I-Reflux nephropathy

I-Reflux nephropathy yisimo lapho izinso zonakaliswa khona ukugeleza emuva komchamo ungene ezinso.

Umchamo ugeleza kusuka ezinso ngalunye ngamashubhu abizwa ngokuthi ama-ureters aye esinyeni. Lapho isinye sigcwele, siyakhama bese sithumela umchamo nge-urethra. Awukho umchamo okufanele uphinde ubuyele ku-ureter lapho isinye sikhama. I-ureter ngayinye ine-valve yendlela eyodwa lapho ingena khona esinyeni evimbela umchamo ekugelezeni ubuyisele emuva i-ureter.

Kepha kwabanye abantu, umchamo ugeleza ubuyele ezinso. Lokhu kubizwa ngokuthi yi-vesicoureteral reflux.

Ngokuhamba kwesikhathi, izinso zingalimala noma zonakaliswe yi-reflux. Lokhu kubizwa ngokuthi yi-reflux nephropathy.

I-Reflux ingenzeka kubantu ama-ureters abo anganamatheli kahle esinyeni noma ama-valve abo engasebenzi kahle. Izingane zingazalwa zinenkinga noma zingaba nokunye ukukhubazeka kokuzalwa kohlelo lwe-urinary oludala i-reflux nephropathy.

I-Reflux nephropathy ingenzeka nezinye izimo eziholela ekuvinjelweni kokugeleza komchamo, kufaka phakathi:

• Ukuvimbela ukuphuma kwesinye, njenge-prostate ekhulisiwe emadodeni
• Amatshe esinye
• Isinye se-neurogenic, esingavela kubantu abane-multiple sclerosis, ukulimala komgogodla, isifo sikashukela, noma ezinye izimo zesistimu yezinzwa (yezinzwa)

I-Reflux nephropathy nayo ingavela ekuvuvukeni kwama-ureters ngemuva kokufakelwa kwezinso noma ekulimaleni kwe-ureter.

Izici zobungozi be-reflux nephropathy zifaka:

• Ukungajwayelekile kwepheshana lomchamo
• Umlando womuntu siqu noma womndeni we-vesicoureteral reflux
• Phinda ukutheleleka ngomgudu womchamo

Abanye abantu abanazimpawu ze-reflux nephropathy. Inkinga ingatholakala lapho ukuhlolwa kwezinso kwenziwa ezinye izizathu.

Uma izimpawu zenzeka, zingafana nalezi ze:

• Ukwehluleka kwezinso okungamahlalakhona
• I-Nephrotic syndrome
• Ukutheleleka ngomgudu womchamo

I-Reflux nephropathy ivame ukutholakala lapho ingane ihlolelwa ukutheleleka okuphindaphindiwe kwesinye. Uma kutholakala i-vesicoureteral reflux, izingane zakwabo zingabuye zihlolwe, ngoba i-reflux ingasebenza emindenini.

Umfutho wegazi ungaba phezulu, futhi kungaba khona izimpawu nezimpawu zesifo sezinso sesikhathi eside (esingapheli).

Ukuhlolwa kwegazi nomchamo kuzokwenziwa, futhi kungafaka:

• BUN - igazi
• I-Creatinine - igazi
• Ukususwa kwe-Creatinine - umchamo negazi
• Ukuhlolwa komchamo noma izifundo zomchamo ezingamahora angama-24
• Isiko lomchamo

Ukuhlola ukuhlolwa okungenziwa kufaka phakathi:

• Iskena se-CT esiswini
• I-ultrasound yesinye
• I-pyelogram efakwa emithanjeni (IVP)
• Izinso ultrasound
• I-radionuclide cystogram
• Phinda wenze kabusha i-pyelogram
• Ukuvala i-cystourethrogram

I-Reflux ye-Vesicoureteral yehlukaniswe ngamabanga amahlanu ahlukene. I-Reflux elula noma emnene ivame ukuwela ebangeni I noma II. Ubukhulu be-reflux nenani lomonakalo ezinso kusiza ukunquma ukwelashwa.

