngamaseli akhiqiza i-ADH ngenxa yesifo esizimele
  
• Ukulahleka kokutholakala kwegazi kwi-pituitary gland
• Ukuhlinzwa endaweni ye-pituitary gland noma i-hypothalamus
• Izimila ngaphakathi noma eduze kwendlala ye-pituitary

I-Nephrogenic DI ibandakanya ukukhubazeka ezinso. Ngenxa yalokho, izinso aziphenduli ku-ADH. Njenge-DI emaphakathi, i-nephrogenic DI ayivamile kakhulu. I-Nephrogenic DI ingabangelwa ngu:

• Imithi ethile, njenge-lithium
• Izinkinga zofuzo
• Izinga eliphakeme le-calcium emzimbeni (hypercalcemia)
• Isifo sezinso, njengesifo sezinso se-polycystic

Izimpawu ze-DI zifaka:

• Ukoma ngokweqile okungaba kukhulu noma okungalawuleki, imvamisa kunesidingo sokuphuza amanzi amaningi noma ukulangazelela amanzi e-ice
• Umthamo omningi womchamo
• Ukuchama ngokweqile, imvamisa kudinga ukuchama njalo ngehora ubusuku nemini
• Umchamo omningi kakhulu, okhanyayo

Umhlinzeki wezokunakekelwa kwempilo uzobuza ngomlando nezimpawu zakho zezokwelapha.

Izivivinyo ezinga-odwa zifaka:

• I-sodium ne-osmolality yegazi
• Inselelo ye-Desmopressin (DDAVP)
• I-MRI yekhanda
• Ukuhlolwa komchamo
• Ukuhlushwa komchamo kanye ne-osmolality
• Ukukhishwa komchamo

Umhlinzeki wakho kungenzeka ukuthi ubonane nodokotela onguchwepheshe wezifo zepituitary ukusiza ukuxilonga i-DI.

Imbangela yalesi simo esingesihle izokwelashwa uma kungenzeka.

I-Central DI ingalawulwa nge-vasopressin (desmopressin, DDAVP). Uthatha i-vasopressin njengomjovo, isifutho samakhala, noma amaphilisi.

Uma i-nephrogenic DI ibangelwa yimithi, ukumisa umuthi kungasiza ekubuyiseleni ukusebenza kwezinso okujwayelekile. Kepha ngemuva kweminyaka eminingi yokusetshenziswa kwemithi ethile, njenge-lithium, i-nephrogenic DI ingaba unomphela.

I-Hereditary nephrogenic DI ne-lithium eyenziwe i-nephrogenic DI iphathwa ngokuphuza uketshezi olwanele ukufanisa ukuphuma komchamo. Imithi eyehlisa ukukhishwa komchamo nayo idinga ukuphuzwa.

I-Nephrogenic DI iphathwa ngemithi elwa nokuvuvukala kanye nezidakamizwa (amaphilisi amanzi).

Umphumela uncike ekuphazamisekeni okuyimbangela. Uma yelashwa, i-DI ayibangeli izinkinga ezinzima noma iholele ekufeni ngaphambi kwesikhathi.

Uma ukulawula ukoma komzimba wakho kuyinto ejwayelekile futhi ukwazi ukuphuza uketshezi olwanele, ayikho imiphumela ebalulekile emzimbeni wamanzi noma kubhalansi kasawoti.

Ukungaphuzi uketshezi olwanele kungaholela ekuphelelweni amanzi emzimbeni nokungalingani kwe-electrolyte, okungaba yingozi kakhulu.

Uma i-DI iphathwa nge-vasopressin futhi ukulawula ukoma komzimba wakho akujwayelekile, ukuphuza uketshezi oluningi kunalokho okudingwa ngumzimba wakho nakho kungadala ukungalingani kwe-electrolyte okuyingozi.

Shayela umhlinzeki wakho uma uba nezimpawu ze-DI.

Uma une-DI, xhumana nomhlinzeki wakho uma kubuya ukuchama kaningi noma ukoma ngokweqile.

• Izindlala ze-Endocrine
• Ukuhlolwa kwe-Osmolality

UHannon MJ, uThompson CJ. IVasopressin, isifo sikashukela insipidus, kanye nesifo se-antidiuresis esingafanele. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 18.

I-Verbalis JG. Ukuphazamiseka kokulinganisela kwamanzi. Ku: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, ama-eds. IBrenner neRector's The Kidney. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2016: isahluko 16.