I-nephropathy ekhunjulwayo

I-memphranous nephropathy yisifo sezinso esiholela ekuguqulweni nasekuvuvukeni kwezakhiwo ngaphakathi kwezinso ezisiza ukuhlunga imfucuza noketshezi. Ukuvuvukala kungaholela ezinkingeni ngokusebenza kwezinso.

I-nephropathy ekhunjulwayo ibangelwa ukuqina kwengxenye yolwelwesi olungaphansi lwe-glomerular. Ulwelwesi lwangaphansi kwe-glomerular luyingxenye yezinso ezisiza ukuhlunga imfucuza noketshezi olungeziwe egazini. Isizathu esiqondile salokhu ukuqina asaziwa.

Ulwelwesi olujiyile alusebenzi ngokujwayelekile. Ngenxa yalokhu, inani elikhulu lamaprotheni lilahleka emchameni.

Lesi simo singesinye sezimbangela ezivame kakhulu ze-nephrotic syndrome. Leli iqembu lezimpawu ezibandakanya amaprotheni emchameni, izinga eliphansi lamaprotheni egazi, amazinga aphezulu we-cholesterol, amazinga aphezulu e-triglyceride, nokuvuvukala. I-memphranous nephropathy ingaba yisifo esiyinhloko sezinso, noma ingahle ihlotshaniswe nezinye izimo.

Lokhu okulandelayo kwandisa ubungozi bakho kulesi simo:

• Umdlavuza, ikakhulukazi umdlavuza wamaphaphu nowekholoni
• Ukuvezwa kobuthi, kufaka phakathi igolide ne-mercury
• Ukutheleleka, kufaka phakathi i-hepatitis B, umalaleveva, ugcunsula kanye ne-endocarditis
• Imithi, kufaka phakathi i-penicillamine, i-trimethadione, nama-cream akhanyisa isikhumba
• I-systemic lupus erythematosus, i-rheumatoid arthritis, isifo se-Graves, nezinye izifo ezizimele

Lesi sifo senzeka nganoma yisiphi isikhathi, kepha sivame kakhulu ngemuva kweminyaka yobudala engama-40.

Izimpawu zivame ukuqala kancane ngokuhamba kwesikhathi, futhi zingafaka:

• I-Edema (ukuvuvukala) kunoma iyiphi indawo yomzimba
• Ukukhathala
• Ukubukeka kogwebu komchamo (ngenxa yamaprotheni amaningi)
• Ukudla okungekuhle
• Ukuchama, ngokweqile ebusuku
• Ukuzuza kwesisindo

Ukuhlolwa komzimba kungakhombisa ukuvuvukala (i-edema).

Ukuhlolwa komchamo kungaveza inani elikhulu lamaprotheni emchameni. Kungase kube negazi emchameni.Izinga lokuhlunga le-glomerular ("isivinini" lapho izinso zihlanza khona igazi) liba cishe livamile.

Olunye uvivinyo lungenziwa ukuze kubonakale ukuthi izinso zisebenza kahle kangakanani nokuthi umzimba uzivumelanisa kanjani nenkinga yezinso. Lokhu kufaka phakathi:

• I-Albumin - igazi nomchamo
• Igazi urea nitrogen (BUN)
• I-Creatinine - igazi
• Imvume ye-Creatinine
• Iphaneli ye-Lipid
• Amaprotheni - igazi nomchamo

I-biopsy yezinso iqinisekisa ukuxilongwa.

Ukuhlolwa okulandelayo kungasiza ekutholeni imbangela ye-nephropathy yolwelwesi:

• Ukuhlolwa kwama-antibodies e-Antinuclear
• I-anti-double strand DNA, uma ukuhlolwa kwama-antibodies enukliya kuqondile
• Ukuhlolwa kwegazi ukuhlola i-hepatitis B, i-hepatitis C, ne-syphilis
• Qedela amazinga
• Ukuhlolwa kwe-Cryoglobulin

Inhloso yokwelashwa ukunciphisa izimpawu nokunciphisa ukuqhubeka kwesifo.