I-reflux ye-vesicoureteral elula, eyinkimbinkimbi (ebizwa nge-primary reflux) ingaphathwa nge:

• Ama-antibiotic athathwa nsuku zonke ukuvikela ukutheleleka komgudu womchamo
• Ukuqapha ngokucophelela ukusebenza kwezinso
• Amasiko omchamo aphindaphindiwe
• I-ultrasound yaminyaka yonke yezinso

Ukulawula umfutho wegazi kuyindlela ebaluleke kakhulu yokwehlisa ukulimala kwezinso. Umhlinzeki wezokunakekelwa kwempilo anganikeza imithi yokulawula umfutho wegazi ophezulu. I-Angiotensin-converting enzyme (ACE) inhibitors kanye ne-angiotensin receptor blockers (ARBs) zivame ukusetshenziswa.

Ukuhlinzwa kuvame ukusetshenziswa ezinganeni ezingaphendulanga ekwelashweni kwezokwelapha.

I-reflux enamandla kakhulu ye-vesicoureteral ingadinga ukuhlinzwa, ikakhulukazi ezinganeni ezingaphenduli ekwelashweni kwezokwelapha. Ukuhlinzwa ukubuyisela i-ureter esinyeni (ukuphindiselwa kabusha kwe-ureteral) kungamisa i-reflux nephropathy kwezinye izimo.

I-reflux enzima kakhulu ingadinga ukuhlinzekwa kabusha. Lolu hlobo lokuhlinzwa lunganciphisa inani nobukhulu bokutheleleka ngomgudu womchamo.

Uma kudingeka, abantu bazokwelashwa izifo ezingamahlalakhona zezinso.

Umphumela uyehluka, kuya ngobukhulu be-reflux. Abanye abantu abane-reflux nephropathy ngeke balahlekelwe ukusebenza kwezinso ngokuhamba kwesikhathi, noma izinso zabo zilimele. Kodwa-ke, ukulimala kwezinso kungahlala unomphela. Uma kuhileleke izinso eyodwa kuphela, enye izinso kufanele iqhubeke nokusebenza ngokujwayelekile.

I-Reflux nephropathy ingadala ukwehluleka kwezinso ezinganeni nakubantu abadala.

Izinkinga ezingavela kulesi simo noma ekwelashweni kwazo zifaka:

• Ukuvinjelwa kwe-ureter ngemuva kokuhlinzwa
• Isifo sezinso esingalapheki
• Ukutheleleka okungapheli noma okuphindaphindayo komgudu womchamo
• Ukwehluleka kwezinso okungamahlalakhona uma zombili izinso zibandakanyekile (kungathuthuka kuye ekugcineni kwesifo sezinso)
• Ukutheleleka kwezinso
• Umfutho wegazi ophezulu
• I-Nephrotic syndrome
• I-Reflux eqhubekayo
• Ukuqhuma kwezinso

Shayela umhlinzeki wakho uma:

• Yiba nezimpawu ze-reflux nephropathy
• Yiba nezinye izimpawu ezintsha
• Bakhiqiza umchamo omncane kunokujwayelekile

Ukwelapha ngokushesha izimo ezibangela i-reflux yomchamo ungene ezinso kungavimbela i-reflux nephropathy.

I-atrophic pyelonephritis engapheli; I-reflux ye-Vesicoureteric; I-nephropathy - i-reflux; I-Reflux yangaphambilini

• Umgudu womchamo wabesifazane
• Umgudu womchamo wabesilisa
• Ukuvala i-cystourethrogram
• I-reflux ye-Vesicoureteral

I-Bakkaloglu SA, iSchaefer F. Izifo zezinso nezindlela zomchamo ezinganeni. 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 74.

UMathews R, uMattoo TK. I-reflux ye-vesicoureteral eyinhloko kanye nephropathy ye-reflux. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, abahleli. I-Nephrology Yomtholampilo Ephelele. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2019: isahluko 61.