I-Nephrotic syndrome

I-Nephrotic syndrome iyiqembu lezimpawu ezibandakanya amaprotheni emchameni, amazinga aphansi wamaprotheni egazini, amazinga aphezulu e-cholesterol, amazinga aphezulu e-triglyceride, ukwanda kwengozi yegazi nokuvuvukala.

I-Nephrotic syndrome ibangelwa yizifo ezahlukahlukene ezilimaza izinso. Lo monakalo uholela ekukhishweni kwamaprotheni amaningi emchameni.

Isizathu esivame kakhulu ezinganeni yisifo sokushintsha esincane. I-membranous glomerulonephritis iyimbangela evame kakhulu kubantu abadala. Kuzo zombili izifo, i-glomeruli ezinso yalimala. IGlomeruli yizakhiwo ezisiza ukuhlunga imfucuza noketshezi.

Lesi simo singenzeka futhi kusuka ku:

• Umdlavuza
• Izifo ezifana nesifo sikashukela, i-systemic lupus erythematosus, i-myeloma eminingi, ne-amyloidosis
• Izinkinga zofuzo
• Ukuphazamiseka komzimba
• Izifo (njenge-strep throat, hepatitis, noma i-mononucleosis)
• Ukusetshenziswa kwemithi ethile

Kungenzeka ngezinkinga zezinso ezinjenge:

• I-glomerulosclerosis egxile futhi eyingxenye
• I-Glomerulonephritis
• I-Mesangiocapillary glomerulonephritis

I-Nephrotic syndrome ingathinta wonke amaqembu wobudala. Ezinganeni, kuvame kakhulu phakathi kweminyaka emibili kuya kwengu-6. Lesi sifo sivela kaningi emadodeni kunabesifazane.

Ukuvuvukala (i-edema) uphawu oluvame kakhulu. Kungenzeka:

• Ebusweni naseduze kwamehlo (ukuvuvukala kobuso)
• Ezingalweni nasemilenzeni, ikakhulukazi ezinyaweni nasemaqakaleni
• Endaweni yesisu (isisu esivuvukile)

Ezinye izimpawu zifaka:

• Ukuqhuma kwesikhumba noma izilonda
• Ukubukeka kwegwebu lomchamo
• Ukudla okungekuhle
• Ukuzuza kwesisindo (ngokungenhloso) kusuka ekugcineni uketshezi
• Ukuquleka

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Ukuhlolwa kwelabhorethri kuzokwenziwa ukubona ukuthi izinso zisebenza kahle kangakanani. Kubandakanya:

• Ukuhlolwa kwegazi le-albhamu
• Ukuhlolwa kwamakhemikhali egazi, njengephaneli eyisisekelo ye-metabolic noma iphaneli ephelele ye-metabolic
• Igazi urea nitrogen (BUN)
• I-Creatinine - ukuhlolwa kwegazi
• Ukuvulwa kwe-Creatinine - ukuhlolwa komchamo
• Ukuhlolwa komchamo

Amafutha avame ukubakhona nasemchameni. Ama-cholesterol egazi namazinga e-triglyceride angaphakama.

Kungadingeka i-biopsy yezinso ukuthola imbangela yokuphazamiseka.

Ukuhlolwa kokukhipha izimbangela ezahlukahlukene kungafaka okulandelayo:

• I-antibody ye-Antinuclear
• Ama-Cryoglobulins
• Qedela amazinga
• Ukuhlolwa kokubekezelelana kwe-glucose
• Ama-antibody e-Hepatitis B no-C
• Ukuhlolelwa i-HIV
• Isici se-rheumatoid
• I-Serum protein electrophoresis (SPEP)
• I-syphilis serology
• Umchamo wamaprotheni electrophoresis (UPEP)

Lesi sifo singashintsha nemiphumela yokuhlolwa okulandelayo:

• Izinga likavithamini D
• Insimbi yeSerum
• Ukusakazwa kwe-Urinary

Izinhloso zokwelashwa ukunciphisa izimpawu, ukuvimbela izinkinga, nokubambezela ukulimala kwezinso. Ukulawula i-nephrotic syndrome, ukugula okuyibangelayo kufanele kulashwe. Ungadinga ukwelashwa impilo yakho yonke.

Ukwelashwa kungafaka noma yikuphi okulandelayo:

• Ukugcina umfutho wegazi ngaphansi noma ngaphansi kuka-130/80 mm Hg ukubambezela ukulimala kwezinso. I-Angiotensin-converting enzyme (ACE) inhibitors noma i-angiotensin receptor blockers (ARBs) yimithi esetshenziswa kakhulu. Ama-ACE inhibitors nama-ARB nawo angasiza ekwehliseni inani lamaprotheni alahlekile emchameni.
• Ama-Corticosteroids nezinye izidakamizwa ezicindezela noma ezithulisa amasosha omzimba.
• Ukwelapha i-cholesterol ephezulu ukunciphisa ubungozi bezinkinga zenhliziyo nemithambo yegazi - Ukudla okunamafutha aphansi, ne-cholesterol ephansi ngokuvamile akwanele kubantu abane-nephrotic syndrome. Imithi yokwehlisa i-cholesterol ne-triglycerides (imvamisa ama-statins) ingadingeka.
• Ukudla okune-sodium eningi kungasiza ngokuvuvukala ezandleni nasemilenzeni. Amaphilisi amanzi (isisu) nawo angasiza kule nkinga.
• Ukudla okunama-protein amancane kungasiza. Umhlinzeki wakho angaphakamisa ukuthi kudliwe amaprotheni amaphakathi (i-1 gram yamaprotheni ngekhilogremu lesisindo somzimba ngosuku).
• Ukuthatha izithako ze-vitamin D uma i-nephrotic syndrome ihlala isikhathi eside futhi ingaphenduli ekwelashweni.
• Ukuthatha izidakamizwa ezincane zegazi ukwelapha noma ukuvimbela amahlule egazi.

Umphumela uyehluka. Abanye abantu bayalulama kulesi simo. Abanye baba nesifo sezinso sesikhathi eside futhi badinga i-dialysis futhi ekugcineni bafakelwe izinso.

Izinkinga zempilo ezingabangelwa i-nephrotic syndrome zifaka:

• Ukungasebenzi kahle kwezinso
• Ukuqina kwemithambo yegazi kanye nezifo zenhliziyo ezihlobene
• Isifo sezinso esingalapheki
• Ukugcwala ngokweqile, ukwehluleka kwenhliziyo, uketshezi okwakhekayo emaphashini
• Izifo, kufaka phakathi i-pneumococcal pneumonia
• Ukungondleki
• I-vein vein thrombosis

Shayela umhlinzeki wakho uma:

• Wena noma ingane yakho niba nezimpawu ze-nephrotic syndrome, kufaka phakathi ukuvuvukala ebusweni, isisu, noma izingalo nemilenze, noma izilonda zesikhumba
• Wena noma ingane yakho nelashwa i-nephrotic syndrome, kodwa izimpawu azithuthuki
• Izimpawu ezintsha ziyakhula, kufaka phakathi ukukhwehlela, ukwehla kokukhishwa komchamo, ukungakhululeki ngokuchama, umkhuhlane, ikhanda elibuhlungu kakhulu

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma unesifo sokuwa.

Ukwelapha izimo ezingadala i-nephrotic syndrome kungasiza ekuvimbeleni lesi sifo.

I-Nephrosis

• Ukwakheka kwezinso

Isifo i-Erkan E. Nephrotic syndrome. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 545.

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.