Ukulawula umfutho wegazi kuyindlela ebaluleke kakhulu yokubambezela ukulimala kwezinso. Inhloso ukugcina umfutho wegazi ungaphansi noma ngaphansi kuka-130/80 mm Hg.

Izinga eliphakeme le-cholesterol egazini kanye namazinga e-triglyceride kufanele alashwe ukunciphisa ubungozi be-atherosclerosis. Kodwa-ke, ukudla okunamafutha aphansi, okune-cholesterol ephansi ngokuvamile akusizi kangako kubantu abane-membranous nephropathy.

Imithi esetshenziselwa ukwelapha i-nephropathy yolwelwesi ifaka phakathi:

• I-Angiotensin-converting enzyme (ACE) inhibitors kanye ne-angiotensin receptor blockers (ARBs) ukwehlisa umfutho wegazi
• Ama-Corticosteroids nezinye izidakamizwa ezicindezela amasosha omzimba
• Imithi (imvamisa izitatimende) yokwehlisa amazinga e-cholesterol ne-triglyceride
• Amaphilisi wamanzi (isisu) ukunciphisa ukuvuvukala
• Abanciphisa igazi ukunciphisa ubungozi bamahlule egazini emaphashini nasemilenzeni

Ukudla okunama-protein amancane kungasiza. Kungaphakanyiswa ukuthi kudliwe amaprotheni alinganiselwe (i-gramu elilodwa lamaprotheni ngekhilogremu isisindo somzimba ngosuku).

Uvithamini D kungadingeka ukuthi ubuyiselwe esikhundleni uma i-nephrotic syndrome ihlala isikhathi eside (engapheli) futhi ingaphenduli ekwelashweni.

Lesi sifo sandisa ubungozi bamahlule egazini emaphashini nasemilenzeni. Abanciphisi begazi bangabekwa ukuvimbela lezi zinkinga.

Umbono uyehluka, kuya ngenani lokulahleka kwamaprotheni. Kungaba nezikhathi ezingenazo izimpawu nokuqubuka ngezikhathi ezithile. Kwesinye isikhathi, isimo siyaphela, noma ngaphandle kokwelashwa.

Iningi labantu abanalesi sifo lizolimala izinso kanti abanye abantu bayoba nesifo se-renal sokugcina.

Izinkinga ezingavela kulesi sifo zifaka:

• Ukwehluleka kwezinso okungamahlalakhona
• I-thrombosis ejulile ye-venous
• Isifo sezinso sokugcina
• I-Nephrotic syndrome
• I-embolism yamaphaphu
• I-vein vein thrombosis

Shayela i-aphoyintimenti nomhlinzeki wakho wezokunakekelwa kwempilo uma:

• Unezimpawu ze-nephropathy yolwelwesi
• Izimpawu zakho ziba zimbi kakhulu noma zingapheli
• Uba nezimpawu ezintsha
• Ukwehlisile ukuphuma komchamo

Ukwelapha ngokushesha ukuphazamiseka nokugwema izinto ezingadala nephropathy yolwelwesi kunganciphisa ubungozi bakho.

I-glomerulonephritis ekhunjulwayo; Isikhumbuzo se-GN; I-glomerulonephritis engaphezulu; I-Glomerulonephritis - ulwelwesi; I-MGN

• Ukwakheka kwezinso

URadhakrishnan J, i-Appel GB. Ukuphazamiseka kwe-Glomerular kanye nama-syndromes we-nephrotic. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 113.

USaha MK, iPendergraft WF, uJennette JC, uFalk RJ. Isifo esiyisisekelo se-glomerular. 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 31.

USalant DJ, uCattran DC. I-nephropathy ekhunjulwayo. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, abahleli. I-Nephrology Yomtholampilo Ephelele. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2019: isahluko 20.